Do Hemp Products Create A Positive Urine Drug Screen For: Emergency Medicine News

Do Hemp Products Make a Positive Urine Drug Screen for Cannabis?: Emergency Medicine News- Log in
or even
- Register
-- Get fresh issue alertsGet alerts








Secondary LogoJournal Logo CollectionsAfter typically the Match

BradyCardia

Brandt's Rants

Diversity Matters

ER Goddess

InFocus

Life in Emergistan

numbERs

Quick Consult

The Speed of Sound

Toxicology Rounds

What Lies Beneath

View All


Case Files

iCubed: Impart, Instruct, Inspire

Lions and Tigers plus Bears

M2E Too! Mellick's Multimedia EduBlog

PhotographED

View All


EMedHome Videos

Emergentology Videos

iCubed Videos

Mellick's M2E Too! Videos

Speed regarding Sound Videos

View All


EM Board Bombs with Blake Briggs, MD, plus Iltifat Husain, MD

EM Logic together with Brady Pregerson, MD

EMCast with Amal Mattu, MD

The Physician Grind @ EMN with Zahir Basrai, MD

Current Procalcitonin Utilization plus Publications

Procalcitonin: Risk Assessment in COVID-19 Bacterial Co-Infection

View All


About the particular Publication

Advertising

Editorial Board

Information regarding Authors

Open Access

Reprints

Rights and Permissions

Subscription Services


- Previous Article
- Next Article


Do Hemp Products Create a Positive Urine Drug Screen regarding Marijuana? Henderson, Robert MD


Products produced with hemp seed have variable concentrations of cannabinoids, in addition to ingestion may guide to positive verification and confirmatory urine testing


Dr. Henderson is a fellow within the division regarding toxicology, department regarding emergency medicine, in MCP/Hahnemann University, currently rotating at National Medical Services, Inc., an independent bioanalytical toxicology testing service in Willow Grove, PA, whose health care director is G. John DiGregorio, MD, the editor regarding Laboratory Rounds. To find out more about NMS, contact Dr. DiGregorio at (215)784-9294 or [email protected].


Can hemp products explain positive urine drug screens for marijuana? These products happen to be used by simply emergency department patients and in courts of law to explain positive urine assessments for marijuana, tend to be these claims validated? In recent many years, there has been an increase in food and cosmetic products sold in the United States that are developed using hemp seeds.


It also has been employed recently for typically the treatment of chemotherapy-associated feeling sick and for the lowering of intraocular stress in glaucoma. Hemp is a product of the marijuana grow Cannabis sativa. It has been applied for thousands of years to manufacture clothing in addition to ropes.


Cannabis sativa contains many resins called cannabinoids including marijuana's energetic ingredient, THC (delta-9 tetrahydrocannabinol). This hydroxy form is transformed into the inactive metabolite, 11-nor-9-carboxy-delta-9 tetrahydrocannabinol, which can be the detectable metabolite. These acids are converted to THC when heated (see Figure 1). It then undergoes hydroxylation in the lean meats to form a good active metabolite, 11-hydroxy-delta-9 tetrahydrocannabinol. Almost all of the THC in the Cannabis plant is within acid forms1.


In addition, very much of the THC is broken lower upon absorption through first pass liver organ metabolism, which blunts its clinical impact. Nevertheless , ingestion regarding the heated grow (i. e., baked goods, brownies) will result in increased THC and metabolites, but absorption is slow and inconsistent. When inhaled, THC is instantly contained in the blood with conversion to be able to 11-nor-9-carboxy THC, happening in minutes. 2, 3 Ingestion of the plant has small clinical effect as the THC is generally in a inactive acid solution form. Dermal assimilation also occurs, yet is much less efficient than other sources of publicity.


TestingThe common urine drug screen uses an immunoassay (IA) to discover 11-nor-9-carboxy THC from cutoff amounts of twenty ug/L, 50 ug/L or 100 ug/L. The Drug abuse plus Mental Health Services Administration and the U. S. Department associated with Defense developed employ 50 ug/L as a cutoff in order to define a positive urine screen with regard to federal and army employees, respectively5, 6.


There is no generally approved cutoff for unexpected emergency department patients. Unfortunately, the immunoassay furthermore detects other cannabinoids, such as those in hemp goods, that can outcome in positive tests without the presence of significant degrees of 11-nor-9-carboxy THC. seven Therefore all optimistic tests should become confirmed with gasoline chromatography/mass spectrometry (GC/MS), which can be specific for THC and their metabolites, and, consequently, specific for cannabis use.


This confirmatory test is usually mandatory in certain work-related settings [see Table 1] including federal in addition to military jobs, nevertheless is not generally performed in typically the ED. SAMHSA plus the Department of Defense define a positive urine confirmation GC/MS as a level higher than 15 ug/L.


Hemp ProductsThe recent increase of food plus cosmetic products that contain hemp raises the question of whether typically the ingestion or assimilation of these products may produce cannabinoids levels that can become detected on a new urine drug display screen in the crisis department. 8 Additionally , there are worries that this use of hemp numerous enhance the urine metabolite concentration to cut-off levels used by simply businesses to identify drug abuse.


