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How long do urine drug tests detect marijuana? There is no simple answer to this question. Detection time depends strongly on the kind and sensitivity of the test employed; the frequency, dosage, and last time of use; the individual subject's genetic makeup, the state of one's metabolism, digestive and excretory systems; and other random, unknown factors.
 
Marijuana - Single Use 1-7+ days
Marijuana - Regular Use 7-100 days
 

DRUG TESTING- URINE & Cannabis studies completed

Undated - Study - Delta(9)-Tetrahydrocannabivarin testing may not have the sensitivity to detect marijuana use among individuals ingesting dronabinol

1971 - Study ~ Delta-9-tetrahydrocannabinol: Metabolism and Disposition in Long-term Marihuana Smokers.

1972 - Study ~ Confirmation of the Presence of 11-Hydroxy-r 9-Tetrahydrocannabinol in the Urine of Marijuana Smokers

1975 - Study ~ Detection of cannabis products in urine by radioimmunoassay.

1978 - Study ~ Homogeneous enzyme immunoassay for cannabinoids in urine.

1981 - Study ~ Laboratory verification of “heavy” and “light” users of cannabis

1982 - Study ~ Persistence of Urinary Marijuana Levels After Supervised Abstinence.

1983 - Study ~ Passive inhalation of marihuana smoke and urinary excretion of cannabinoids

1985 - Study ~ Excretion patterns of cannabinoid metabolites after last use in a group of chronic users

1986 - Study ~ Contact highs and urinary cannabinoid excretion after passive exposure to
marijuana smoke

1987 - Study ~ Cannabinoid intake by passive smoking

1988 - Study ~ Marijuana-Laced Brownies: Behavioral Effects, Physiologic Effects, and Urinalysis in Humans Following Ingestion

1990 - Study ~ Cross-reactivity of selected compounds in the Abbott TDx cannabinoid assay.

1993 - Study ~ Effect of freezing on the concentration of drugs of abuse in urine.

1993 - Study ~ High urinary cannabinoids from a hashish body packer.

1994 - Study ~ Increased detection of marijuana use with a 50 micrograms/L urine screening cutoff.

1997 - Study - Hemp oil causes positive urine tests for THC

1997 - Study ~ Hemp oil ingestion causes positive urine tests for Δ9-tetrahydrocannabinol carboxylic acid

1997 - Study ~ A procedure to overcome interferences caused by the adulterant "Klear" in the GC-MS analysis of 11-nor-delta9-THC-9-COOH

1997 - Study ~ Excretion of Cannabinoids in Urine After Ingestion of Cannabis Seed Oil.

1997 - Study ~ Marijuana-positive urine test results from consumption of hemp seeds in food products.

1999 - Study - Potassium nitrite reaction with 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine in relation to the drug screening analysis

1999 - Study ~ Urinary excretion profiles of 11-nor-9-carboxy-delta9-tetrahydrocannabinol: a delta9-THCCOOH to creatinine ratio study.

1999 - Study ~ Adulteration of urine by "Urine Luck".

1999 - Study ~ Potassium nitrite reaction with 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine in relation to the drug screening analysis

1999 - Study ~ Concentration of Marijuana Metabolites in the Urine After Ingestion of Hemp Seed Tea.

2000- Study ~ Cannabinoid mimics in chocolate utilized as an argument in court

2000 - Study ~ Effects of pyridinium chlorochromate adulterant (urine luck) on testing for drugs of abuse and a method for quantitative detection of chromium (VI) in urine.

2001 - Study - Delta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results of a clinical study

2001 - Study ~ Evaluating the impact of hemp food consumption on workplace drug tests.

2001 - Study ~ Delta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results of a clinical study

2002 - Study ~ Effects of Stealth adulterant on immunoassay testing for drugs of abuse.

2002 - Study ~ A procedure for the detection of Stealth adulterant in urine samples.

2002 - Study ~ Effects of oxidizing adulterants on detection of 11-nor-delta9-THC-9-carboxylic acid in urine.

2002 - Study ~ Monitoring urinary excretion of cannabinoids by fluorescence-polarization immunoassay: a cannabinoid-to-creatinine ratio study.

2003 - Study ~ Urinary Cannabinoid Detection Times after Controlled Oral Administration of {Delta}9-Tetrahydrocannabinol to Humans

2003 - Study ~ Urinary excretion profiles of 11-nor-9-carboxy-Delta9-tetrahydrocannabinol: a Delta9-THC-COOH to creatinine ratio study #2.

2003 - Study ~ Urinary excretion profiles of 11-nor-9-carboxy-Delta9-tetrahydrocannabinol. Study III. A Delta9-THC-COOH to creatinine ratio study.

2004 - Study ~ Passive Inhalation of Cannabis Smoke.

