A drug metabolite is a remnant of the drug after being broken down by the body, and the most common metabolizer of a medication is the liver. Prescription methamphetamine (Desoxyn) is composed entirely of the d isomer. Furthermore, if they can prove they are taking a medicine that can produce a false positive (by producing a legitimate prescription), the administrator may schedule another test 30 to 60 days later. eCollection 2023. Patient variability in body mass, urine pH and concentration, and renal and hepatic function can also affect the detection window. With a valid prescription, an appointed Medical Review Officer (MRO) can rule out false positives. Would you like email updates of new search results? What Can Cause A False Positive For Methamphetamemes . . Antihistamines and some sleep aids containing diphenhydramine (like Benadryl) could cause a false positive result for PCP or methadone. Can OTC and prescription drugs affect a pregnancy test? Prescription methamphetamine (Desoxyn) is composed entirely of the d isomer. False-positive results Due to the potential for cross-reactivity associated with immunoassay urine drug screens, several prescription and non-prescription drugs have been reported to cause false-positive results. you should drink of water per day. There are 2 main methods for urine drug testing, screening and confirmatory.2 Immunoassay testing is primarily used for initial screening. What exactly is Captagon and why was it banned? False positive for Methamphetamines is quite common because some amphetamine (AMP) and Methamphetamine urine immunoassay (IA) kits are prone to false-positive results due to poor specificity of the antibody according to a study published in the Journal of Analytical toxicology. Alcohol in hand sanitizer (from heavy use), certain liquid medications, and mouthwash or other breath cleaning products could cause you to test positive for drinking alcohol. and transmitted securely. sharing sensitive information, make sure youre on a federal Barbiturate tests are generally reliable, and false-positives and -negatives are rare.5 Similarly, immunoassays for cocaine are sensitive and specific. Adderall. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. All Rights Reserved. Many of the over-the-counter drugs that are used to treat ADD and ADHD have components that are similar to those found in methamphetamine 3.Ritalin, Adderall and Dexedrine may all cause someone to have a false-positive drug test for meth 1. Drug-free workplace guidelines and resources. Before False positive results for methamphetamine occur about 10 to 15 times out of 100 tests and it is usually due to one major reason, Insufficient Laboratory Tests for Confirmation, although other reasons can be added. 2023 Jan 5;2023:4370648. doi: 10.1155/2023/4370648. Does Zantac (ranitidine) cause false positives for methamphetamine? Small doses have central stimulant effects without significant peripheral actions. A false positive means that the test has detected the presence of these substances in your body when you havent actually taken them. This is a tricyclic antidepressant used for chronic pain, neuropathy (nerve pain), depression, and migraine prevention. , including the frequency of drug use and the how fast the drug is metabolized by the body. When consumed in large quantities (such as in a poppy seed bagel or muffin), the tiny black seeds might cause a false positive drug result for opioids. As noted, the first test is the IA screening test. Brief Summary: Background: - Some legal over-the-counter drugs (such as Vicks VapoInhaler ) and some foods (such as poppy seeds) may cause a positive screening drug test. Desoxyn [package insert]. D-methamphetamine increases alertness, concentration, energy, and in high doses, can induce euphoria, enhance self-esteem, and increase libido. These traits make d-methamphetamine very attractive to a potential abuser. Accessed April 8, 2021. Dimetapp (Brompheniramine) However, IA drug screens have limited sensitivity and specificity due in part to capture antibody cross-reactivity with structurally similar interfering compounds, producing false-positive results. Some examples include NSAIDs, dextromethorphan, and some antidepressants. New DOT Drug Testing Cutoff Levels 2021/2022. Clipboard, Search History, and several other advanced features are temporarily unavailable. A positive methamphetamine test could be caused by use of an OTC product, a prescription drug, or illicit use (Table 1). The laboratory may run up to 3 distinct tests to produce a complete amphetamine profile. Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens. A saliva test can identify meth within 10 minutes after use, and it will produce positive results up to four days later If there has been an overdose, flumazenil can be used as a Table 1 Approximate detection times for a urine drug screen and substances causing false-positives Drug Detection Window Substance Causing False-Positives Alcohol 2 . False-positive results can be due to a laboratory error, but the most common reason for a false-positive methamphetamine test is other medications or substances that have a similar structure to methamphetamine. that you have taken it.. This information is intended as an educational piece and should not be used as the sole source for clinical decision making. Methamphetamine has 2 isomers, d-methamphetamine and l-methamphetamine. If, under their physicians approval, the person can be off the medicine for that length of time, a negative test should result.. What Can Cause A False Positive For Methamphetamines? Updated March 15, 2021. Federal government websites often end in .gov or .mil. This means you're not pregnant but the test says you are. False-negative results . Many medicines you can purchase at your local chemist containing pseudo-ephedrine, ephedrine, or other sympathomimetic amines tend to interfere with urine screening tests and cause false positive results for amphetamines, but do not cause positive test results in the gas chromatography/mass spectrometric, or GC/MS, confirmation, thus pose no . 2021 Nov 30;2021:7134394. doi: 10.1155/2021/7134394. Grunbaum AM, Rainey PM. 2017 May;92(5):774-796. doi: 10.1016/j.mayocp.2016.12.007. Tonic water contains quinine, and when consumed in large amounts could lead to false positive results for opiates. trigger a false positive urine result for opiates. Immunoassay technology uses antibodies to detect drug metabolites. UIC's seven health sciences colleges and health care delivery enterprise. 11 /11. Heres what you should know if youre prescribed this antibiotic. The implications of potential false-positive urine drug screen (UDS) results for patients receiving commonly prescribed medications were evaluated. Comprehensive Psychiatry, 94, 152126. https://doi.org/10.1016/j.comppsych.2019.152126. hCG is produced by the placenta and is present in urine from . Case Reports of Aripiprazole Causing False-Positive Urine Amphetamine Drug Screens in Children. Standridge JB, Adams SM, Zotos. Pseudoephedrine: Used for sinus and nasal congestion, pseudoephedrine (Sudafed) can be the cause of false positive tests for amphetamine or methamphetamine. Avoid smoking, alcoholic beverages, and unnecessary medications. Ferguson M, Borowiak E. Ask the Expert: False Positive Amphetamine Urine Screens. Summary. Verification of the test results with a different screening test or additional analytical tests should be performed to avoid adverse consequences for the patients. Nelson ZJ, Stellpflug SJ, Engebretsen KM. Rifampin, an antibiotic used to treat tuberculosis, can also lead to a false positive. Frequency of false positive amphetamine screens due to bupropion using the Syva EMIT II immunoassay. There are several instances where you may be asked to complete a drug testemployers may require one when youre applying for a new job, or if you are a student or an athlete. 8600 Rockville Pike PMC For this reason, immunoassay testing should be considered preliminary and presumptive. January 23, 2017. Amphetamines are central nervous system stimulants that cause a reaction of of amphetamine-containing drugs . If youre taking labetalol, you could have a false positive test for amphetamine, methamphetamine, or LSD. In addition to prescription medications, these other common substances can lead to a false positive drug test. https://www.uspharmacist.com/article/urine-drug-screening-minimizing-false-positives-and-false-negatives-to-optimize-patient-care#:~:text=The%20FGAs%20chlorpromazine%2C%20prochlorperazine%2C%20haloperidol,cause%20false%2Dpositive%20LSD%20results.&text=Thioridazine%20may%20additionally%20cause%20false,in%20structure)%20and%20methadone%20results. In our latest question and answer, the pharmacist discusses what over the counter and prescription drugs can cause false positives for methamphetamine on drug tests. International Agency for Research on Cancer - Screening Group. Accessed April 8, 2021. However, this is not the case. Labetalol: Labetalol (Trandate) is both an alpha- and beta-blocker drug used for blood pressure control. Morgantown, WV: Somerset Pharmaceuticals, Inc.; 2012. Immunoassay tests have a significant problem with 'cross-reactivity'. Pediatrics. 