The best excuses for positive drug screens

Specialties Ob/Gyn

Published

I have recently had a lot of positive UDS pts, and the excuses I hear as to why they are positive simply blow my mind! Anyone have any good stories? I'll start with my favorites.....

+ marijuana: I was trapped in a car with 10 other people smoking and the windows were broken

+methamphetamine: I don't use it, I just cook it, and usually not at my own house

+cocaine: I was asleep, and my boyfriend blew it up my nose. The 2 gay men that live next to me put cocaine in their air vents, and it must have got into my apartment.

**my all-time favorite: well, of course my wife is positive for cocaine, you have no idea how many cokes she drinks everyday**

Anyone else??? :)

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I could understand not knowing one was positive for barbiturates. I was given a pain med, took a drug screen & popped positive for barbs. It turned out the pain med I was prescribed had barbiturates in it.

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Specializes in NICU, ICU, PICU, Academia.

Poppy seed muffins!

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Specializes in Community, OB, Nursery.
Poppy seed muffins!

I've always wondered exactly how many poppy seeds/muffins one would have to eat to pop a + opiates; knowing my rotten luck I'd be one of those slow metabolizers that would be + on Saturday for a muffin I ate on Monday. That would defy the half-lives of most opiates but I'm not taking any chances. ROFL

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what would you do if a client expressly refused to be tested?

I've worked in Texas my whole career, and we've never needed consent. We are also required to file a report with CPS (child protective services) for all positive screens. As far as PTL and abruptions go, it's not something that is done routinely unless there is past history or a very strong suspicion. I have actually had a pt ask if her abruption could have been caused by the cocaine she used that day. Hmmmm.....
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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

IMO, abruption and preterm delivery should always be cause for requesting a test.

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Specializes in L&D Endo Pre-Op.
what would you do if a client expressly refused to be tested?

That would have to fall on the doctor's shoulders!

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Specializes in LTC Rehab Med/Surg.

My post was off topic.

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Specializes in many.

Who has experience with testing all patients?

In my clinical we need consent to screen in the outpatient setting. Inpatient there is no consent needed. Our current population has a more drug users than one would think. Making an admission of previous use is certainly not a clear standard for completing a screening, think about all the reasons one would not tell the truth if one had used in the past.

No, I am not saying that anyone who ever used drugs is a liar. I am saying that in our society, there are personal ramifications of admitting personal use of prescription or street drugs.

From the other side of things, who is to say who should be tested? If it's left to the MD where I work, then none of our private patients would get tested. Apparently having good insurance means you don't use drugs (in the minds of the private MDs).

Recently we learned that a practitioner in a local suboxone clinic told her client specifically to withhold the information that she was in treatment when she was in labor and came to the hospital. The patient was told "babies born to suboxone moms don't usually have withdrawal symptoms and the staff would be prejudiced against you" - in other words, everything would be okay with the baby and the staff would treat you differently than the rest of their patients.

IMHO - we need to test EVERYONE. It is in the best interest of the child. If the clinician gets to decide who gets tested, we are looking at a situation where the personal prejudices of the practitioner are applied to the patient. If everyone gets tested, experience shows we can save newborn lives.

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Specializes in many.

in response to the original question...

"someone must have laced my cigarettes with cocaine to try to get me addicted"

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Specializes in many.

this might help

MythBusters: Poppy Seed Drug Test MiniMyth : Video : Discovery Channel

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Specializes in Maternity.
I've always wondered exactly how many poppy seeds/muffins one would have to eat to pop a + opiates; knowing my rotten luck I'd be one of those slow metabolizers that would be + on Saturday for a muffin I ate on Monday. That would defy the half-lives of most opiates but I'm not taking any chances. ROFL

Yup, I've been sold this one too.

http://www.bidmc.org/YourHealth/TherapeuticCenters/DrugAddiction.aspx?ChunkID=156998

Is quite a nifty website regarding this but form what I do remember is that about 90% of the active opoid is removed in conventional food/seed preparation these days and once the detectable level above 300ng/ml has been reached it has a very short half life in the blood and urine so unlikely to give two false positive tests an hour apart.

Apparently it also doens't show up on hair tests but these aren't commmonly done.

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Specializes in critical care.
Why are you testing so many women for drugs? Just wondering the circumstances by which so many women are getting drug tested.

In my state, prenatal drug testing is actually a legal requirement.

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