Positive Urine Drug Sceen-Please Read

[catkaminski]

I have been in the nursing field for ten years. I recently was off work on a medical leave. When I returned to work I had to submit to a mandatory urine drug screen, which I willingly did of course. I recieved a phone call around 2 weeks later from the MRO (Medical Review Officer) who informed me that my test results were in and that I had a positive urine drug screen. I was shocked!!!!!!!!!!!!!! He then went on to inform me that it was benzodiazipines and that I neede to provide legal proof for the positve test. He said he needed a letter from a physician that I had been prescribed a medication with this classification. I could not account for any med that I would have taken in this category. I then remembered that I had went for a colonoscopy on March 27th and I was given Versed/Midazalom, I quickly had my physician fax the proof to them (Occupational Health). A couple days later the MRO called me back and told me that the medications I recieved during the colonoscopy could not be the culprit for my positive test, as it had been too long since the colonoscopy was performed (27 days). He reported my positive drug screen to my employer, who now wants to have a formal meeting with me tomorrow (May 20th at noon). I am so worried and I am totally inicent. I guess from what my boss says I may end up suspended for three days or more without pay pending there investigation into this and I will be retested. Anyone ever been through anything similar? Is there any kind of legal advice out there for me???????????????

[TCASII, ADN]

This part:

>>Maybe you eat a ton of bananas? They have trace amounts of diazepam in them, but seriously it wouldn't show on a drug screen

Man, I've been skimming books like crazy over here, and can't find the source of the banana comment. I did find another reference that at least gives credence to the fact endongenous ligands for benzodiazepine receptors exist. I thought it was in a previous version of the text I mention below that I saw the banana remark in, but no dice. Here's what the following edition states:

Kaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Ed. Lippincott Williams & Wilkins, 2000. James C. Ballenger, M.D. Volume II Section 31.10 Benzodiazepine Receptor Agonists and Antagonists pp. 2318

Endogenous Ligands "As with the opioids, the presence of a receptor suggests that endogenous ligands may exist for the benzodiazepine receptor. Such an endogenous compound could, theoretically, be either an anxiogenic inverse agonist or an anxiolytic agonist. Although no ligands have been found in living humans, several candidates have been put forward, including DBI, thought to have anxiogenic properties. Interestingly, desmethyldiazepam, the metabolite of diazepam and chlordiazepoxide, was isolated from brains of rats never exposed to benzodiazepines. Similarly, Sandra File and colleagues have found these same metabolites in human brains stored in the 1940s, long before the chemical synthesis of benzodiazepines two decades later. This also could have come from dietary sources, in that diazepam and lorazepam (Ativan) have been found in various foods."

The latest edition, 8th, there is mention of DBI in more detail, however, no more comments about food sources as endogenous ligands.

[Gompers, BSN, RN]

Yes I take Effexor XR and I take Deseryl that is all they are antidepressants.I do not take any thing else except over the counter stuff for headaches and I do occaisionally take bentyl for my stomach. I certainally do not take or use any illegal or non prescribed drugs.

What is Bentyl?

I only ask because I was on Librax for nervous stomachaches when I was in nursing school, and I came up positive for barbituates. Not the same med or same result, but just wondering. I had no idea at the time that the barbituate properties of my med were the reason it worked so well!

[TCASII, ADN]

Dicyclomine (Bentyl), used to treat IBS.

Librax should've come back + for benzodiazepines, since it contains Librium (chlordiazepoxide). Can't imagine the antispasmodic clidinium causing a problem.

[mommatrauma, RN]

What is Bentyl?

I only ask because I was on Librax for nervous stomachaches when I was in nursing school, and I came up positive for barbituates. Not the same med or same result, but just wondering. I had no idea at the time that the barbituate properties of my med were the reason it worked so well!

It is given mainly to prevent painful spasm of the gut and urinary bladder and is especially helpful for Irritable or spastic bowel, diverticulosis, diarrhea, colic and bladder spasms...

[Gompers, BSN, RN]

Librax should've come back + for benzodiazepines, since it contains Librium (chlordiazepoxide). Can't imagine the antispasmodic clidinium causing a problem.

I know it was the librium that caused the positive result. My problem was more psychological than physical, so the librium helped me more than the clidinium did. That's why I said what I did.

The occupational health nurse is the one who said it was a barbitiuate - so if it's actually a benzo then she was wrong. This was 8 years ago, but I still remember that angry answering machine message, like it was yesterday!!!

If Bentyl is used to prevent spasms, isn't it possible to have some sort of benzo in it???

[mommatrauma, RN]

I know it was the librium that caused the positive result. My problem was more psychological than physical, so the librium helped me more than the clidinium did. That's why I said what I did.

The occupational health nurse is the one who said it was a barbitiuate - so if it's actually a benzo then she was wrong. This was 8 years ago, but I still remember that angry answering machine message, like it was yesterday!!!

If Bentyl is used to prevent spasms, isn't it possible to have some sort of benzo in it???

Dicyclomine is an anticholinergic drug, a medication that reduces the effect of acetylcholine, a chemical released from nerves that stimulates muscles, by blocking the receptors for acetylcholine on smooth muscle (a type of muscle). It also has a direct relaxing effect on smooth muscle. It is used to treat or prevent spasm in the muscles of the gastrointestinal tract in the irritable bowel syndrome.

[PicklesRN, RN]

Man, I've been skimming books like crazy over here, and can't find the source of the banana comment. I did find another reference that at least gives credence to the fact endongenous ligands for benzodiazepine receptors exist. I thought it was in a previous version of the text I mention below that I saw the banana remark in, but no dice. Here's what the following edition states:

Kaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Ed. Lippincott Williams & Wilkins, 2000. James C. Ballenger, M.D. Volume II Section 31.10 Benzodiazepine Receptor Agonists and Antagonists pp. 2318

Endogenous Ligands "As with the opioids, the presence of a receptor suggests that endogenous ligands may exist for the benzodiazepine receptor. Such an endogenous compound could, theoretically, be either an anxiogenic inverse agonist or an anxiolytic agonist. Although no ligands have been found in living humans, several candidates have been put forward, including DBI, thought to have anxiogenic properties. Interestingly, desmethyldiazepam, the metabolite of diazepam and chlordiazepoxide, was isolated from brains of rats never exposed to benzodiazepines. Similarly, Sandra File and colleagues have found these same metabolites in human brains stored in the 1940s, long before the chemical synthesis of benzodiazepines two decades later. This also could have come from dietary sources, in that diazepam and lorazepam (Ativan) have been found in various foods."

The latest edition, 8th, there is mention of DBI in more detail, however, no more comments about food sources as endogenous ligands.

I'm about 99% positive my b/f has this book, I'm going to find it, maybe there is more before or after this section.

[PicklesRN, RN]

Endogenous Ligands "As with the opioids, the presence of a receptor suggests that endogenous ligands may exist for the benzodiazepine receptor. Such an endogenous compound could, theoretically, be either an anxiogenic inverse agonist or an anxiolytic agonist. Although no ligands have been found in living humans, several candidates have been put forward, including DBI, thought to have anxiogenic properties. Interestingly, desmethyldiazepam, the metabolite of diazepam and chlordiazepoxide, was isolated from brains of rats never exposed to benzodiazepines. Similarly, Sandra File and colleagues have found these same metabolites in human brains stored in the 1940s, long before the chemical synthesis of benzodiazepines two decades later. This also could have come from dietary sources, in that diazepam and lorazepam (Ativan) have been found in various foods."

Is there any way you would be willing to scan this page of the book and send it to me? My source doesn't show the final sentence about Diazepam and lorazepam being in that paragraph at all.

Thanks!