How to Pass a Urine Drug Screen


It’s easy.

Don’t use drugs.

Ah, come on. You didn’t think I was going to help anyone falsify a drug screen, did you?

Patients on methadone or Suboxone usually have to take urine drug screens (though in my office we use oral swabs because they are less invasive). Drug screens are essential to detect ongoing drug use or relapse to drug use. It’s kind of like using X-rays to detect growth of cancer. The earlier it’s detected, the better. Addiction is a disease that convinces its sufferers to lie so that the addiction can continue. In the end, drug screens help people recover from addiction, and are also important tools to measure the success of current treatment. When used in the right way, drug screening really does help patients.

Sometimes drug screens are wrong. The usual drug test is a quick and relatively cheap screen for the most commonly used drugs. If that screen is positive, but the patient denies drug use, a second test can be done that is very accurate, called a GC/MS (gas chromatograph/mass spectrophotometer) Because this second test is expensive, most clinics either ask the patient to pay for it, or run these tests only where the first test shows an unexpected result. Each lab hired to do a clinic’s drug screens has different screening tests, and use different reagents (chemicals) to do the test. False positives can occur, most often for benzodiazepines and amphetamines. Fortunately, cocaine and marijuana screens rarely turn out to be in error.

So what should you do if you get a positive drug screen and you know you have not used the drug in question? First, talk with the doctor about all of your prescription and over the counter medications. Your doctor should already know which drugs may cause false positives for that particular lab’s test chemicals. You may want to ask your clinic to do a GC/MS on the urine drug test in question. Also, consider herbal/health food pills as a source for the positive screen. Dietary supplements do not undergo FDA approval before being marketed, and can be sold without any evidence of effectiveness or safety, so there’s little oversight of these products. Some studies discovered that dietary supplements can have ingredients not listed on the label. (1) In the case of athletes who must take drug tests, some supplements have been shown to contain banned substances.

I have a patient who repeatedly tested positive on drug screens for benzodiazepines, and the GC/MS showed Valium. This mystified her, and she said she didn’t take any benzodiazepines. Only after stopping a dietary supplement advertised to help with anxiety did her drug screen turn negative. I am convinced this supplement cause her positive drug screen.

More about drug screens in a future blog.

  1. Maughan RJ, Contamination of dietary supplements and positive drug tests in sports. Journal of Sports Science 2005; 23(9):883-9

One response to this post.

  1. Was she taking bulgaris root? (please excuse the spelling) I have heard its a “natural” valium sold at health stores. I too was taking several different “natural remedies” and tested positive for benzos. I am interested to see what she was taking.


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