2004 - Study ~ Urinary excretion profiles of 11-nor-9-carboxy-delta9-tetrahydrocannabinol and 11-hydroxy-delta9-THC: cannabinoid metabolites to creatinine ratio study IV.

2005 - Study ~ Papain: a novel urine adulterant.

2006 - Study - Detection time of regular THC use in urine shorter than often assumed

2007 - Study ~ Urine drug test interpretation: what do physicians know?

2007 - Study ~ Family physicians' proficiency in urine drug test interpretation.

2007 - Study - The effects of adulterants and selected ingested compounds on drugs-of-abuse testing in urine

2007 - Study - Toxicity From the Use of Niacin to Beat Urine Drug Screening

2007 - Study - Simultaneous GC–EI-MS Determination of Δ9-Tetrahydrocannabinol, 11-Hydroxy-Δ9-Tetrahydrocannabinol, and 11-nor-9-Carboxy-Δ9-Tetrahydrocannabinol in Human Urine Following Tandem Enzyme-Alkaline Hydrolysis

2008 - Study ~ Urine Drug Screening: Practical Guide for Clinicians

2008 - Study - Urinary elimination of 11-nor-9-carboxy-delta9-tetrahydrocannnabinol in cannabis users during continuously monitored abstinence

2009 - Study - Identifying New Cannabis Use with Urine Creatinine-Normalized THCCOOH Concentrations and Time Intervals Between Specimen Collections

2009 - Study - Extended urinary Delta9-tetrahydrocannabinol excretion in chronic cannabis users precludes use as a biomarker of new drug exposure

2009 - Study - Do Delta(9)-tetrahydrocannabinol concentrations indicate recent use in chronic cannabis users?

2009 - Study - Urinary toxicological screening: Analytical interference between niflumic acid and cannabis

2009 - Study ~ Evaluation of a Human On-site Urine Multidrug Test for Emergency Use With Dogs

2009 - Study ~ Passive inhalation of cannabis smoke--is it detectable?

2009 - Letter ~ Short communication: Urinary excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a pregnant woman following heavy, chronic cannabis use.

2010 - Study ~ Urine Drug Screening: A Valuable Office Procedure

2010 - Study ~ Delta9-tetrahydrocannabivarin testing may not have the sensitivity to detect marijuana use among individuals ingesting dronabinol.

2010 - Study ~ Testing for cannabis in the work-place: a review of the evidence.

2010 - Study ~ Quantitation of Total 11-Nor-9-Carboxy-Delta 9-Tetrahydrocannabinol in Urine and Blood Using Gas Chromatography-Mass Spectrometry (GC-MS).

2010 - Study ~ Differentiating new cannabis use from residual urinary cannabinoid excretion in chronic, daily cannabis users.

2010 - Study ~ Detection of cannabigerol and its presumptive metabolite in human urine after Cannabis consumption.

2010 - Study ~ Screening for the synthetic cannabinoid JWH-018 and its major metabolites in human doping controls.

2010 - News ~ Now, There's a Test for That -- Norchem's "Fake Marijuana" Test Reveals Significantly Increased Abuse of Spice/K2

2011 - Study ~ The current status of community drug testing via the analysis of drugs and drug metabolites in sewage

2011 - Study ~ A method for CP 47, 497 a synthetic non-traditional cannabinoid in human urine using liquid chromatography tandem mass spectrometry

2011 - Study ~ Liquid chromatography-tandem mass spectrometry analysis of urine specimens for K2 (JWH-018) metabolites.

2011 - Study ~ Zinc Reduces the Detection of Cocaine, Methamphetamine, and THC by ELISA Urine Testing. 8 to 11 mg of zinc daily; over 40 mg/day can cause zinc poisoning.

2011 - Study ~ Concentrations of delta9-tetrahydrocannabinol and 11-nor-9-carboxytetrahydrocannabinol in blood and urine after passive exposure to Cannabis smoke in a coffee shop.

2011 - Study ~ Quantitative measurement of JWH-018 and JWH-073 metabolites excreted in human urine.

2011 - Study ~ Differentiating new cannabis use from residual urinary cannabinoid excretion in chronic, daily cannabis users.

2011 - Study ~ Efavirenz interference in urine screening immunoassays for tetrahydrocannabinol.

2011 - News ~ NMS Labs & Cerilliant Announce Identification Of Major Metabolite Of The Synthetic Cannabinoid JWH-073

2011 - News ~ What Causes False Positives in Marijuana Drug Testing?

2012 - Study ~ Unexpected interference of baby wash products with a cannabinoid (THC) immunoassay.

