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Some CBD products may yield cannabis-positive urine drug tests

In a study of six adults, Johns Hopkins Medicine researchers report evidence that a single vaping episode of cannabis that is similar in chemical composition to that found in legal hemp products could possibly result in positive results on urine drug screening tests commonly used by many employers and criminal justice or school systems.

The U.S. government defines hemp as any crop of cannabis containing 0.3% THC or less in dry weight. THC (delta-9-tetrahydrocannabinol) is the substance in cannabis that confers a “high” and produces the subjective and cognitive effects that are typically synonymous with cannabis. The 2018 U.S. Farm Bill legalized the production and sale of hemp, and now as a result, consumer hemp products, such as oils, vaping cartridges and hemp flowers for smoking can be legally purchased in specialty stores, general retail stores and through websites across the U.S.

Hemp is now increasingly finding use in medicine and wellness markets, particularly for its component CBD, short for cannabidiol, which is one of the more than 100 cannabinoids found in the cannabis plant. According to New York-based investment bank Cowen & Co., the market for CBD last year ranged from $600 million and $2 billion in sales. Despite the size of this booming industry, it remains largely unregulated.

In a paper published Nov. 4 in the Journal of Analytical Toxicology, the researchers report that two out of six study participants tested positive after vaping cannabis that contained 0.39% THC using urine testing methods that are consistent with testing frequently performed for employment-related or criminal justice-related urine drug testing programs. Though the cannabis used in this study does not currently meet the federal definition of hemp, the THC concentration of 0.39% exceeds federal regulation by just 0.09%.

“People who use legal hemp products for medical intent rarely just use them once as we did in this study, and prior studies show that THC and its metabolites may accumulate with repeated use,” says postdoctoral fellow Tory Spindle, Ph.D., a researcher in the Behavioral Pharmacology Research Unit at the Johns Hopkins Bayview Medical Center. “What this means is that people need to be wary of single-dose or cumulative THC exposure and be aware that these now legal products may cause an unexpected positive result on a drug test.”

“Because the market for CBD products is so new and the popularity of use is growing so quickly, we want the public to be aware that a positive drug test is possible,” says Ryan Vandrey, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. Vandrey and his collaborators at the University of Pennsylvania previously showed in a JAMA study that 21% of CBD/hemp products sold on the Internet contained THC, even though it wasn’t listed on the product labels. “I have a hard time finding anyone who hasn’t used a CBD product at least once, but most are completely unaware of the possibility of THC exposure or a positive drug test as a result of using these newly legalized products,” says Vandrey.

trials demonstrated CBD to be an effective treatment for two rare forms of pediatric epilepsy, however, there is currently insufficient evidence to support use for any other health condition according to the U.S. Food and Drug Administration. Despite this, CBD product suppliers and consumers claim benefits of CBD for a wide range of purposes, including everything from anxiety to insomnia to general wellness. CBD products can be swallowed in the form of an oil/tincture, eaten in a food product (e.g., gummy bears), inhaled using “vape pens” similar to electronic cigarettes, or applied topically to the skin in a cream, patch, balm or gel.

For the current study, the researchers recruited three women and three men with an average age of 31 years old. One participant self-reported as African American and the rest as white.

The batch of cannabis used in this particular study contained 10.5% CBD and 0.39% THC, a 27 to 1 ratio of CBD to THC that is similar to what is often found in legal hemp/CBD products. In the study, research volunteers vaporized a little less than 1 gram of cannabis, which contained a total dose of 100 milligrams of CBD and 3.7 milligrams of THC. To vape the cannabis, heated cannabis vapor was collected into a balloon that was then inhaled by the participant.

In addition to vaping the high CBD/low THC cannabis, study volunteers also were given pure CBD in a capsule, vaporized pure CBD and placebo (a mock CBD pill and vaporized cannabis in which CBD and THC had been removed) in three other dosing sessions, one week apart from each other. In all active drug conditions (excluding placebo), the CBD dose delivered was 100 milligrams per session.

