A common heartburn medication caused a false-positive cannabis test in a 13-year-old with cyclic vomiting
A 13-year-old girl with cyclic vomiting syndrome received a false-positive cannabinoid urine screen caused by intravenous pantoprazole, highlighting a drug interaction that mimics CHS screening.
Quick Facts
What This Study Found
A 13-year-old with recurrent episodic vomiting was being screened for cannabis use because clinicians increasingly consider cannabinoid hyperemesis syndrome (CHS) in patients with cyclic vomiting. After receiving intravenous pantoprazole (a proton pump inhibitor) for her GI symptoms, her urine cannabinoid screen came back positive.
This was determined to be a false positive caused by the medication. The pantoprazole package insert references this potential interference, but the phenomenon had not been documented in the published medical literature. The interaction is particularly problematic because patients with cyclic vomiting are both likely to receive PPIs and likely to be screened for cannabis.
The case highlights the importance of confirming positive immunoassay results with more specific testing methods before attributing vomiting to cannabis use.
Key Numbers
One patient, age 13. False positive caused by intravenous pantoprazole (a PPI). The interference is documented in the pantoprazole package insert but not in published medical literature prior to this case.
How They Did This
Single case report describing a false-positive cannabinoid urine screen in a pediatric patient with cyclic vomiting syndrome who received intravenous pantoprazole, with discussion of the clinical implications.
Why This Research Matters
As CHS awareness grows, more vomiting patients are being screened for cannabis. If a common medication can cause false-positive results, patients could be wrongly diagnosed with CHS, leading to inappropriate treatment recommendations and potentially ignoring the true cause of their symptoms.
The Bigger Picture
Drug testing accuracy matters enormously when the result changes the diagnosis. As CHS becomes a more common consideration in emergency departments, understanding that common medications can cause false-positive cannabis screens prevents misdiagnosis.
What This Study Doesn't Tell Us
Single case report. The mechanism of the false positive is not fully explained. It is unclear whether oral pantoprazole or other PPIs cause the same interference. Prevalence of this false-positive result is unknown.
Questions This Raises
- ?How common are PPI-induced false-positive cannabis screens?
- ?Do all PPIs cause this interference or only pantoprazole?
- ?Should confirmatory testing be standard before diagnosing CHS based on a positive screen?
Trust & Context
- Key Stat:
- Pantoprazole caused false-positive cannabis urine screen
- Evidence Grade:
- Single case report documenting a previously unpublished drug-test interference.
- Study Age:
- Published in 2015. Awareness of PPI-cannabinoid screen interference may have improved since.
- Original Title:
- 13-year-old girl with recurrent, episodic, persistent vomiting: out of the pot and into the fire.
- Published In:
- Pediatrics, 135(4), e1060-3 (2015)
- Database ID:
- RTHC-00954
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
Can medications cause false-positive cannabis tests?
Yes. In this case, the PPI pantoprazole caused a false-positive cannabinoid urine screen in a 13-year-old. The interference is noted in the drug's package insert but was not previously documented in medical literature.
How can false positives be avoided?
Positive immunoassay screening results should be confirmed with more specific testing methods like GC-MS or LC-MS/MS. Clinicians should also consider what medications the patient is taking before interpreting results.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-00954APA
Felton, Diana; Zitomersky, Naamah; Manzi, Shannon; Lightdale, Jenifer R. (2015). 13-year-old girl with recurrent, episodic, persistent vomiting: out of the pot and into the fire.. Pediatrics, 135(4), e1060-3. https://doi.org/10.1542/peds.2014-2116
MLA
Felton, Diana, et al. "13-year-old girl with recurrent, episodic, persistent vomiting: out of the pot and into the fire.." Pediatrics, 2015. https://doi.org/10.1542/peds.2014-2116
RethinkTHC
RethinkTHC Research Database. "13-year-old girl with recurrent, episodic, persistent vomiti..." RTHC-00954. Retrieved from https://rethinkthc.com/research/felton-2015-13yearold-girl-with-recurrent
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.