2012 - News ~ Strange Reason for Baby's Positive Pot Test Found

2012 - News ~ Baby Soaps and Shampoos Trigger Positive Marijuana Tests

2012 - News ~ Broncos Linebacker Failed Two Drug Tests By Providing 'Non-Human Urine'


 

 

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Delta(9)-Tetrahydrocannabivarin testing may not have the sensitivity to detect marijuana use among individuals ingesting dronabinol

One case of analytical interference between cannabis and niflumic acid resulting in a false-positive screening in a 3-year-old girl is described.


CASE REPORT: The child was hospitalized because of behavioral disturbances of unknown origin. The only noteworthy finding in her medical history was a drug treatment including suppositories of niflumic acid, started 5 days before.

The initial urinary toxicological screening was positive for cannabinoids, but the child's parents strongly denied the exposure. Another analysis was performed by the same laboratory on the same urine sample using chromatography and confirmed the absence of any cannabinoids, while clearly identifying the presence of niflumic acid.

COMMENTS: Immunoanalysis for toxicological analysis has various limitations that must be known. False-positive results of the urinary screening for cannabis in patients treated with niflumic acid are well recognized although seldom reported. All usual screening tests are not concerned by this ill-explained interference with niflumic acid and all formulations can be involved except transcutaneous formulations.

Because of the wide use of this nonsteroidal anti-inflammatory drug, particularly in pediatric patients, it is important to know that this type of interference can occur with various screening tests for cannabis so that misleading conclusions can be avoided.

 





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Detection time of regular THC use in urine shorter than often assumed

According to a review in the current issue of the journal Drug Court Review "it is uncommon for occasional marijuana smokers to test positive for cannabinoids in urine for longer than seven days using standard cutoff concentrations. Following smoking cessation, chronic smokers would not be expected to remain positive for longer than 21 days, even when using the 20 ng/mL cannabinoid cutoff." By using a cut-off of 50 ng/ml in drug screening assays the detection window would typically be not longer than ten days for regular users and between 3-4 days for occasional users.

The author, Dr. Paul Cary of the University of Missouri, noted that it is usually assumed by scientists, the legal system and users of cannabis that the use of cannabis is detectable in the urine by drug screenings 30 days or longer after last consumption. However, he points out that many studies that found a long detection time had major methodical weaknesses. The most serious of these limiting factors would be "the inability to assure marijuana abstinence of the subjects during the studies."

Despite these limitations of the available studies his analysis revealed that very long cannabinoid detection times (30 days or more) are rare. The average detection window for the THC metabolite THC-COOH in urine of regular cannabis users at a cut-off concentration of 20 ng/ml in the studies reviewed by Dr. Cary was 14 days. In many of the studies "only one single subject was the source of the maximum cannabinoid detection time." He concluded that "these rare occurrences have had a disproportional influence" on the perception on the length cannabis use can be detected in urine after last consumption.

The full text is available for free at: www.ndci.org/NDCIR%20VI.pdf

(Source: Cary PL. The marijuana detection window: determining the length of time cannabinoids will remain detectable in urine following smoking: a critical review of relevant research and cannabinoid detection guidance for drug courts. Drug Court Rev 2005;5(1):23-58.)

 

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The effects of adulterants and selected ingested compounds on drugs-of-abuse testing in urine

Dasgupta A

The Department of Pathology and Laboratory Medicine, University of Texas Health Sciences Center, Houston, TX 77030, USA.

Household chemicals such as bleach, table salt, laundry detergent, toilet bowl cleaner, vinegar, lemon juice, and eyedrops are used for adulterating urine specimens. Most of these adulterants except eyedrops can be detected by routine specimen integrity tests (creatinine, pH, temperature, and specific gravity); however, certain adulterants such as Klear, Whizzies, Urine Luck, and Stealth cannot.

These adulterants can successfully mask drug testing if the concentrations of certain abused drugs are moderate.

Several spot tests have been described to detect the presence of such adulterants in urine. Urine dipsticks are commercially available for detecting the presence of such adulterants, along with performance of tests for creatinine, pH, and specific gravity.

Certain hair shampoo and saliva-cleaning mouthwashes are available to escape detection in hair or saliva samples, but the effectiveness of such products in masking drugs-of-abuse testing has not been demonstrated. Ingestion of poppy seed cake may result in positive screening test results for opiates, and hemp oil exposure can cause positive results for marijuana.

These would be identified as true-positive results in drugs-of-abuse testing even though they do not represent the actual drug of abuse.

Published 21 August 2007 in Am J Clin Pathol, 128(3): 491-503.
Full-text of this article is available online (may require subscription).

 

 
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Toxicity From the Use of Niacin to Beat Urine Drug Screening

Five States, January--September 2006

In addition to its use as a nutritional supplement, niacin (nicotinic acid or vitamin B3) is medically prescribed to treat hyperlipidemia and hypercholesterolemia.