The drug testing cut-off used to determine a “positive” result in this study was a “screening” concentration of at least 50 nanograms per milliliter of THCCOOH, a metabolite used to indicate whether someone has used cannabis, in the urine sample using an on-site “dipstick” test. A positive on that test was then “confirmed” at a 15 nanograms per milliliter cut-off of THCCOOH using a more sensitive test method.

Two of the six participants who vaped the low-THC/high-CBD cannabis tested positive for THCCOOH.

No positive urine drug test results were observed in the other test sessions (pure CBD capsules, pure CBD vape or placebo).

“These results suggest that pure CBD, used once by itself, will not cause a positive drug test,” says Vandrey. Adding to this, Spindle points out that it “does not take much THC exposure to trigger a positive test for some people.” There may be variation from person to person in drug metabolism and puffing behaviors such as inhalation depth, which might contribute to the breakdown or buildup of cannabinoids in the body, the researchers say.

The team says they plan to repeat their studies using products that fall within the current federal hemp regulations with respect to THC content, and additionally study the impact of repeated CBD/hemp exposure on drug testing outcomes.

Other authors on the study were Edward Cone and George Bigelow of Johns Hopkins, David Kuntz of Clinical Reference Laboratory, John Mitchell of RTI International and Ronald Flegel of the Substance Abuse and Mental Health Services Administration (SAMHSA).

This research was supported by SAMHSA and the National Institute on Drug Abuse (T32DA07209).

COI: Vandrey has been a paid consultant for or received honoraria from Zynerba Pharmaceuticals, FSD Pharma and Canopy Health Innovations Inc.

Hemp is now increasingly finding use in medicine and wellness markets, particularly for its component CBD, short for cannabidiol, which is one of the more than 100 cannabinoids found in the cannabis plant. According to New York-based investment bank Cowen & Co., the market for CBD last year ranged from $600 million and $2 billion in sales. Despite the size of this booming industry, it remains largely unregulated.

In a paper published Nov. 4 in the Journal of Analytical Toxicology, the researchers report that two out of six study participants tested positive after vaping cannabis that contained 0.39% THC using urine testing methods that are consistent with testing frequently performed for employment-related or criminal justice-related urine drug testing programs. Though the cannabis used in this study does not currently meet the federal definition of hemp, the THC concentration of 0.39% exceeds federal regulation by just 0.09%.

“People who use legal hemp products for medical intent rarely just use them once as we did in this study, and prior studies show that THC and its metabolites may accumulate with repeated use,” says postdoctoral fellow Tory Spindle, Ph.D., a researcher in the Behavioral Pharmacology Research Unit at the Johns Hopkins Bayview Medical Center. “What this means is that people need to be wary of single-dose or cumulative THC exposure and be aware that these now legal products may cause an unexpected positive result on a drug test.”

“Because the market for CBD products is so new and the popularity of use is growing so quickly, we want the public to be aware that a positive drug test is possible,” says Ryan Vandrey, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. Vandrey and his collaborators at the University of Pennsylvania previously showed in a JAMA study that 21% of CBD/hemp products sold on the Internet contained THC, even though it wasn’t listed on the product labels. “I have a hard time finding anyone who hasn’t used a CBD product at least once, but most are completely unaware of the possibility of THC exposure or a positive drug test as a result of using these newly legalized products,” says Vandrey.

Trials demonstrated CBD to be an effective treatment for two rare forms of pediatric epilepsy, however, there is currently insufficient evidence to support use for any other health condition according to the U.S. Food and Drug Administration. Despite this, CBD product suppliers and consumers claim benefits of CBD for a wide range of purposes, including everything from anxiety to insomnia to general wellness. CBD products can be swallowed in the form of an oil/tincture, eaten in a food product (e.g., gummy bears), inhaled using “vape pens” similar to electronic cigarettes, or applied topically to the skin in a cream, patch, balm or gel.

For the current study, the researchers recruited three women and three men with an average age of 31 years old. One participant self-reported as African American and the rest as white.