833 S. Wood St., Suite B12, College of Pharmacy, (MC 886), Chicago, IL 60612, 2023 The Board of Trustees of the University of Illinois, UI Health is UICs academic health enterprise. Labetalol can also cause a false positive for amphetamine or methamphetamine because a labetalol metabolite is structurally similar to amphetamine. Off-label Use of Pain Treatment No Longer Covered by Insurance, Musculoskeletal Ultrasound: A Primer for Primary Care, The Next Barriers to Care: Your Local Pharmacy, Why Podiatric Medicine Must Embrace Pain Management. The first test is an immunoassay (IA) screening test for the amphetamine class of medications, which includes both amphetamines and methamphetamines. When a patients urine drug screen tests positive for methamphetamine by mass spectrometry, the result has serious implications for the patient and the provider. To quote a study published in the Journal of Clinical Biochemistry, " commonly used soap and wash products used for newborn and infant care as potential causes of false positive THC screening results .". University of Illinois at Chicago College of Pharmacy. August 18,2016. . , and other over-the-counter cough suppressants, may cause a drug screen to be positive for opiates and/or PCP. Cincinnati, OH: Procter & Gamble; 2010. " - Michael Lohan !!!. Moeller KE, Kissack JC, Atayee RS, Lee KC. The Adderall will show up as a false positive for Methamphetamines. The third and final test is the methamphetamine d,l-isomer test by MS (Figure 2). Urine drug testing is frequently performed by immunoassay (IA) due to ease of use, rapid turn-around time and the ability to screen multiple drug classes. DISCLAIMER: The topics and articles published on this website including text, graphics, videos info graph and other material are for informational purposes only and should not be substituted for professional medical advice. Unable to load your collection due to an error, Unable to load your delegates due to an error. Conclusion: Thats because common. The https:// ensures that you are connecting to the This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Pharmacy names, logos, brands, and other trademarks are the property of their respective owners. In 1998, the DHHS increased the cutoff for opiates from 300 ng/mL to 2000 ng/mL to avoid false positive tests from poppy seed ingestion, as well as routine prescription drug use. The temperature of urine should be between 90 to 100 degrees Fahrenheit measured within 4 minutes of collection; the pH should be consistent with the range of 4.5 to 8; the specific gravity should be between 1.002 and 1.030; and the creatinine should be greater than 20 mg/dL. Usually, an immunoassay screening test for methamphetamine is a methamphetamine/amphetamine combined test, so will detect any medication or substance that resembles methamphetamine OR amphetamine. doi: 10.7759/cureus.19082. Drug detection times The drug has been linked to false-positive drug test results for amphetamine. If I took 1/4 of a 5mg tablet in the morning and had a urine drug test that afternoon will it show positive even if only a trace? The pain medication, . Ritalin (methylphenidate) and Adderall are used to treat ADHD, and are well known to cause a false positive for amphetamines and methamphetamines. Rifampin, an antibiotic used to treat tuberculosis, can also lead to a false positive result for opiates. The weight loss drug phentermine, may produce a false positive drug test. Analytes and their cutoffs. Certain antidepressant drugs are more prone to false-positive readings. There are chances that they show up as false positives for AMP during the test. A retrospective chart review of 10,011 urine drug screens found that of 362 initial positive amphetamine tests, 128 (35%) were false positives. Ofloxacin has also been shown to cause a false positive test for amphetamine or methamphetamine. Purpose. Its important to note that no drug test is 100% accurate. Epub 2014 Jul 1. could make you test positive for barbiturates and THC (marijuana/cannabinoids); and ibuprofen can also make you test positive for PCP. ) CBD is the non-psychoactive portion of the marijuana plant that has become a very popular remedy for everything from pain control, to promoting sleep, to helping relieve anxiety. If the screening test is positive (a reaction greater than the cutoff), then a mass spectrometry (MS) confirmation test is performed to determine which specific compounds, amphetamine and/or methamphetamine, are present. 