The first question to be answered is whether the goods claiming to consist of hemp seeds in fact contain THC. Significant heating is needed to convert THC acid to THC, and THC is easily filtered out associated with solution. Hemp seeds employed in food items typically contain much less than one % total THC. 9 However, THC content material may depend read more about production methods as compared to on the THC concentration of typically the hemp seeds.


For example, research of hemp seed-containing beer showed no detectable THC or perhaps metabolites since the seed products are filtered before to mixture using the beer. 10 Analysis of hemp green tea revealed only a five percent transformation of THC acid to THC whenever prepared in typically the typical fashion (boiling for one minute). When boiled for 45 minutes, ninety five percent of the particular THC acid A was transformed into THC. When this green tea was filtered with a paper filter, only one percent from the THC remained1.


As anticipated, the concentrations regarding metabolites also usually are quite variable. Thus, THC concentration is highly variable in hemp products. The hemp teas in addition to hemp trail pubs probably have the highest concentrations whereas beer and rapidly prepared coffee and tea have really little THC.


Hemp Product StudiesSteinagle, et al analyzed 20 volunteers along with urine GC/MS that drank hemp tea. Seven in the volunteers had detectable 11-nor-9-carboxy-delta-9-THC urine levels although the highest level was only eight ug/L, well under the SAMHSA and Department of Defense cutoffs11.


Fortner, ainsi que al tested volunteers who ingested 1 to 2 snack bars created with hemp seeds. Five of the particular 13 urine individuals tested exceeded the particular 50 ug/L cutoff, but only two had detectable amounts (0. 7 in addition to 3. 1 ug/L) via GC/MS, significantly under the SAMHSA and Department of Defense cutoff. They identified that 24 regarding 108 screening IA tests detected metabolite levels greater than 50 ug/L. one None of the particular subsequent confirmatory GC/MS tests detected virtually any 11-nor-9-carboxy-delta-9-THC. They furthermore performed serial urine testing on volunteers who ingested hemp seed cookies.


Callaway, et ing also studied a new volunteer who taken in two teaspoons associated with uncooked hemp seeds oil each day for one month. The level detected by GC/MS ranged from 36-87 ug/L, well above the cutoff regarding 15 ug/L. This volunteer had noticeable cannabinoids on urine IA screen regarding only 17 hrs, but the attention peaked well beneath the occupational cutoff. Struempler, et 's performed serial urine immunoassays over a offer who ingested about three teaspoons of unheated hemp seed oil per day. In late the study period, the screening IA and confirmatory GC/MS exceeded the SAMHSA and Department regarding Defense cutoffs and remained positive with regard to three additional days. They then analyzed a single consumption of 24 g. After only 4 days, the immunoassay detected a degree of 55 ug/L.


Costantino, ou al studied volunteers who ingested about three teaspoons of unheated hemp oil. one Urine IA screen detected cannabinoids above the 50 ug/L cutoff in one-half of the volunteers at four plus twenty four hours, but not one in all subjects in 48 hours. The confirmatory GC/MS concentrations were above 15 ug/L in one-half from the volunteers at eight and twenty four hours and ranged from 0 in order to 79 ug/L.


Products produced along with hemp seeds have got variable concentration associated with cannabinoids and consumption may lead in order to positive screening in addition to confirmatory urine tests both in the ED and in businesses. Products of which undergo prolonged heat during preparation without filtration such because hemp teas in addition to hemp oil are usually more likely to be able to elevate urine levels.


References Cited Here


Cited Here



Source


- Full-Size
: Email
-- + Favorites
- Export
- View in Gallery


Colleague's E-mail is Invalid


EMN QUICK LINKS


Home


Blogs


Enews Archive


Enews Sign-up


EMN Archive


Videos


Search EMN


Email us


Related Articles Colleague's E-mail is Invalid


Your concept has been effectively delivered to your friend.


Save my selection


Article Level MetricsRelated Links - Articles in PubMed simply by Robert Henderson, MD
- Articles in Google Scholar by Robert Henderson, MD
- Other content articles in this record by Robert Henderson, MD


Related Videos Most Popular - Most Viewed
- Most Emailed


First Person: Why I'm Leaving Emergency Medicine


Post-It Pearls: A Tip for More Rapid Potassium Infusions


Toxicology Rounds: A Non-Diabetic with Lactic Acidosis? Ask about Metformin Anyway


M2E Too!: The Torsed Testicle Traction Technique


Special Report: The Human Cost of ED Boarding


View All


Never Miss an Issue


Browse Journal Content


- Most Popular
-- For Authors
- About the Publication
- Past Issues
- Current Issue
Register on the website
Get eTOC Alerts


For Journal Authors


- Submit an article
- How to publish with Wolters Kluwer


Customer Service


- Sign Up for a free of charge Subscription
- Activate Journal Subscription
-- Browse the assist middle
- Help
Call us at: -- EMAIL:
#@@#@!![email protected]
- TEL: (USA):
TEL: (Int’l):


800-638-3030 (within USA)
301-223-2300 (international)


-
--


Privacy Policy (Updated June 1, 2020)
Legal Disclaimer
Terms of Use


- Feedback
- RSS Feeds
- LWW Journals


Copyright © 2022
Wolters Kluwer Health, Inc. and/or its subsidiaries. All rights reserved.


For information on cookies and exactly how you can deactivate them visit the Privacy and Cookie Policy. This web site uses cookies. By continuing to utilize this website you are usually giving consent in order to cookies being utilized.