Use of niacin in low doses usually leads to few adverse drug reactions (ADRs); however, at larger doses, niacin can cause skin flushing, itching, and occasionally more serious effects. The 2005 annual report of the American Association of Poison Control Centers documented 3,109 reports of exposures to niacin. During 2006, the Rocky Mountain Poison and Drug Center (RMPDC) in Denver, Colorado, received multiple calls regarding ADRs after nonmedical use of niacin.

A review of call records indicated various uses of niacin, including attempts to alter or mask results of urine drug tests, although no scientific evidence exists that ingestion of niacin can alter a drug test result.

To determine the extent of niacin use in attempts to alter drug test results, reports to RMPDC of niacin ADRs were reviewed for the period January--September 2006. The results identified 18 persons who reported nonsuicidal, intentional, nonmedical reasons for using niacin, including eight who specified altering drug test results as their reason for using niacin.

 Ten other persons, among an additional 18 who offered no reason for niacin use, were categorized as possible users of niacin to try to alter drug test results because of their ages or the amount of niacin ingested. Clinicians, especially those whose patients include teens and young adults, should be aware of the potential use of niacin in attempts to defeat urine drug tests.

RMPDC serves Colorado, Hawaii, Idaho, Montana, and southern Nevada, a total population of approximately 10 million. RMPDC staff members searched their database for telephone calls reporting niacin exposures during January--September 2006.

Calls regarding niacin exposures were divided into six categories: 1) unintentional dosing errors in therapeutic users, 2) ADRs after therapeutic use, 3) pediatric unintentional exposures, 4) suicide attempts, 5) ADRs with no reason given for niacin use, and 6) ADRs after nonsuicidal, intentional, nonmedical use. Data collected included the person's age, sex, circumstances of exposure, symptoms, and outcome.

Persons who gave no reason for niacin use but were aged <30 years or who reported taking at least 1,000 mg or "large amounts" of niacin in one ingestion were cateogorized as possible users of niacin to defeat urine drug testing. The study was approved by RMPDC's institutional review board and granted a waiver of consent.

A total of 92 calls (72 from persons at home and 20 from health-care providers) reported exposures to niacin. Thirty calls (33%) reported dosing errors or ADRs after therapeutic use, 23 (25%) referred to unintentional pediatric exposures, and 18 (20%) reported ADRs after nonsuicidal, intentional, nonmedical use. An additional 18 calls (20%) reported niacin ADRs with no reason stated for the exposure. Three calls (3%) described attempted suicides.

Among the 18 persons who said their ADRs resulted from nonsuicidal, intentional, nonmedical use of niacin, the median age, excluding three adults of unknown ages, was 18 years (range: 15--50 years).

Eight of the 18 persons said they took niacin (1,000 mg--8,000 mg) to alter or mask a drug screening; eight others said they took niacin (400 mg--5,000 mg) to "purify, cleanse, or flush" their bodies; and two said they used niacin as a diet pill.

Among the 18 persons who gave no reason for niacin use, eight were aged <30 years, and two patients of unknown age reported taking a 2,000-mg dose and "large amounts" of niacin, respectively; under the case definition, those 10 persons were categorized as possible users of niacin to defeat urine drug testing.

Calls regarding the 18 persons who either said their ADRs resulted from attempts to alter drug test results or who were categorized as possible users of niacin for that purpose came from all five states covered by RMPDC.

Twelve calls came from Colorado, two from Idaho, and one each from Hawaii, Montana, and southern Nevada; one call came from California via a manufacturer's hotline telephone number.

Among the 28 who either gave a nonmedical reason for niacin use (18 persons) or who stated no reason but were categorized as possible users of niacin to alter drug test results (10 persons), the most common ADRs reported were tachycardia, flushed skin, rash, nausea, and vomiting. Thirteen of the 28 were treated at or referred to a health-care facility. No deaths were reported.

Reported by: C Mendoza, MD, K Heard, MD, Rocky Mountain Poison and Drug Center, Denver Health Medical Center, Colorado.

Editorial Note:

Niacin is well established as a medical treatment for hyperlipidemia and available by prescription in 50-mg to 500-mg tablets or capsules. The initial recommended therapeutic daily dose is 100 mg, three times a day, titrated to a maximum daily dose of 1,000 mg.

Extended-release niacin tablets and capsules (at 125 mg--1,000 mg) also are available by prescription, usually in a dose of 500 mg at bedtime, to a maximum of 2,000 mg per day.

The therapeutic use of niacin often is limited by dermatologic and gastrointestinal ADRs (e.g., tachycardia, flushing, rash, nausea, vomiting, or abdominal pain). These effects usually are self-limited and are more common with dosages >1,000 mg per day, but can occur at any dose. Hepatotoxicity is a rare but serious adverse effect, usually associated with chronic use.

