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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 CBD make you fail a drug test?

Drug tests identify tetrahydrocannabinol (THC) or its metabolites. Although these tests do not screen for CBD, some CBD products contain low quantities of THC that could theoretically make a person fail a drug test.

CBD products derive from hemp, a federally legal low-THC type of cannabis. While some CBD products claim to contain no THC, contamination may have occurred during the manufacturing process. In some cases, the manufacturer’s labeling may be incomplete.

Keep reading to learn whether CBD shows up on a drug test.

Share on Pinterest While drug tests do not screen for CBD, its presence may cause a person to fail.

Cannabis sativa is an extremely versatile plant that growers cultivate for numerous purposes, ranging from food, such as hemp seed, hemp-based construction materials, and medicinal and recreational uses.

Researchers have identified over 400 chemical compounds in the cannabis plant, of which about 80 are biologically active.

The most important biologically active compounds in cannabis are cannabinoids. These compounds are specific to the cannabis plant and appear nowhere else in nature.

Some of the more abundant cannabinoids include THC, CBD, cannabigerol (CBG), cannabinol (CBN), and cannabichromene (CBC).

THC is the primary psychoactive compound in cannabis and is intoxicating. CBD does have some psychoactive effects, which is why researchers are studying its potential in treating mental health conditions, such as depression and anxiety. However, it does not have the same intoxicating properties as THC.

The Food and Drug Administration FDA state that products that contain more than 0.3% THC are illegal, and the United States Drug Enforcement Agency (DEA) list them as a Schedule I drug.

THC binds to receptors in different parts of the brain. These receptors normally attach to the endocannabinoids, which are natural compounds that the human body produces.

The following table lists areas in the brain that THC targets and its effects:

Brain area Effect
Hippocampus impairs short-term memory
Neocortex impairs judgment and sensations
Basal ganglia alters reaction time and movements
Hypothalamus increases appetite
Nucleus accumbens causes euphoria
Amygdala causes panic and paranoia
Cerebellum causes a feeling of being drunk
Brainstem controls nausea and vomiting
Spinal cord reduces pain

CBD does not seem to bind to the same receptors as THC.

Scientists are still unsure how CBD exerts its effects, but they think it might boost endocannabinoid levels or bind to serotonin receptors. Serotonin is a hormone that regulates mood, happiness, and anxiety.

In animal and preliminary human studies, CBD has demonstrated some potential therapeutic effects, including:

  • reducing inflammation
  • relieving pain
  • controlling anxiety
  • controlling psychosis
  • promoting neuroprotection
  • preventing vomiting

According to a 2020 article, urine drug tests usually target the following substances:

  • alcohol
  • amphetamines
  • benzodiazepines
  • opiates
  • cocaine
  • cannabis

The urine test is the most common diagnostic test for cannabis. The urine drug screen is an “immunoassay test,” which uses antibodies designed to latch on to specific drugs or their metabolites — in this case, the presence of THC and its metabolites.

If the antibodies identify a drug, they will produce a signal that shows the test as “positive.”

According to an article in American Family Physician (AAFP), the federal government sets drug concentration levels for urine drug screening.

If a test detects a drug under this concentration threshold, it will return a negative result. If a person tests positive on the screening test, they may have to undergo a follow-up test.

Confirmatory tests, such as gas chromatography and mass spectroscopy or high-performance liquid chromatography, are more accurate in detecting drugs and their metabolites.

Doctors must take great care when analyzing the results of a positive cannabis test since false-positive and false-negative results are possible.

People who unexpectedly test positive on a urine drug screen should speak with their doctor.

The AAFP note that the test may detect weed for 3 days after a single use and more than 30 days after heavy use.

This occurs because THC is soluble in fat the body stores it in the fat compartments of the body. As a person burns or recycles this fat, it slowly releases the THC, and the kidneys eliminate it and its metabolites.

Researchers are also interested in using breath and saliva tests to detect cannabis in certain situations outside of the laboratory.

In theory, traffic police could use breath tests to check for impaired driving on the road. However, this technology is new and not yet fully understood.

For more information and resources on CBD and CBD products, please visit our dedicated hub.

Theoretically, people can fail a drug test if they consume a CBD product that also contains THC.

CBD-rich products derive from cannabis or hemp, both of which contain the full spectrum of cannabinoids, including THC.

In a 2019 analysis of 67 CBD-containing food products in Germany, researchers found that 25% of the samples contained THC above the 2.5 milligrams-per-day dose associated with intoxicating side effects.

Although manufacturers may state that they eliminate the THC from their products, this may not be the case. Sometimes, the product has not been third-party tested or is inappropriately labeled, misrepresenting the actual THC dose.

People can also receive a false-positive result for cannabis or THC on a urine drug screen if they use other drugs, including:

  • dronabinol
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and sulindac
  • pantoprazole
  • efavirenz

One study in the Journal of Analytical Toxicology demonstrated that people exposed to passive, or second-hand cannabis smoke, can test positive on a saliva drug test.

Cannabis-free volunteers sat in an unventilated room for several hours with five people who each smoked one cannabis cigarette.

The researchers detected THC in the saliva of each of the cannabis-free volunteers, but these amounts declined over the time spent in the room. Researchers do not know whether exposure to second-hand cannabis smoke will produce a positive saliva test outside of the study environment.

An older study tested whether second-hand cannabis smoke can result in a positive urine drug screen.

The researchers collected 80 urine samples 24 hours after they exposed cannabis-free participants to second-hand cannabis smoke. Only two samples tested positive, but none tested at or above federal thresholds.

It is possible to fail a drug test from taking CBD as some CBD products contain THC. Learn more here.