The batch of cannabis used in this particular study contained 10.5% CBD and 0.39% THC, a 27 to 1 ratio of CBD to THC that is similar to what is often found in legal hemp/CBD products. In the study, research volunteers vaporized a little less than 1 gram of cannabis, which contained a total dose of 100 milligrams of CBD and 3.7 milligrams of THC. To vape the cannabis, heated cannabis vapor was collected into a balloon that was then inhaled by the participant.

In addition to vaping the high CBD/low THC cannabis, study volunteers also were given pure CBD in a capsule, vaporized pure CBD and placebo (a mock CBD pill and vaporized cannabis in which CBD and THC had been removed) in three other dosing sessions, one week apart from each other. In all active drug conditions (excluding placebo), the CBD dose delivered was 100 milligrams per session.

The drug testing cut-off used to determine a “positive” result in this study was a “screening” concentration of at least 50 nanograms per milliliter of THCCOOH, a metabolite used to indicate whether someone has used cannabis, in the urine sample using an on-site “dipstick” test. A positive on that test was then “confirmed” at a 15 nanograms per milliliter cut-off of THCCOOH using a more sensitive test method.

Two of the six participants who vaped the low-THC/high-CBD cannabis tested positive for THCCOOH.

No positive urine drug test results were observed in the other test sessions (pure CBD capsules, pure CBD vape or placebo).

“These results suggest that pure CBD, used once by itself, will not cause a positive drug test,” says Vandrey. Adding to this, Spindle points out that it “does not take much THC exposure to trigger a positive test for some people.” There may be variation from person to person in drug metabolism and puffing behaviors such as inhalation depth, which might contribute to the breakdown or buildup of cannabinoids in the body, the researchers say.

The team says they plan to repeat their studies using products that fall within the current federal hemp regulations with respect to THC content, and additionally study the impact of repeated CBD/hemp exposure on drug testing outcomes.

Other authors on the study were Edward Cone and George Bigelow of Johns Hopkins, David Kuntz of Clinical Reference Laboratory, John Mitchell of RTI International and Ronald Flegel of the Substance Abuse and Mental Health Services Administration (SAMHSA).

This research was supported by SAMHSA and the National Institute on Drug Abuse (T32DA07209).

A small study concludes that caution is warranted for users of ‘high CBD, low THC’ cannabis products.

Can You Take CBD and Pass a Drug Test?

Not always, even though it’s legal. Here’s how to protect yourself.

The 26-year-old video producer from Reno, Nev., was shocked when a drug test he took as part of a job application came back positive for marijuana. The problem? He hadn’t used marijuana, he says. Instead, J.C., who prefers not to use his name, had taken CBD, or cannabidiol, from hemp to help with sleep and anxiety. And unlike THC, a related compound in cannabis plants, CBD can’t get you high.

“I thought I was in the clear,” J.C. says. “From everything that I had heard, CBD oil wasn’t supposed to show up on drug tests.”

CBD is going mainstream. Late last year Congress made CBD from hemp legal at the federal level. And it’s increasingly found on store shelves, now even sold in some CVS, Rite Aid, and Walgreens stores. An estimated 64 million people have tried CBD in the past 24 months, according to a January 2019 nationally representative survey by Consumer Reports of more than 4,000 adult Americans, using it for pain, insomnia, anxiety, and other health problems.

But as more people try it, one unexpected “side effect” could be failing an employer’s drug test, and even losing a job as a result.

Consider Bianca Thurston of Pennsylvania and Coni Hass of California. They are jointly suing Koi CBD, alleging that they failed drug tests because of the company’s CBD product; Thurston lost her job. Or Douglas Horn, a truck driver in New York who alleges that he lost his job after taking a CBD product made by Dixie (aka Dixie Elixirs).

Koi CBD told Consumer Reports in a statement about the lawsuit: “Koi prides itself on providing the highest-quality products while being a leader in the industry. We take claims regarding our products very seriously. We are investigating this matter and the allegations, which at this time, are unproven and unverified. We remain focused on continuing to carefully craft and offer a full array of beneficial cannabinoid products.”