No scientific evidence indicates that taking niacin can alter a urine drug test result. However, readily accessible information on the Internet lists ingestion of niacin as a way to prevent detection of tetrahydracannabinol (THC), the main psychoactive ingredient of marijuana. An Internet search on the words "niacin" and "marijuana" can produce tens of thousands of results.

In addition to sales as a prescription drug, niacin is sold over the counter (in 100-mg to 500-mg tablets) and generally is regarded as a safe nutritional supplement with well-known dermatologic and gastrointestinal ADRs that usually are self-limited and resolve with supportive care.

Death from acute overdose has not been reported, and a minimum lethal dose has not been established. However, severe effects in some patients have been reported. A report in press on use of niacin to defeat urine drug tests describes four cases of niacin toxicity that included hepatotoxicity, metabolic acidosis, variations in blood glucose, neutropenia, and electrocardiographic effects. Two of the four patients had life-threatening ADRs; one had taken 5,500 mg of niacin during a 36-hour period, and the other had taken 2,500 mg during a 48-hour period.

The findings in this report are subject to at least four limitations. First, the data were collected retrospectively from the RMPDC database; although a specific data set was gathered for each case, persons might have misrepresented the circumstances of their niacin use, leading to misclassification, underreporting of dosages, or inaccurate reporting of symptoms. Second, persons who did not cite a reason for using niacin and were aged <30 years and persons who took more than 1,000 mg or "large amounts" of niacin were categorized as possible users of niacin to alter drug test results; however, those persons might have used niacin for other reasons, including treatment of hyperlipidemia.

Third, poison center data might not be representative of all niacin exposures; patients with less severe or no symptoms from niacin use would not contact a poison center. Finally, RMPDC is a regional poison center, and the use of niacin to attempt to alter or mask drug test results might be a regional phenomenon. Further research of national poison center data can provide additional information regarding nonmedical use of niacin.

Public health measures such as school-based education and authoritative Internet communications might help prevent ADRs if directed at those who are prompted to misuse niacin by claims that are not substantiated scientifically. This report underscores the importance of taking medications in appropriate doses and for approved indications as directed by a health-care provider. With the Internet now a common source of medical information, clinicians can expect to encounter patients with unusual ADRs resulting from nonscientific drug use (8) and should familiarize themselves with these effects and counsel their patients accordingly.

References

  1. CDC. Niacin intoxication from pumpernickel bagels---New York. MMWR 1983;32:305.
  2. Lai MW, Klein-Schwartz W, Rodgers GC, et al. 2005 annual report of the American Association of Poison Control Centers' national poisoning and exposure database. Clin Toxicol 2006;44:803--932.
  3. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486--97.
  4. Poisondex® system. Greenwood Village, CO: Thomson Micromedex.
  5. Temple BR. Vitamins. In: Dart RC, Caravati EM, McGuigan M, et al, eds. Medical toxicology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2004:1022--3.
  6. Bloomquist SE, Dart RC. Cardiovascular drugs. In: Dart RC, Caravati EM, McGuigan M, et al, eds. Medical toxicology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2004:645--7.
  7. Mittal MK, Florin T, Perrone J, Delgado JH, Osterhoudt KC. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. In press. 2007.
  8. Cone EJ. Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the Internet. Drug Alc Depend 2006;83S:S31--9.

 

 

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.


References to non-CDC sites on the Internet are provided as a service to CMMC readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in CMMC were current as of the date of publication.

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Identifying New Cannabis Use with Urine Creatinine-Normalized THCCOOH Concentrations and Time Intervals Between Specimen Collections

Smith ML, Barnes AJ, Huestis MA

 Journal of Anayticall Toxicol 2009 May; 33(4):185-9.

A previously recommended a method for detecting new cannabis use with creatinine-normalized 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol (THCCOOH) urine concentrations in periodically collected specimens for treatment, workplace and judicial drug testing applications is refined by considering the time interval between urine collections.

All urine specimens were collected from six less-than-daily cannabis users who smoked placebo, 1.75%, and 3.55% THC cigarettes in randomized order, each separated by one week. Ratios (n = 24,322) were calculated by dividing each creatinine-normalized THCCOOH concentration (U2) by that of a previously collected specimen (U1).

Maximum, 95% limit, and median U2/U1 ratios with 15 and 6 ng THCCOOH/mL cutoff concentrations, with and without new use between specimens, were calculated for each 24-h interval after smoking up to 168 h and are included in tables. These ratios decreased with increasing interval between collections providing improved decision values for determining new cannabis use. For example, with a 15 ng THCCOOH/mL cutoff concentration and no new use between specimens, the maximum, 95% limit, and median U2/U1 ratios were 3.05, 1.59, and 0.686, respectively, when the collection interval was </= 24 h and 0.215, 0.135, and 0.085 when it was 96-119.9 h.

