Search found 922 matches

by Robert Swotinsky MD
Thu Nov 21, 2019 3:12 pm
Forum: Drug and Alcohol Testing
Topic: Hair test positive for codeine only with no prescription
Replies: 1
Views: 3033

Re: Hair test positive for codeine only with no prescription

There is limited data in the medical/scientific literature about poppy seeds and positive results. These data indicate that codeine is not detected in hair using typical cutoffs after considerable poppy seed consumption. Report the result as verified positive.
by Robert Swotinsky MD
Sun Nov 17, 2019 8:46 pm
Forum: Drug and Alcohol Testing
Topic: Safety concern
Replies: 1
Views: 2850

Re: Safety concern

The federal drug testing regulations and guidelines do not define what to report or how to report it in federally regulated testing programs. In programs that are not federally regulated, there are likewise no regulations or guidelines that address this topic. As a matter of good medical practice, i...
by Robert Swotinsky MD
Fri Nov 01, 2019 3:47 pm
Forum: Drug and Alcohol Testing
Topic: "Temporary" shy bladder and pre-employment DOT
Replies: 4
Views: 4989

Re: "Temporary" shy bladder and pre-employment DOT

The DOT test is supposed to be done first because DOT says so. Nevertheless, the failure to provide a urine specimen after 3 hrs w/fluids offered does trigger a shy bladder evaluation for the purpose of determining if there is a medical reason for inability to provide the urine specimen and if so, i...
by Robert Swotinsky MD
Sat Oct 26, 2019 3:53 pm
Forum: Drug and Alcohol Testing
Topic: "Temporary" shy bladder and pre-employment DOT
Replies: 4
Views: 4989

Re: "Temporary" shy bladder and pre-employment DOT

Repeat the DOT pre-employment urine test. A temporary shy bladder does not trigger a directly observed collection procedure. If the donor fails to provide a sufficient specimen, have him return to the urologist. I think recurrent urethral stricture is an indication for surgical repair. Ask for the u...
by Robert Swotinsky MD
Thu Oct 24, 2019 6:58 pm
Forum: Drug and Alcohol Testing
Topic: Old prescriptions
Replies: 5
Views: 8250

Re: Old prescriptions

Thank you drjchill for your post! I was surprised this was published in 2018 and I am learning about it today! I could have/should have mentioned it in the MRO Update newsletter, but didn't. Maybe I'll put something in the next issue about this. In mid-2017, HHS issued a new MRO manual, the first in...
by Robert Swotinsky MD
Tue Oct 22, 2019 4:17 pm
Forum: Drug and Alcohol Testing
Topic: Underage test clients
Replies: 2
Views: 3325

Re: Underage test clients

Thank y ou Shawn Harrington for signing into the web site after I accidentally cleared out the member list a few days ago. You get the coveted #2 spot on the (new) members list. ____ MROs should not provide parents with results of drug tests that employers have ordered on their adolescent children. ...
by Robert Swotinsky MD
Wed Oct 16, 2019 6:52 pm
Forum: Drug and Alcohol Testing
Topic: GC-MS failed to distinguish between CBD and THC
Replies: 1
Views: 2927

Re: GC-MS failed to distinguish between CBD and THC

The 2012 Journal of Analytical Toxicology article referenced in the NY Times article describes conversion of CBD to THC when incubated w/acid, heat, and time. This phenomenon has been described in other studies, too. The article does not describe the GC/MS being unable to distinguish between CBD and...
by Robert Swotinsky MD
Wed Oct 02, 2019 5:46 pm
Forum: Drug and Alcohol Testing
Topic: Refusal to test with negative result
Replies: 5
Views: 3800

Re: Refusal to test with negative result

The collector uses a CCF for the 1st specimen. The collector uses a different CCF for the 2nd specimen. If the 2nd specimen is adequate, the collector sends the 1st specimen (or, if split, the 1st Bottle A and Bottle B) with its CCF and the second specimen (or, if split, the 2nd Bottle A and Bottle ...
by Robert Swotinsky MD
Tue Oct 01, 2019 5:05 pm
Forum: Drug and Alcohol Testing
Topic: Refusal to test with negative result
Replies: 5
Views: 3800

Re: Refusal to test with negative result

The collector should have discarded the 1st specimen. At this point, the test outcome is a refusal to test as this "trumps" the negative result from the suspect specimen.
directly observed collection procedure.jpg
directly observed collection procedure.jpg (67.88 KiB) Viewed 3790 times
by Robert Swotinsky MD
Wed Sep 18, 2019 6:31 pm
Forum: Drug and Alcohol Testing
Topic: Invalid with pH 9.07
Replies: 2
Views: 2551

Re: Invalid with pH 9.07

If the pH is in the 9.0 – 9.5 range and the specimen was exposed to heat over time, the MRO reports the test as cancelled and informs the DER that no further action is required unless a negative result is required. Urine pH can rise into the 9.0 – 9.5 range due to the effects of microbial activity, ...