Dixie Elixirs did not respond to a request for a comment.

So how can you fail a drug test after taking CBD? The urine test most commonly used doesn’t even look for CBD but instead a compound created by the body when it metabolizes THC, says Barry Sample, senior director of science and technology at Quest Diagnostics, the largest administrator of drug tests in the U.S. “There isn’t going to be a laboratory analytical false positive confusing CBD with a THC metabolite.”

But Sample says that CBD products could have more THC than the label claims. CBD products from hemp sold in retail stores and online aren’t supposed contain more than 0.3 percent THC, or tetrahydrocannabinol, the compound in marijuana that can get you high.

It’s also possible that over time, the small amounts of THC allowed in CBD products could build up in the body to detectable levels.

And while New York City recently passed a law that, starting May 10, 2020, will bar many employers from testing prospective employees for marijuana, that is still the exception, even in states that allow marijuana for medical or adult recreational use. In fact, more than half of employers test job applicants for it, says Kate Kennedy, spokesperson for the Society for Human Resource Management, an industry group. That can help companies lower costs for disability insurance and workers’ compensation. Some people who work for the federal government or military or as pilots, bus drivers, train conductors, or truck drivers are also subject to drug testing.

So if you use CBD, especially if you are applying for a job or work in a sensitive field, you should be aware of the possible need to pass a drug test. Here’s more on how to do it, as well as advice on how to avoid that problem or deal with a positive drug test because of CBD.

Mislabeled Products

CBD products often have more THC than claimed, research suggests. For example, a 2017 study in JAMA found that 18 of 84 CBD products, all purchased online, had THC levels possibly high enough to cause intoxication or impairment.

And those elevated levels might also be high enough to cause you not to pass a drug test.

That’s what Horn, the truck driver from New York, alleges happened to him after taking a product advertised to contain “zero THC.”

After losing his job because of the failed drug test, the lawsuit says Horn purchased a sample of the CBD product, had it tested, and found that, contrary to the claim, it did contain THC—enough, the lawsuit alleges, to cause a THC level in his urine of 29 nanograms per milliliter (ng/mL). That’s double the amount that typically triggers a positive result, says Sample at Quest Diagnostics.

Mislabeled CBD products are a growing problem for American workers, Sample believes. “It’s buyer beware,” he says. “There’s not always truth in labeling on the products.”

And he believes those high levels could be due in part to how THC levels are measured in hemp plants. While those plants are supposed to contain no more than 0.3 percent THC, that’s based on the dry weight of the plant. “But dry weight doesn’t necessarily equate to what’s in the finished product,” Sample says.

Plus, he says, in some cases that percentage is based on the weight of the whole plant, or on the weight of the buds or flowers, which tend to have more THC.

Adding to the confusion is that each state can determine how it samples and tests hemp plants for THC content, says Aline DeLucia, senior policy analyst for the National Association of State Departments of Agriculture. When sampling the hemp plant, “the closer you get to the flower, the higher the THC content. So some states collect the top 6 inches of the plant, while others do it differently,” DeLucia says. But “everybody is onboard that we need some kind of uniformity.”

And once CBD is turned into a “finished” product, such as an oil, a lotion, a tincture, a pill, or a vape liquid, few states dictate how those should be tested for THC, save for Oregon and soon Vermont. State agriculture departments, DeLucia says, don’t have jurisdiction over testing these products for safety.

Last, some states allow medical CBD products obtained through permitted channels to contain more than 0.3 percent THC. For example, the cutoff in Georgia and Virginia is 5 percent, Sample says, a level that is definitely high enough to cause impairment and a failed drug test.

Best bet: To increase the likelihood that a product doesn’t have more THC than claimed, look for a manufacturer that can provide a Certificate of Analysis, or COA, for its product. That document shows the results of a company’s testing for THC, CBD, and various contaminants. Though that testing is voluntary (except in Indiana and Utah) and the results aren’t confirmed by independent experts, for now it’s the best information available. If a store or website can’t provide you with a COA, look for another product. Read more about how CBD products are tested.