2,6 In addition to medications, several other substances have been associated with false-positives, such as baby wash products, supplements, and food. Accessed October 9, 2012. Didrex is metabolized to methamphetamine. Drug tests are also performed in the workplace to identify illicit substance abuse. Results from such tests should be confirmed using additional analytical methods, including gas chromatography-mass spectrometry. Additionally, drugs can be detected in the urine for a longer duration compared to blood or serum, and the concentration is typically higher. According to one, , false positive drug tests are most commonly reported for amphetamine and methamphetamine. Epub 2017 Mar 18. Pract Pain Manag. False-negatives and false-positives from immunoassays can lead to adverse consequences for patients and providers. Laboratory principles. The aim of this paper is to report the first case of atomoxetine leading to false-positive urine drug screen. Aripiprazole causing false positive urine amphetamine drug screen in an adult patient with bipolar disorder. Cureus. She took the medicine twice a day (at 8 am and 8 pm), and the last dose was administered 9 hours before ED access. Besides prescription sources, methamphetamine (ie, crystal meth) can also be produced in small, clandestine laboratories using ephedrine or pseudoephedrine as a key ingredient. The DHHS cutoff values were developed for adults, and lower thresholds should be used for infants. Metformin. , its highly unlikely that secondhand smoke will cause a false positive test for marijuana. Pseudoephedrine. Common medications that contain hCG include Pregnyl, Profasi, Novarel, and Ovidrel. Abstract and Figures. Epub 2015 Nov 2. Dextromethorphan, the active ingredient in Robitussin-DM, Delsym, and other over-the-counter cough suppressants, may cause a drug screen to be positive for opiates and/or PCP. These tests do not use antibodies and can accurately determine the exact molecule being looked for. 2011 Jun;7(2):105-8. doi: 10.1007/s13181-010-0131-5. Vicks VapoInhaler [package insert]. . Updated: 6:28 PM MDT May 25, 2016. Benzodiazepines also are regulary missed on enzyme immunoassay screens. Several medications can produce a false-positive result for methadone on the urine drug screen: diphenhydramine, doxylamine, clomipramine, chlorpromazine, quetiapine, thioridazine, and verapamil. Eldepryl [package insert]. Accessed October 4, 2012. For example, testing for medication adherence would necessitate lower thresholds. What Medications Can Cause A False Positive For Methamphetamemes Online Shop Are Blood Pressure Meds Fast Acting Rubbing Neck To Lower Blood Pressure Horse Chestnut And Blood Pressure Meds What Helps High Blood Pressure Go Down What Medications Can Cause A False Positive For Methamphetamemes.. And counting the time, it has been blood pressure meds and chronic cough nearly a day since what . Murray EP, Mansy L, Lackey JT, Link RC, Bonanni S, Sorensen AA. All of the following medications have documented cases of causing a false positive for either amphetamine or methamphetamine: Amantadine. J Anal Toxicol. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. Hair strand drug tests detect the presence of drug metabolites in the follicle. A possible false-positive test result for methamphetamine occurred during the laboratory testing of a parolee's urine. Based on a 1991 Department of Health and Human Services Technical Advisory, a d-methamphetamine level that is >20% of the total is considered indicative of a source other than an OTC product or a metabolite of selegiline. These sources could include a prescription medication or illegally manufactured methamphetamine. Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole) are used to treat gastroesophageal reflux disease (GERD) or peptic ulcer disease (PUD) and can cause a false positive for THC. Medically reviewed by Carmen Fookes, BPharm. What Does A Faint Line On A Drug Test Mean? Liquid chromatography/tandem mass spectrometry (LC-MS/MS) is an alternative to GC-MS and may be more time efficient. Esposito FM, Crumpton S, Mitchell J, Flegel RR. The immunoassays can cross-react with commonly used medications or its metabolites and show a false positive level for substances that are banned by an employer. Labetalol: Labetalol (Trandate) is both an alpha- and beta-blocker drug used for blood pressure control. Furthermore, if they can prove they are taking a medicine that can produce a false positive (by producing a legitimate prescription), the administrator may schedule another test 30 to 60 days later. For this reason, immunoassay testing should only be considered preliminary and should be followed up by confirmatory testing whenever a test comes back positive. Quinolone antibiotics, such as Levaquin (levofloxacin) or Cipro (ciprofloxacin) are commonly prescribed for certain infections (urinary tract, sinus, etc.). This prescription antibiotic works well and quickly to treat UTI, but it does have side effects. Hows long is Valium detectable in the system? Poppy seeds. The commonly prescribed antidepressant, trazodone, has been reported to cause false positives in 3,4-methylenedioxymethamphetamine (MDMA) UDSs. Conclusion. An official website of the United States government. Urine tests can detect more recent drug use, while hair follicle . Many drug abusers will make the commitment to stop, and you therefore need an accurate test to verify and confirm this. A 2008 study by the Mayo Clinic found multiple substances that could . 