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What are the underlying causes for positive cocaine test?

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General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
I am a 57 year old grandmother of five who absolutely loves my job. Recently I was randomly selected for a mouth swab random drug screen that came back positive for cocaine. I thought it was a prank because anyone that knows my feeling about medications knows I am paranoid about any drug because I am fatally allergic to a type of anesthesia that caused me to stop breathing. I feel so violated that this test came back positive as I would never ever even think of using such a terrible thing. I am being terminated because of this and am at a total loss and feel like I'm in the worst nightmare ever. What can I do? I drank coffee and ate a banana ten minutes before my swab and talked to the nurse the who time it was in my mouth. I take Effexor and flexeril, miralax, vitamin b and d and occasionally something for a headache.
Posted Mon, 3 Feb 2014 in Medicines and Side Effects
Answered by Dr. Chakravarthy Mazumdar 1 hour later
Brief Answer: Go for specific test at Lab Detailed Answer: Hi Though most drug screen tests have improved the way they are done, it still has a lot of errors. There is no federal monitoring that is done to test the authenticity of these test the minimal threshold concentration varies for each drug. Most cocaine test for an important metabolite and this can give false positives for many different cases. For e.g Amoxicillin, tea from coco tree, liver disese, kidney disease, anesthetic agents as well. Hence I am not worried here and instead straight away visit the doctor to order specific test at a lab. This is extremely important for work place purposes before they terminate. So you have still options left to keep your job.
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Follow-up: What are the underlying causes for positive cocaine test? 42 minutes later
I went yesterday and had a secure chain urine test collected which we should know results of tomorrow. What else would you suggest? My employer said the only option I have is to re-test the same swab and this doesn't make sense to me, how do I know the lab didn't inadvertently mix my swab up with someone elses.
Answered by Dr. Chakravarthy Mazumdar 16 hours later
Brief Answer: Review the medicines and sample swab given Detailed Answer: Hi By now you would have got the result of the secure chain test. What does it say? I suggest to review the medication and habits with a local doctor. Check if any of them would give a false positive result. Some accredited labs mark the sample with a number and they would type the same number on the test report. You may check that if there is any change in the sample. Good luck
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Follow-up: What are the underlying causes for positive cocaine test? 7 hours later
I wont get the results from urine test until this afternoon. I learned yesterday that the lab that did the original swab has sent the same swab to a different area of their lab to test further and the results will take several days. I'm thinking this could help and they will find a different explanation for the false positive for cocaine, do you agree? What will they be testing for with this additional testing? At this point I am very fearful I could have some form of a kidney or liver disease or diabetes. As long as it's not life threatening, it would almost be welcomed rather than being accused of using an illegal drug which I would never ever consider.
Answered by Dr. Chakravarthy Mazumdar 20 minutes later
Brief Answer: Wait for results and do not lose cool Detailed Answer: Hi They may come up with any explanation if they found that the initial test was false positive. Do not worry this is not the way to diagnose liver or kidney or even diabetes. They have specific tests unlike cocaine screening. They would be testing other metabolites of cocaine metabolism which are quite specific other than benzoylecgonine. Thanks
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