Small Amounts of THC Can Build Up

Many legitimate CBD products contain small amounts of THC. And when taken regularly over as little as four to six days, that THC can accumulate in the body, according to several studies.

That’s because THC is fat-soluble, says Norbert E. Kaminski, Ph.D., professor of pharmacology and toxicology at Michigan State University in East Lansing. So THC that isn’t immediately metabolized by the body will be stored in fat tissue. And “over time, THC and THC metabolites will be slowly released,” Kaminski says. As a result, it’s possible to test positive for THC and not pass a drug test, even after you’ve stopped taking the product.

Sample, at Quest Diagnostics, says that chronic, heavy users of marijuana could test positive even a month after they stop using it.

Best bet: Consider products that are claimed to be “CBD only” and have COAs showing that they contain zero THC. Also, you can try tracking your own THC levels with an at-home drug test, says Mitch Earleywine, Ph.D., a professor of psychology at the University at Albany, State University of New York, who has studied the medicinal use of CBD. If you test positive but need to be THC-free, consider taking a two- to three-week break from the product to clear THC from your system, he says.

What to Do If You Failed a Drug Test

Talk with your employer. That’s what worked for J.C., in Nevada, after he tested positive for marijuana use. Armed with documentation from his doctor that he was taking CBD to treat anxiety and insomnia, he met with company co-founder Matt Ross, chief operating officer of the Slumber Yard—a website that tracks user experiences with buying and using mattresses—and explained why he was taking it. He even took the bottle in for his employer to see.

“I wasn’t familiar with CBD at the time,” Ross says. But he and his partner appreciated that J.C. addressed the situation. “He was really talented as a video editor, and we felt comfortable enough to get past it.”

If that doesn’t work, try your company’s HR department. If your employer resists, you may be able to seek protection through the Americans with Disabilities Act and state disability laws. Those laws allows people with documented needs to get exceptions, or “reasonable accommodations,” to account for their medical situation. While the ADA does not apply to marijuana—because it remains illegal on the federal level, even for medical use—it’s still worth asking your company’s HR department, says James Reidy, an attorney at Sheehan Phinney Bass & Green who focuses on drug policy issues with employers. That’s because CBD from hemp is now legal on a federal level.

If you have any documentation from a medical provider, that can help, too. And you may have more luck if you live in Arizona, Arkansas, Connecticut, Delaware, Illinois, Maine, Massachusetts, Minnesota, New York, Pennsylvania, or West Virginia. Those states have passed laws providing some protection for people who use medical marijuana, potentially including CBD, Reidy says.

Other states, such as likeCalifornia, Montana, Oregon, and Washington have laws to assure that companies located in those states do not have to provide “reasonable accommodations” for people who use medical marijuana, and leave it up to each employer to decide, Reidy says. In those states, though, it’s still worth asking your company’s HR department about it if you’ve failed a drug test for marijuana after taking CBD.

Ask for a retest. If you’ve stopped taking CBD for a few weeks or longer, or took CBD infrequently, and still test positive for marijuana, consider asking for a retest. Though there are safeguards in place to prevent errors, Sample says, in rare cases they do happen.

In addition, some companies might set the threshold for THC very low to catch as many people as possible, Earleywine says. But doing so means the test can generate “some false positives, people who look as if they’ve used THC when they haven’t.”

Stop or skip using CBD products if faced with an upcoming drug test. That’s the only way to ensure that your CBD won’t trigger a positive test result for marijuana. And that includes stopping use of topical CBD lotions, oils, and cosmetic products, says Kaminski at Michigan State University. And it’s best to stop two to three weeks before the test, he adds. That should allow for enough time for any THC and THC metabolites to clear out of your system.

If you have to pass a drug test, you might want to skip taking CBD. Here’s why and how to protect yourself, with details from Consumer Reports on whether you can take CBD and pass a drug test.