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From: Robert Swotinsky MD
Date: 21 Dec 2004
Time: 18:15:01 -0800
Remote Name: 68.166.232.122
Is this the million-dollar question? I hope so. I think I got all the other ones correct, though I did have to use my Phone a Friend option and call on Dr. Steve for the "Split specimen testing - iodate" answer last month.
Bottom line on borrowed use of OTC codeine-containing cough medicine: I'd call the test "negative." Here's why:
(1) Federal law prohibits the transfer of prescribed controlled substances to any person other than the patient for whom it was prescribed. (This is the basis by which federal regulators have advised MROs to verify borrowed Rx as "positive.")
(2) OTC codeine is a controlled substance, but is not a prescribed controlled substance. Thus, the federal law cited in "1" doesn't apply.
(3) Verifying this as positive would probably be counterproductive to the program's integrity and seems unfair to the donor. Workplace drug testing is, or at least originally was, intended to identify heroin. Codeine gets picked up, too, because the tests for heroin look at the metabolites morphine and codeine. I don't think anyone would argue that workplace drug testing is intended to identify misuse of codeine. There may be some doubt as to handle this kind of situation, but when in doubt I'd try to do the right thing and in this case I would call it negative. And, yes, I'm from Massachusetts, I voted for Kerry, blah blah blah.
The use of codeine purchased from Canada or Mexico is ok if the travel is recent. Customs allows travelers to bring personal-use quantities (generally, 90 days worth) of medications into the US. The traveler is supposed to get his or her own prescription in this country after that time. So, if the medicine was obtained in a different country and brought in the US within the past 90 days, that'd be an acceptable explanation that is consistent with DOT. And, if it's an OTC medicine that was purchased in a different country, then Mr. and Mrs. Smith can share that drug, at least for 90 days.