Amphetamine, methamphetamine, medical marijuana

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Amphetamine, methamphetamine, medical marijuana

Post by mshamshad » Mon Oct 26, 2020 12:46 pm

I have a preemployment drug screen for a crossing guard(non DOT, 10 panel) that is positive for Amphetamines (>5000ng/ml), Methamphetamine (>5000) and Cannabis (>300). She is prescribed Aderall and has a medical Marijuana card. Kindly advise how to report test. 1) Postive for cannabis with annotation of medical marijuana card to employer? 2) Negative for Amphetamine (due to prescription) and 3) Positive for methamphetamine (should I ask for L and d isomers)??

Thank you

Robert Swotinsky MD
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Re: Amphetamine, methamphetamine, medical marijuana

Post by Robert Swotinsky MD » Mon Oct 26, 2020 2:29 pm

Yes, ask for d & l isomers if they have not already been performed.

The methamphetamine is not explainable by the use of Adderall (amphetamine). Methamphetamine is metabolized to amphetamine. But, amphetamine is not metabolized to methamphetamine. That's why you need to get d & l isomers - to help figure out what you're going to do about the methamphetamine-positive lab result.

The usual practice of MROs is to report each THCA-positive as positive unless there is a prescription that explains the result. Medical marijuana recommendations are not prescribed use. If the employer chooses to accept such use as an explanation for a THCA-positive, so be it. From an MRO's perspective, it's best to stick to the science and practice of medicine. Marijuana is not established as a medicine, and it is certainly not a prescription medicine.

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