Likelihood of Positive Urine Screens of THC-COOH After Daily Use of Full-Spectrum Hemp Extracts Varies as a Function of Screening Criterion Used.

The authors recruited nineteen daily users of retail oral hemp-derived CBD products (≤0.3% Δ9-tetrahydrocannbinol; THC) and collected urine samples that were screened for 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), a metabolite of THC. Urine samples were aliquoted into two samples-one that was subjected to immunoassay (IA) testing and the other shipped to a third-party laboratory for confirmation testing. Findings showed that the daily use of oral hemp-derived CBD extracts consistently resulted in positive urine IA screening results for THC-COOH at the 20 ng/mL detection criterion; however, positive results at the 50 ng/mL criterion were rare. Confirmation testing of each sample using LC-MS/MS analysis showed a positivity rate of 42% (range 37-178 ng/mL) at the >15 ng/mL criterion, which was intermediate to the two IA screening tests, suggesting that the IA 20 ng/mL and 50 ng/mL tests used are subject to high rates of false positive and negative results, respectively. Therefore, efforts should be made to increase public awareness regarding the risk of positive drug test results following oral hemp-derived CBD product use.