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ACMT Position Statement: Interpretation of Urine for Tetrahydrocannabinol Metabolites

  • Nicholas Connors
  • Michael J. Kosnett
  • Ken Kulig
  • Lewis S. Nelson
  • Andrew I. StolbachEmail author
Position Statement

The position of the American College of Medical Toxicology (ACMT), endorsed by the American Academy of Clinical Toxicology (AACT), the American Academy of Emergency Medicine (AAEM), the American College of Emergency Physicians (ACEP), and the American Society of Addiction Medicine (ASAM) is as follows:

A positive test for tetrahydrocannabinol (THC) metabolite indirectly indicates that THC, a psychoactive compound in cannabis, has been present in the body. Urine THC metabolite tests are not designed to identify synthetic cannabinoids or CBD. The test results do not identify route of THC exposure, source of exposure, specific timing of exposure, dose, intentional or accidental nature of exposure, or clinical impairment.

Background

Urine cannabinoid testing has been used to improve workplace safety, although the benefit of such testing is not supported for many forensic or clinical applications. Forensic testing refers to application of an assay to answer a legal question; clinical...

Keywords

Cannabidiol Cannabinoid Drug testing THC Urine tox screen 

Notes

Compliance with Ethical Standards

Disclaimer

While individual practices may differ, this is the position of the American College of Medical Toxicology at the time written, after a review of the issue and pertinent literature.

Conflict of Interest

None.

References

  1. 1.
    Office of the Federal Register of the United States, National Archives and Records Administration. Federal Register Vol. 82, No. 13. https://www.govinfo.gov/content/pkg/FR-2017-01-23/pdf/FR-2017-01-23.pdf Accessed May 2, 2019.
  2. 2.
    Kulig K. Interpretation of workplace tests for cannabinoids. J Med Toxicol. 2017;13:106–10.CrossRefGoogle Scholar
  3. 3.
    Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010;67:1344–50.CrossRefGoogle Scholar
  4. 4.
    Johnson-Davis KL, Sadler AJ, Genzen JR. A retrospective analysis of urine drugs of abuse immunoassay true positive rates at a national reference laboratory. J Anal Toxicol. 2016;40:97–107.CrossRefGoogle Scholar
  5. 5.
    Kapur BM. False positive drugs of abuse immunoassays. Clin Biochem. 2012;45:603–4.CrossRefGoogle Scholar
  6. 6.
    Saitman A, Park HD, Fitzgerald RL. False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol. 2014;38:387–96.CrossRefGoogle Scholar
  7. 7.
    Goodwin RS, Darwin WD, Chiang CN, Shih M, Li S, Huestis MA. Urinary elimination of 11-Nor-9-carboxy-9-tetrahydrocannabinol in cannabis users during continuously monitored abstinence. J Anal Toxicol. 2008;32:562–0.CrossRefGoogle Scholar
  8. 8.
    Shalit N, Barzilay R, Shoval G, Shlosberg D, Zweigenhaft N, Weizman A, et al. Characteristics of synthetic cannabinoid and cannabis users admitted to a psychiatric hospital: a comparative study. J Clin Psychiatry. 2016;77:e989–95.CrossRefGoogle Scholar
  9. 9.
    Nahler G, Grotenhermen F, Zuardi AW, Crippa JAS. A conversion of oral cannabidiol to delta9-tetrahydrocannabinol seems not to occur in humans. Cannabis Cannabinoid Res. 2017;1:81–6.CrossRefGoogle Scholar

Copyright information

© American College of Medical Toxicology 2020

Authors and Affiliations

  • Nicholas Connors
    • 1
    • 2
  • Michael J. Kosnett
    • 3
  • Ken Kulig
    • 4
  • Lewis S. Nelson
    • 5
  • Andrew I. Stolbach
    • 6
    Email author
  1. 1.Department of Emergency MedicineMedical University of South CarolinaCharlestonUSA
  2. 2.Palmetto Poison CenterColumbiaUSA
  3. 3.University of Colorado School of MedicineAuroraUSA
  4. 4.Toxicology Associates, Prof LLCDenverUSA
  5. 5.Rutgers New Jersey Medical SchoolNewarkUSA
  6. 6.Johns Hopkins University School of MedicineBaltimoreUSA

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