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The dextromethorphan defense: dextromethorphan and the opioid screen
A B Storrow1, M R Magoon, J Norton
1Wilford Hall Medical Center/PSAE, Department of Emergency Medicine, Lackland AFB, TX 78236-5300, USA.
Summary
A single dose of dextromethorphan, even at twice the normal amount, did not cause a false positive on urine opioid screening tests. This finding is important for understanding drug interactions and accurate drug testing.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Chemistry
Background:
- Dextromethorphan is structurally related to opioid analgesics.
- Urine drug screening assays, such as Enzyme-Multiplied Immunoassay Technique (EMIT), are commonly used for drug detection.
- The potential for dextromethorphan to interfere with opioid screening requires investigation.
Purpose of the Study:
- To evaluate if a single oral dose of dextromethorphan results in a false positive urine opioid screen.
- To assess the impact of standard and double doses of dextromethorphan on opioid immunoassay results.
Main Methods:
- A randomized, triple-blind, placebo-controlled, crossover study involving 20 adult volunteers.
- Participants received single oral doses of dextromethorphan (20 mg or 40 mg), codeine (30 mg), or placebo, separated by at least 72 hours.
- Urine samples were analyzed using EMIT opioid screens six hours after medication ingestion.
Main Results:
- All urine EMIT assays were negative for opioids six hours after dextromethorphan ingestion at both 20 mg and 40 mg doses.
- Urine assays were positive for opioids after codeine ingestion and negative after placebo ingestion, as expected.
Conclusions:
- A single therapeutic or supratherapeutic dose of dextromethorphan is unlikely to cause a false positive urine opioid EMIT screen.
- This study provides evidence that dextromethorphan does not interfere with qualitative urine opioid screening assays at the tested dosages and time points.