No. 10 - I got some herbs from a little man in Chinatown
Any drug that is illegal or requires a prescription in the United States will require a medical explanation if discovered in a urine drug test.
Herbs, vitamins or any other medication, natural remedies or otherwise are not considered medically explainable. It does not matter if the patient grew
their own herbs or purchased vitamins at the flea market - Unless there is a prescription in the person’s name consistent with the substance found in the urine there is no medical explanation and the test must be reported as positive.
No. 9 - That's not Heroin in my underwear that's Soy Sauce!
As part of the medical review process for a potentially positive “opiate” the donor needs to undergo a physical exam. The examiner typically looks for “track marks’ left by needles. A full exam is necessary to explore all sorts of places since addicts will look to either hide or find unused veins.
On one occasion I had a donor who upon undressing tried to hide from me a little package of something black that he was keeping in his underwear. His explanation was that it was his soy sauce and he did not want to share with his coworkers. I told him that I did not think anybody would be interested in sharing anything in that package unless they were on drugs. Perhaps, say
somebody wanting some oh I don't know um… some black tar heroin maybe. Yep that's what it was.He was verified as a positive test.
No. 8 - I live next to a Crystal Meth lab
Passive inhalation or “second hand smoke” is often claimed as an excuse, implying that the positive donor was somehow unwittingly or accidentally exposed to a drug.
The Federal Regulations (49 CFR Part 40.151(d). direct the MRO to report as positive any medical explanation that provides passive inhalation as the source of drug. This direction is based on the large volume of scientific evidence showing how difficult it would be to provide a positive urine drug test based only on passive exposure. Please remember that MROs are in the business of verifying medical explanations not determining a donor’s credibility.
The second hand smoke excuse comes in many variations often times the donor claims to have been in someone else's car, or visiting a friends house. Donors claiming proximity are always at a loss to explain why they didn't leave, or if it was at their house or in their car why they did not ask the those doing the drugs to leave. An amazing number state they were at work
driving in a company vehicle. It is always fun to try to get them to tell me who was actually driving and how they could be driving and doing the drugs at the same time. I always give those companies lots of “leeway on the freeway.” I also inform the company of the safety sensitive issues raised.
On one occasion, after I had verified a donor as positive for marijuana, his wife called me. The wife wanted me to know that the positive drug test was
not her husband’s fault because she had secretly been smoking “pot” in their bedroom after he had gone to sleep and she was certain that he was unaware
of it.
No. 7 - I'm taking Medical Marijuana
Medical marijuana exists as a prescription pill that needs to be prescribed by a treating physician.Medically acceptable uses are for the patient who has glaucoma, nausea from cancer chemotherapy, or weight loss from HIV. Persons fitting these criteria are highly unlikely to be working in any safety sensitive position.
Recent laws passed around the United States including Hawaii are ignoring the science (the active ingredient is concentrated in the pill form) allowing individual to smoke marijuana (which has higher concentrations of
the active ingredient in getting the "high"). Due to the high cost of law enforcement Canada has recently ceased arresting individuals with small amounts pf marijuana (presumed for personal use) on their person.
No. 6 - I can't go! Honest Doc, I ain 't got any more in me
While this excuse is not really an excuse for a positive test per se, it is commonly used to try to explain why a donor cannot give a sufficient amount of urine. "Shy Bladder" is the term used to describe when a donor is unable to provide a satisfactory quantity of urine in the allotted period of time.
Inability to provide the urine is considered a "refusal to test". A refusal to test is usually considered worse than a positive test result since refusing such a test is normally grounds for employment termination without
a chance or the benefit of any rehabilitation.
Often times an experienced and possibly deceptive donor may give only a small amount of urine on several attempts but never provide enough to be sent to the lab for testing. Sometimes these donors are trying to buy time while trying to allow their system enough time to clear the drug. They feel they can accomplish this by having an unsuspecting inexperienced urine collector allow them to leave without a complete testing sample and to return another day. Of course this would give the patient a chance to "clean up their act" before returning to give a sufficient urine sample.
No. 5A - But Heroin is legal in Amsterdam … where I was on vacation.
A donor may travel to a country that allows the use of “recreational drugs” that may be perfectly legal in that country but are illegal in the United States. A positive report from the lab should be verified as positive by the MRO since the “non-medical’ use of drugs is not relevant to the MRO process.(The MRO verifies if there is a legitimate medical explanation for the presence of the drug or it’s metabolites in the donor’s urine). There may also be some safety concerns for a company that employs such an individual and it is the MRO’s duty to inform a company of all safety concerns uncovered during the MRO process.
