Patient's positive fentanyl tests traced to fentanyl-laced street cannabis

A 50-year-old man in opioid addiction treatment kept testing positive for fentanyl despite abstaining from opioids. The source was traced to his street-purchased cannabis, and switching sources resolved the fentanyl-positive tests.

Hopwood, Taylor et al.·Journal of the American Pharmacists Association : JAPhA·2020·Preliminary EvidenceCase Report
RTHC-02615Case ReportPreliminary Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

A patient receiving buprenorphine for opioid use disorder repeatedly tested positive for fentanyl on urine drug screens while denying opioid use but admitting to smoking street cannabis 2-3 times weekly. After changing cannabis sources, fentanyl tests became negative and remained so.

Key Numbers

Patient was 50 years old, using cannabis 2-3 times weekly for headache relief and sleep. Fentanyl-positive UDS resolved after changing cannabis source. Stable on buprenorphine afterward.

How They Did This

Single case report from an office-based opioid treatment program documenting the timeline of fentanyl-positive urine drug screens in relation to cannabis source changes.

Why This Research Matters

This case demonstrates that fentanyl contamination of street cannabis is a real phenomenon that can complicate addiction treatment and put cannabis users at risk of unintentional opioid exposure.

The Bigger Picture

As the fentanyl crisis intersects with the unregulated cannabis market, this case highlights the harm reduction argument for regulated cannabis sources that can be tested for contaminants.

What This Study Doesn't Tell Us

Single case report with limited generalizability. No laboratory testing of the cannabis itself was performed. The frequency of fentanyl contamination in street cannabis is unknown.

Questions This Raises

  • ?How common is fentanyl contamination of street cannabis?
  • ?Should addiction treatment programs consider cannabis adulteration when interpreting drug screens?
  • ?Would legal cannabis access reduce this risk?

Trust & Context

Key Stat:
Fentanyl-positive tests resolved after changing cannabis source
Evidence Grade:
Preliminary: single case report.
Study Age:
Published in 2020 in Journal of the American Pharmacists Association.
Original Title:
Unintentional use of fentanyl attributed to surreptitious cannabis adulteration.
Published In:
Journal of the American Pharmacists Association : JAPhA, 60(6), e370-e374 (2020)
Database ID:
RTHC-02615

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

Describes what happened to one person or a small group.

What do these levels mean? →

Frequently Asked Questions

Is fentanyl-laced cannabis common?

The case report notes that there is no systematic monitoring or reliable data on the frequency of cannabis adulteration with fentanyl. This case demonstrates it can occur, but how often is unknown.

Why would cannabis be laced with fentanyl?

The case does not determine why, and intentional lacing versus cross-contamination during handling is unclear. In unregulated drug markets, products can become contaminated at any point in the supply chain.

Read More on RethinkTHC

Cite This Study

RTHC-02615·https://rethinkthc.com/research/RTHC-02615

APA

Hopwood, Taylor; Dowd-Green, Caitlin; Mason, Melissa; Stewart, Rosalyn W. (2020). Unintentional use of fentanyl attributed to surreptitious cannabis adulteration.. Journal of the American Pharmacists Association : JAPhA, 60(6), e370-e374. https://doi.org/10.1016/j.japh.2020.07.003

MLA

Hopwood, Taylor, et al. "Unintentional use of fentanyl attributed to surreptitious cannabis adulteration.." Journal of the American Pharmacists Association : JAPhA, 2020. https://doi.org/10.1016/j.japh.2020.07.003

RethinkTHC

RethinkTHC Research Database. "Unintentional use of fentanyl attributed to surreptitious ca..." RTHC-02615. Retrieved from https://rethinkthc.com/research/hopwood-2020-unintentional-use-of-fentanyl

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.