 More from this Journal of analytical toxicology[J Anal Toxicol

 

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Potassium nitrite reaction with 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine in relation to the drug screening analysis

Journal of Forensic Science. 1999 Sep;44(5):951-5.

Lewis SA Sr, Lewis LA, Tuinman A.

Analytical Services Organization, Lockheed Martin Energy Systems, Inc., Oak Ridge, TN 37831-8244, USA.

Abstract

Recently potassium nitrite has been used as an adulterant to interfere with the analysis of 11-nor-delta 9-tetrahydro-cannabinol-9-carboxylic acid (THC-COOH) in urine. A comprehensive study of the THC-COOH and nitrite reaction chemistry and stability under various conditions is presented. Reverse phase high performance liquid chromatography (HPLC) and negative electrospray mass spectrometry (ESMS) results are given to substantiate the derived reaction mechanism and properties leading to reaction termination. The addition of potassium carbonate as a buffering agent prior to or following sample void as a means of preventing the formation of a nitroso-complexed form of the 11-nor-delta 9+-tetrahydrocannabinol-9-carboxylic acid is evaluated.

PMID: 10486947 [PubMed - indexed for MEDLINE]

 

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Delta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results of a clinical study

ElSohly MA, deWit H, Wachtel SR, Feng S, Murphy TP

 J Anal Toxicol 2001 Oct; 25(7):565-71.

Delta9-tetrahydrocannabinol (THC), the main psychologically active ingredient of the cannabis plant (marijuana), has been prepared synthetically and used as the bulk active ingredient of Marinol, which was approved by the FDA for the control of nausea and vomiting in cancer patients receiving chemotherapy and as an appetite stimulant for AIDS patients.

Because the natural and the synthetic THC are identical in all respects, it is impossible to determine the source of the urinary metabolite of THC, 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), in a urine specimen provided in a drug-testing program. Over the last few years there has been a need to determine whether a marijuana positive drug test is the result of the ingestion of marijuana (or a related product) or whether it results from the sole use of Marinol.

We have previously proposed the use of delta9-tetrahydrocannabivarin (THCV, the C3 homologue of THC) as a marker for the ingestion of marijuana (or a related product) because THCV is a natural component of most cannabis products along with THC and does not exist in Marinol.

We have also reported that THCV is metabolized by human hepatocytes to 11-nor-delta9-tetrahydrocannabivarin-9-carboxylic acid (THCV-COOH); therefore, the presence of the latter in a urine specimen would indicate that the donor must have used marijuana or a related product (with or without Marinol).

In this study, we provide clinical data showing that THCV-COOH is detected in urine specimens collected from human subjects only after the ingestion of marijuana and not after the ingestion of Marinol (whether the latter is ingested orally or by smoking). Four subjects (male and female) participated in the study in a three-session, within-subject, crossover design. The sessions were conducted at one-week intervals.

Each subject received, in separate sessions and in randomized order, an oral dose of Marinol (15 mg), a smoked dose of THC (16.88 mg) in a placebo marijuana cigarette, or a smoked dose of marijuana (2.11% THC and 0.12% THCV).

Urine samples were collected and vital signs were monitored every 2 h for a 6-h period following drug administration. Subjects were then transported home, were given sample collection containers and logbooks, and were instructed to record at home the volume and time of every urine collection for 24 h, and once a day for the remainder of a week (6 days).

Subjects were also instructed to freeze the urine samples until the next session. All urine samples were analyzed by GC-MS for THC-COOH and THCV-COOH using solid-phase extraction and derivatization procedure on RapidTrace and TBDMS as the derivative. The method had a limit of detection of 1.0 ng/mL and 1.0 ng/mL for THCV-COOH and THC-COOH, respectively.

 More from this Journal of analytical toxicology[J Anal Toxicol]

  

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Urinary elimination of 11-nor-9-carboxy-delta9-tetrahydrocannnabinol in cannabis users during continuously monitored abstinence

 Goodwin RS, Darwin WD, Chiang CN, Shih M, Li SH, Huestis M

 J Anal Toxicol 2008 Oct; 32(8):562-9.

The time course of 11-nor-9-carboxy-Delta9-tetrahydrocannnabinol (THCCOOH) elimination in urine was characterized in 60 cannabis users during 24 h monitored abstinence on a closed research unit for up to 30 days.

Six thousand, one hundred fifty-eight individual urine specimens were screened by immunoassay with values > or = 50 ng/mL classified as positive. Urine specimens were confirmed for THCCOOH by gas chromatography-mass spectrometry following base hydrolysis and liquid-liquid or solid-phase extraction. In 60%, the maximum creatinine normalized concentration occurred in the first urine specimen; in 40%, peaks occurred as long as 2.9 days after admission. Data were divided into three groups, 0-50, 51-150, and > 150 ng/mg, based on the creatinine corrected initial THCCOOH concentration.