No. 5B - I got some pills while I was on vacation in Mexico/Phillipines.
If the donor is unaware of what the ingredients are in a particular non prescription medication obtained outside of the United States then the MRO can use their judgment as to the medical explanation offered by the donor to
the MRO. If the donor has a prescription or if a prescription is not needed in a foreign country and the donor has a verifiable legitimate medical explanation, the MRO can verify the test as negative. However, if the donor shows signs of abuse or unauthorized use it can be verified as positive.
No. 4A - So, how come my Parole test was negative! The test I did with my parole officer was negative, so how can yours be positive?
No. 4B - The other test I did to check if I was clear or not came back negative so how can yours be positive?
Is it one of those strange freaks of nature or just a coincidence that whenever this excuse is given, the second urine test ( which is always done before the first test results even come back) are always negative. ALWAYS ! Sometimes the second test is even done by certified collectors labs and MROs. Regardless of the reliability or lack reliability of the second test
the point is that the second test is not part of the MRO process for the first test. Each test needs to stand alone, and the only test that matters or is considered is the one that the donor agreed to provide for the
employer and the MRO agreed to verify. ie. The first test.
The second test is of course a donor’s attempt to challenge the validity and reliability of the first test. The MRO and the employers need to keep their
eye on the ball and not be distracted by red herrings. Even if this means listening to a Union grievance as to validity of testing procedures and lab technique and the collectors performance, or responding to a patients
personal physician who has known the patient since they were knee high to a grass hopper and are absolutely unable to understand why the drugscreen may be positive. Please remember that the labs are SAMSHA certified and held to very rigorous standards. These labs spend tens of thousands of dollars to maintain that certification. Collectors and MRO’s must be certified now as
well.
If the donor truly feels that they want a “second opinion” on a specimenThe donor can always get the split sample sent to a different lab for confirmation sent from lab 1. Each urine stands alone so just because one
done earlier in the day or at a friends house or a test bought over the internet comes back negative does not mean that the next test will be. Some tests are more sensitive and some urines less concentrated
Not all instant tests are created equal. Some are more sensitive than others and there are times of day that the urine can be more or less concentrated, so that in fact 1 test is neg while another is positive.
No. 3 - No Way! I took some “stuff” that was guaranteed to give me a clean test! I took something that cleaned my system...
ADULTERATION - Probably an adulterant to try to fool the test but the joke is on them because all the labs look for the most common adulterants before they even do the actual test and if there are adulterants it is the same as a refusal to test.
An adulterant is something that either tries to mask or hide that the drug that was in the urine or fool the testing device into giving an erroneous or convoluted reading (even more difficult now since the technology is improved).
Also many adulterant manufacturing companies offer a two for one refund if you can give them a copy of the lab results (Donor’s asking for a copy of their results is a good sign that something is up)
No. 2 - That’s not my urine !! I snuck my kid’s urine into the test.
(Those that live by the false cup die by the false cup) If they fool the collector and they sign that it is their urine, then it is therefore considered their urine. What this also means is that their kid is doing
drugs too, and this is an all too common problem in Hawaii. There are many times that a family will all work for a company and they all get tested on the random system and they all come up positive. It is a social problem not just a medical one
One of my all time favorite drug test stories is about a donor who when advised that her post offer drug test had been reported by the lab as positive for amphetamine and methamphetamine, screamed cried and yelled for 5 minutes before admitting that she had successfully brought in her 14 year old child’s urine. She stated that she knew her urine would be positive for THC, so she asked her child to provide the specimen. It never occurred to her that the child’s urine could ever be positive. I suggested that both her and her child seek counseling for substance abuse. After all, she was not going to be getting the job she recently applied for.
No. 1 - I did not know they were going to do drug tests today!
It always amazes me how some people answer the questions posed by the MRO. Especially how some people feel that honesty is the best policy after they have been caught. Perhaps they feel that by being honest they will get a break. That’s why random testing is so important and not just upon hire. Every week I get several positive drug screens from persons who are applying for a job that requires post-offer drug testing. They tell their potential employer that they have no reason not to submit to a drug test and they came to the job interview knowing there was going to be a drug test and yet they fail. Very often when we go onsite we have to hide our vehicles or lock the gate so that no one can leave . We learned early on that if donors see us preparing to test they turn around and go home or even call in sick.
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Call us to help develop your Drug Screening Policy. To schedule your company's Drug Screens, complete the Drug Screening Registration on our Corporate Forms page and contact wellness@themedicalcorner.com and a Medical Corner staff member will respond directly.
