Few things about the marijuana issue inflame me more than workplace and student drug testing.  I’m still trying to imagine how, if you had a time machine, we could visit Thomas Jefferson and the other hemp farmers discussing our Bill of Rights and explain to them in America of the future, employers routinely seize citizens’ urine to determine their fitness for employment and discriminate against them if hemp shows up in their system.  I think Ben Franklin would actually LOL.

Of course we all know that cannabis metabolites show nothing about one’s current impairment and will remain in one’s system for weeks or months following cessation of use.  We’ve talked about the perverse incentive this creates to use alcohol and other toxic addictive drugs that clear from one’s system in two to three days.  And now, this information from the American Psychiatric Association leads me to better understand why we’re seeing such an uptick in prescription drug abuse.

Medical News: APA: Drug Test Results Often Flawed – in Meeting Coverage, APA from MedPage Today.

NEW ORLEANS — That poppy seeds can lead to false-positive results on tests for opioid abuse is not just an urban legend, researchers said [at the American Psychiatric Association's annual meeting last May].

Another example is that most standard drug tests don’t screen for the opioid drug oxycodone, as well as a handful of other opioids including methadone and fentanyl, noted Smith, who conducted the research while he was at Boston Medical Center.

Opioid tests screen for morphine and codeine, which are two of the most common metabolites of many — but not all — opioids. They’re not metabolites of oxycodone, methadone, fentanyl, tramadol (Ultram), and buprenorphine (Subutex, Suboxone), Smith said.

Similarly, only certain metabolites of benzodiazepines are detected on most assays. That means diazepam, nordiazepam, and oxazepam (Serax) will be detected, but alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) aren’t frequently screened.

In their review, the researchers found that drug tests generally have a sensitivity of 90% to 95%, and a specificity of 85% to 90%. These numbers are a “pretty good basis” for making clinical decisions, Smith said, but that means “one in 20 [tested patients] are going to have inaccurate results, and those are more likely to be false positive than false negative.”

Many substances aside from poppy seeds cause these false-positives. Cold medications can give a positive read on amphetamines, as can bupropion (Wellbutrin) and tricyclic antidepressants.

Sertraline (Zoloft) and oxaprozin (Daypro) can alert physicians to a benzodiazepine problem when there is none.

The HIV medication efavirenz (Sustiva) can come up as a positive for marijuana use, and dextromethorphan, rifampin, and quinolones could show as an opioid problem.

There is a Jackson’s Food Store – a gas station / convenience store chain out West – that is two blocks from my home.  I walk my dog there every day as I pick up my fountain Diet Coke refill for lunch.  I’ve gotten to speak with most of the employees about marijuana – my pot leaf hat leads to lots of these conversations.  One of the kids pumping gas there is a sweet young man who is a migraine sufferer whom I’ve told would be a shoo-in for a medical marijuana card.

Then one day recently I notice that there are a whole bunch of new workers.  I find out that the store had come up $1,800 short in an audit, so in response, Jackson’s was drug testing all their employees.  Three employees admitted to occasional marijuana use and now they are unemployed.  There is no evidence that any of them were filching cash from register and since the firings the shortages from the till haven’t ceased.  But Jackson’s feels better, I guess, for having some scapegoats to blame.

Ironically, the one young man who could really use medical marijuana still has his job.  ”I only toke a tiny bit and only if the pain is just unbearable,” he told me, “because I just can’t lose this job – I have to take care of my wife and kid.  Luckily I hadn’t had a bad migraine for a few weeks, so I was able to pass the test.”  Even if he had a medical marijuana card, his job wouldn’t be protected.  My wife, a migraine patient herself, volunteered that her regular use of cannabis has turned what used to be weekly migraines to seasonal migraines – maybe four a year – and when they do come, they are moderate and not “drill a hole in my head” painful like before.

Now some would say, “Well, they knew the rules on drug testing; they don’t have to work there.”  Keep in mind that Portland, Oregon is suffering some >10% unemployment.  And then try to imagine your life if finding aspirin or ibuprofen or acetaminophen or naproxen in your system meant the end of your job and you have a splitting headache.

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Hemp Headlines

1. Mother Jones explains how the Drug Czar is mandates to lie about marijuana
2. Rachel Hoffman’s Law goes into effect tomorrow in Florida
3. Cannabis has not shown “any evidence of increasing schizophrenia” in the UK
4. Two San Antonio women die from Fentanyl patches

California Marijuana Report with Eric Brenner

• Convicted dispensary owner Charles Lynch

Daily Toker Tunes by Marijuana Music Awards . com

• 2009 AMMA Best Country Song – ‘Chickasaw County’ by Jimmy Aldridge

Government at Work

• Loretta Nall with an interesting tale of President Obama’s college friend, Rep. Artur Davis of Alabama, asking people online during his gubernatorial campaign about which policies they’d like to see enacted, much like Obama’s “Open for Questions“.

(WOAI.com) SAN ANTONIO — Controversy is brewing over a patch used for pain relief. At least two people in San Antonio have died after using the Fentanyl patch, and their families are blaming what they say is a defect.

Like most medicinal patches, Fentanyl is used by peeling off a sticky side and placing it against the skin of a patient. The patch is left on the skin for up to 72 hours and is supposed to provide the exact amount of medication needed.

However, the families of two San Antonio women who died say the patch they were prescribed to relieve their pain ended up killing them.

According to lawsuits filed by family members, both women suffered chronic pain. So, their doctors suggested Fentanyl patches.

Fentanyl is stronger than morphine. When it is applied to the skin, it then delivers a certain amount of Fentanyl into the patient.

While wearing the patches, Donna Singleton and Ellen Burks died. Their families say both suffered an overdose of Fentanyl because the patches were defective.

Similar patches have been recalled before because a cut along the side of the patch allowed too much Fentanyl to leak and cause a possible overdose.

Wait a minute, didn’t the Food & Drug Administration approve the use of these Fentanyl patches?  Why, doesn’t that mean it’s safe?  We know for sure that the FDA wouldn’t let people stick a patch on their body loaded with a Schedule II drug if it weren’t safe, even if this Fentanyl is just one isomer short of being Schedule I “China White” heroin.

We know this because they protect us from that evil Schedule I medical marijuana that never killed anybody in 5,000 years.