There were statistically significant correlations between groups and number of days until first negative and last positive urine specimens; mean number of days were 0.6 and 4.3, 3.2 and 9.7, and 4.7 and 15.4 days, respectively, for the three groups. These data provide guidelines for interpreting urine cannabinoid test results and suggest appropriate detection windows for differentiating new cannabis use from residual drug excretion.


 
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Extended urinary Delta9-tetrahydrocannabinol excretion in chronic cannabis users precludes use as a biomarker of new drug exposure

Lowe RH, Abraham TT, Darwin WD, Herning R, Cadet JL, Huestis MA

 Drug Alcohol Depend 2009 Nov 1; 105(1-2):24-32.

BACKGROUND: Generally, urinary 11-nor-9-carboxy-Delta9-tetrahydrocannabinol (THCCOOH) after alkaline hydrolysis is monitored to detect cannabis exposure, although last use may have been weeks prior in chronic cannabis users. Delta9-Tetrahydrocannabinol (THC) and 11-hydroxy-THC (11-OH-THC) concentrations in urine following Escherichia coli beta-glucuronidase hydrolysis were proposed as biomarkers of recent (within 8h) cannabis use.


OBJECTIVE: To test the validity of THC and 11-OH-THC in urine as indicators of recent cannabis use.


METHODS: Monitor urinary cannabinoid excretion in 33 chronic cannabis smokers who resided on a secure research unit under 24h continuous medical surveillance. All urine specimens were collected individually ad libidum for up to 30 days, were hydrolyzed with a tandem E. coli beta-glucuronidase/base procedure, and analyzed for THC, 11-OH-THC and THCCOOH by one- and two-dimensional-cryotrap gas chromatography mass spectrometry (2D-GCMS) with limits of quantification of 2.5 ng/mL.


RESULTS: Extended excretion of THC and 11-OH-THC in chronic cannabis users' urine was observed during monitored abstinence; 14 of 33 participants had measurable THC in specimens collected at least 24h after abstinence initiation. Seven subjects had measurable THC in urine for 3, 3, 4, 7, 7, 12, and 24 days after cannabis cessation. 11-OH-THC and THCCOOH were detectable in urine specimens from one heavy, chronic cannabis user for at least 24 days.

CONCLUSION: For the first time, extended urinary excretion of THC and 11-OH-THC is documented for at least 24 days, negating their effectiveness as biomarkers of recent cannabis exposure, and substantiating long terminal elimination times for urinary cannabinoids following chronic cannabis smoking.

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Simultaneous GC–EI-MS Determination of Δ9-Tetrahydrocannabinol, 11-Hydroxy-Δ9-Tetrahydrocannabinol, and 11-nor-9-Carboxy-Δ9-Tetrahydrocannabinol in Human Urine Following Tandem Enzyme-Alkaline Hydrolysis

 
J Anal Toxicol. Author manuscript; available in PMC 2009 June 2.
Published in final edited form as:
PMCID: PMC2689549
NIHMSID: NIHMS118620
Simultaneous GC–EI-MS Determination of Δ9-Tetrahydrocannabinol, 11-Hydroxy-Δ9-Tetrahydrocannabinol, and 11-nor-9-Carboxy-Δ9-Tetrahydrocannabinol in Human Urine Following Tandem Enzyme-Alkaline Hydrolysis
 
Tsadik T. Abraham, Ross H. Lowe, Stephane O. Pirnay, William D. Darwin, and Marilyn A. Huesti
Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 5500 Nathan Shock Drive, Baltimore, Maryland, 21224
 
Université Paris Descartes, Faculté de Pharmacie, Neuropsychopharmacologie des Addictions, CNRS, UMR7157 et Université Paris 7, INSERM, U705, Paris F-75010, France
 
Abstract
A sensitive and specific method for extraction and quantification of Δ9-tetrahydrocannabinol (THC), 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THCCOOH) in human urine was developed and fully validated.
 
To ensure complete hydrolysis of conjugates and capture of total analyte content, urine samples were hydrolyzed by two methods in series.
 
Initial hydrolysis was with Escherichia coli β-glucuronidase (Type IX–A) followed by a second hydrolysis utilizing 10N NaOH. Specimens were adjusted to pH 5−6.5, treated with acetonitrile to precipitate protein, and centrifuged, and the supernatants were subjected to solid-phase extraction.
 
Extracted analytes were derivatized with BSTFA and quantified by gas chromatography–mass spectrometry with electron impact ionization. Standard curves were linear from 2.5 to 300 ng/mL. Extraction efficiencies were 57.0−59.3% for THC, 68.3−75.5% for 11-OH-THC, and 71.5−79.7% for THCCOOH. Intra- and interassay precision across the linear range of the assay ranged from 0.1 to 4.3% and 2.6 to 7.4%, respectively.
 
