There’s been a lot of news about the wife of Indonesian comedian Bintang Emon testing positive for drugs, even though she doesn’t use drugs. She admitted to recently taking flu medication.
The news went viral; many media outlets asked whether the flu medicine contained drugs. Is it dangerous?
Professor Zullies Ikawati, a pharmaceutical expert at Universitas Gadjah Mada (UGM), explained this issue. She believes that conducting urine tests to detect drugs is crucial.
By conducting these tests, she explained that several compounds could be examined, including THC (marijuana), MET (methamphetamine), AMP (amphetamine), MOP (morphine), BZO (benzodiazepine), COC (cocaine), and DOMA (carisoprodol).
These compounds can be measured in urine samples using various analytical methods, with immunoassay and chromatography techniques being the most commonly used or, if possible, combined into immunochromatography.
Testing with these techniques is relatively quick and easy. The immunochromatography kit is a test strip based on immunochromatography. It results from the binding of antigen-antibody labeled with specific dyes so that it can be seen without requiring special equipment or personnel with special skills.
“Once again, testing with immunochromatography kits is fast, cheap, easy, and relatively accurate. With this method, drug substances or their metabolites can be detected,” Professor Ikawati said on Thursday (May 2).
“Immunoassay tests are quite sensitive and specific to certain substances, but they can also be susceptible to false positives due to cross-reactivity with other substances with similar chemical structures.”
Furthermore, Professor Ikawati explained that several legal and commonly used drugs are known to cause false positives in drug urine tests using immunoassay methods due to their chemical structures resembling illicit substances.
In some reports on Bintang Emon’s wife’s case, it was mentioned that the medication consumed was flu medicine, namely Nalgestan and Actifed.
These flu medications contain decongestant drugs such as phenylpropanolamine and pseudoephedrine, antihistamines such as chlorpheniramine maleate and triprolidine, and cough medicines like dextromethorphan.
Some of these drugs belong to the amino compound category, which has structural similarities to some drugs in the narcotic group.
“So, it’s not surprising if they yield false positives in drug screenings,” she said.
Here are some other examples of drugs known to cause false positives in specific situations: pain relievers and anti-inflammatory drugs like Ibuprofen can show false positives for marijuana (THC). Naproxen (Aleve) can also show false positives for THC.
In cough and cold medications, the presence of dextromethorphan, found in many over-the-counter cough medicines, can yield false positives for opiates or phencyclidine (PCP). Pseudoephedrine (found in decongestants) can show false positives for amphetamines.
In antidepressants, drugs like Sertraline (Zoloft) can show false positives for benzodiazepines or LSD. Bupropion (Wellbutrin) can show false positives for amphetamines. And in antipsychotic medications, drugs like Quetiapine (Seroquel) can show false positives for methadone or tricyclic antidepressants.
Other drugs include Ranitidine (Zantac), a stomach acid reducer, which can show false positives for methamphetamine or amphetamine. Trazodone, commonly used as a sleep aid or antidepressant, can yield false positives for amphetamines or methamphetamine.
In antihistamines, Diphenhydramine (Benadryl) can sometimes show false positives for methadone, opioids, or PCP. In anticonvulsants, drugs like Phenytoin (Dilantin) and carbamazepine can also show false positives for barbiturates or opioids.
Professor Ikawati reiterated that these false positives can occur due to chemical cross-reactivity between these drugs and the antibodies used in immunoassay tests to detect drugs.
Therefore, it’s crucial to understand that the likelihood of false positives depends on the specificity and sensitivity of the immunoassay kit used and other specific conditions during testing.
“If the initial urine test results are positive in the initial screening, it is usually recommended to confirm the test using methods like GC-MS (Gas Chromatography-Mass Spectrometry) or LC-MS (Liquid Chromatography-Mass Spectrometry) to verify these results,” she explained.
Professor Ikawati mentioned that confirmation tests can differentiate between actual drugs and other substances that may have similar chemical structures.
Chromatography, especially when combined with mass spectrometry, is a highly accurate method for confirming positive results from initial screening tests like immunoassays.
GC-MS is the gold standard in drug testing due to its high accuracy and reliability. This method can precisely identify and quantify drug substances in samples by separating chemical components and identifying each based on mass and molecular structure.
However, this method is more expensive, requires specialized equipment and time, and is usually performed in a laboratory after initial tests indicate positive results.
This process is essential to ensure that the initial positive results are accurate and not due to interference from other substances or specific conditions that can cause false positives.
“Combining these two methods helps improve the accuracy and reliability of drug urine tests,” she concluded.
So, how can false positives like what happened to Bintang Emon’s wife, who experienced a false positive drug test result, be prevented? Professor Ikawati revealed that this can occur due to ignorance or unpreparedness during testing.
If a drug test is planned, such as for school or job applications, it is advisable to avoid using other medications before the drug test. However, if the test is done suddenly, inform the testers about any medications consumed to anticipate false positives.
“If necessary, the drug test can be repeated after a few days to allow the elimination of other drugs from the body,” she said.
Professor Ikawati emphasized that drugs that yield false positive results cannot be said to contain narcotics and be dangerous. It cannot be concluded that these drugs contain drugs. As for their danger, it also cannot be generalized and depends on the type of drug.
“However, these drugs, if used for their intended purposes, are not dangerous. Components of flu medication, for example, are over-the-counter and non-addictive drugs. So, there’s no need to worry. Use drugs legally and correctly according to doctor’s instructions or information on drug packaging,” she advised.
Author: Agung Nugroho
Photo: Freepik.com