Creating Creatinine: How to Pass a Urine Drug Test
DOI:
https://doi.org/10.17140/NPOJ-7-126Keywords:
Urine drug screen; Urine drug test; Creatine; Creatinine; Detoxification.Abstract
Here we report on a patient that consumed recreational drugs, successfully passing a urine drug screen (UDS) by consuming a
marketed detoxification product. After some exploration of the product consumed, there proved to be a viable mechanism by
which the UDS outcome can be manipulated. The UDS relies on urine meeting specific concentration criteria to validate the sample. Dilute samples may mask the tested drugs as they fall below a concentration threshold for detection. Common UDS require a
specific gravity with a reference range of 1.003-1.035 and a urine creatinine concentration above 20 mg/dL. Participants are told
not to drink fluid for 4-5-hours pre-test to allow urine to concentrate above these thresholds. The 21-year-old female we describe
along with each UDS had lab drawings on two separate occasions in which both measurements revealed elevated serum creatinines of 1.8 mg/dL. She had ingested QCarbo Maximum Strength Same-Day Cleansing Formula™, a marketed detoxification
product, the day prior to the lab draws. The product recommended that the consumer ingest a large volume of water to “flush”
the drugs from the body. This resulted in dilution of her urine to cause the drug levels to fall below the detectable range, while still
exceeding the urine creatinine concentration to provide a valid test. Although she was unaware that this product increased both
serum and urine creatinine, this proved successful. She passed the test and was awarded the position.
References
Herbal Clean®. QCarbo 32oz 1 Step Maximum Cleanse. https:// herbalclean.com/products/qcarbo32-detox-drink. Accessed January 24, 2023.
Substance Abuse and Mental Health Services Administration (SAMHSA). Drug-free workplace guidelines and resources. https://www.samhsa.gov/workplace/resources. Accessed January 24, 2023.
Mendes RR, Pires I, Oliveira A, Tirapegui J. Effects of creatine supplementation on the performance and body composition of competitive swimmers. J Nutr Biochem. 2004; 15(8): 473-478. doi: 10.1016/j.jnutbio.2003.12.012
Villena VP. Beating the system: A study of a creatinine assay and its efficacy in authenticating human urine specimens. J Anal Toxicol. 2010; 34(1): 39-44. doi: 10.1093/jat/34.1.39
Kellum JA, Lameire N; KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013; 17(1): 204. doi: 10.1186/cc11454
Grauwiler SB, Drewe J, Scholer A. Sensitivity and specificity of urinary cannabinoid detection with two immunoassays after controlled oral administration of cannabinoids to humans. The Drug Monit. 2008; 30: 530-535. doi: 10.1097/FTD.0b013e318180c7c2
Franz S, Skopp G, Musshoff F. The effect of creatine ingestion on urinary creatinine concentration: Does supplementation mask a heavy dilution? Drug Test Anal. 2022; 14(1): 162-168. doi: 10.1002/ dta.3165
Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc. 1999; 31(8): 1108-1110. doi: 10.1097/00005768- 199908000-00005
Lugaresi R, Leme M, de Salles Painelli V, et al. Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet? J Int Soc Sports Nutr. 2013; 10(1): 26. doi: 10.1186/1550-2783-10-26
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