Accuracy was within 15% of target concentrations. This method was applied to the analysis of urine specimens collected from individuals participating in controlled administration cannabis studies, and it may be a useful analytical procedure for determining recency of cannabis use in forensic toxicology applications.

Introduction

Cannabis (marijuana, hashish) obtained from the complex Cannabis sativa plant is the most widely used illicit drug in the world. Self administered for its mood-altering properties, cannabis dependence and tolerance can develop. Euphoria, relaxation, altered-time perception, lack of concentration, and impaired learning and memory characterize its unique spectrum of behavioral effects...read entire text

 
 
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Do Delta(9)-tetrahydrocannabinol concentrations indicate recent use in chronic cannabis users?

Karschner EL, Schwilke EW, Lowe RH, Darwin WD, Pope HG, Herning R, Cadet JL, Huestis MA

 Addiction 2009 Dec; 104(12):2041-8.

AIMS: To quantify blood Delta(9)-tetrahydrocannabinol (THC) concentrations in chronic cannabis users over 7 days of continuous monitored abstinence.


PARTICIPANTS: Twenty-five frequent, long-term cannabis users resided on a secure clinical research unit at the US National Institute on Drug Abuse under continuous medical surveillance to prevent cannabis self-administration. 


MEASUREMENTS: Whole blood cannabinoid concentrations were determined by two-dimensional gas chromatography-mass spectrometry.


FINDINGS: Nine chronic users (36%) had no measurable THC during 7 days of cannabis abstinence; 16 had at least one positive THC > or =0.25 ng/ml, but not necessarily on the first day. On day 7, 6 full days after entering the unit, six participants still displayed detectable THC concentrations [mean +/- standard deviation (SD), 0.3 +/- 0.7 ng/ml] and all 25 had measurable carboxy-metabolite (6.2 +/- 8.8 ng/ml).

The highest observed THC concentrations on admission (day 1) and day 7 were 7.0 and 3.0 ng/ml, respectively. Interestingly, five participants, all female, had THC-positive whole blood specimens over all 7 days. Body mass index did not correlate with time until the last THC-positive specimen (n = 16; r = -0.2; P = 0.445).


CONCLUSIONS: Substantial whole blood THC concentrations persist multiple days after drug discontinuation in heavy chronic cannabis users. It is currently unknown whether neurocognitive impairment occurs with low blood THC concentrations, and whether return to normal performance, as documented previously following extended cannabis abstinence, is accompanied by the removal of residual THC in brain. These findings also may impact on the implementation of per se limits in driving under the influence of drugs legislation.

 

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Urinary toxicological screening: Analytical interference between niflumic acid and cannabis

Boucher A, Vilette P, Crassard N, Bernard N, Descotes J 

One case of analytical interference between cannabis and niflumic acid resulting in a false-positive screening in a 3-year-old girl is described.


CASE REPORT: The child was hospitalized because of behavioral disturbances of unknown origin. The only noteworthy finding in her medical history was a drug treatment including suppositories of niflumic acid, started 5 days before.

The initial urinary toxicological screening was positive for cannabinoids, but the child's parents strongly denied the exposure. Another analysis was performed by the same laboratory on the same urine sample using chromatography and confirmed the absence of any cannabinoids, while clearly identifying the presence of niflumic acid.

COMMENTS: Immunoanalysis for toxicological analysis has various limitations that must be known. False-positive results of the urinary screening for cannabis in patients treated with niflumic acid are well recognized although seldom reported. All usual screening tests are not concerned by this ill-explained interference with niflumic acid and all formulations can be involved except transcutaneous formulations.

Because of the wide use of this nonsteroidal anti-inflammatory drug, particularly in pediatric patients, it is important to know that this type of interference can occur with various screening tests for cannabis so that misleading conclusions can be avoided.

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Hemp oil causes positive urine tests for THC

J Anal Toxicol. 1997 Oct;21(6):482-5.

Costantino A, Schwartz RH, Kaplan P.

American Medical Laboratory, Chantilly, Virginia 20151, USA.

Abstract

A hemp oil product (Hemp Liquid Gold) was purchased from a specialty food store. Fifteen milliliters was consumed by seven adult volunteers. Urine samples were taken from the subjects before ingestion and at 8, 24, and 48 h after the dose was taken.

All specimens were screened by enzyme immunoassay with SYVA EMIT II THC 20, THC 50, and THC 100 kits. The tetrahydrocannabinol carboxylic acid (THCA) concentration was determined on all samples by gas chromatography-mass spectrometry (GC-MS) (5). A total of 18 postingestion samples were submitted. Fourteen of the samples screened above the 20-ng cutoff, seven were above the 50-ng cutoff, and two screened greater than the 100-ng cutoff. All of the postingestion samples showed the presence of THCA by GC-MS.

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