6. doi: 10.1002/emp2.12702. Accessed April 8, 2021. are commonly prescribed for certain infections (urinary tract, sinus, etc.). Methods for urine drug testing Public Health Nigeria Public Health Nigeria an Interdisciplinary public health movement focused on health education, advancing fair public health policies, promoting fitness, healthy diets, responsible behavior, community health and general wellbeing. Although this is not a high percentage, the consequences for failing a drug test could jeopardize your career, education, or job prospects. They can distinguish between the l- and d-isomers of methamphetamine (only the d-isomer is psychoactive and illegal). A number of routinely prescribed medications have been associated with triggering false-positive UDS results. quinine, and when consumed in large amounts could lead to, Coca tea is made from coca leaves, which are part of the coca plant from which. Based on how urine drug tests work, it makes sense that anticonvulsant drugs have a . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). WebMD.com says between 5 - 10% of people will fail due to a false positive drug test. For example, if donor were to claim that they had a methamphetamine positive because they used a Vicks inhaler, then the lab can order a d/l isomer separation to determine if the drug present in the specimen is at least 80% l-methamphetamine. Common over-the-counter anti-inflammatory pain medications such as. Nationwide Testing Association Inc. https://ntatesting.com/did-a-vicks-inhaler-cause-my-positive-test/. About 5% Of All People Fail Their Test, Are Not Guilty And Must Then Prove Their Innocence. Additionally, you can ask to take a more accurate and conclusive test that can detect drug compounds in a specific manner such as gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC). I would counsel [anyone who received a false-positive test to ask] the administrator to do a more specific test, says Dr. McFadden, who recommends samples be sent away to labs to have a more specific mass spectroscopy assay done. Results from such tests should be confirmed using additional analytical methods, including gas chromatography-mass spectrometry. It can feel a little unnerving to be asked to take a drug test, and it is important to know that there are some medications and other substances that could cause a false positive drug test result. The implications of potential false-positive urine drug screen (UDS) results for patients receiving commonly prescribed medications were evaluated. Substance Abuse and Mental Health Services Administration (SAMHSA). November 25, 2008. In addition, benzphetamine (Didrex) is a schedule III medication approved for treatment of obesity. Several common prescriptions, over-the-counter medications, herbs, vitamins, and even some foods could trigger a false positive drug test. If the IA test is negative, no further testing is required and the amphetamines are considered negative. Immunoassay testing for methamphetamine uses antibodies to look for certain drug metabolites (these are the compounds a drug breaks down into), and is the most common test used for initial screening. Moeller KE, Kissack JC, Atayee RS, Lee KC. Medical exposure to cocaine Urine drug screens are the most common test (although other body fluids may be analyzed). Various immunoassay drug tests are available on the market, and each test uses a proprietary antibody technology, leading to differences in false-positive results between tests.7 Furthermore, immunoassays may be reformulated to correct for false-positive, which may not be adequately reflected in published literature. A false-positive test result means that your drug test shows the presence of a medication or substance that you aren't actually taking. Most drug tests are simple, urine based immunoassay tests. I Have Never Used Methamphetamine, But My Urinalysis Says I Do. There is no definitive research suggesting that other drugs can cause a false positive for gabapentin, aside from Lyrica (pregabalin), a drug closely related to it. Pract Pain Manag. Promethazine. It is used for its powerful euphoric effects, which are similar to those of cocaine. False positive results on urine drug tests can happen. Prednisone is a corticosteroid that is detectable in your urine, so if you are taking the drug, it is possible that you will test positive for steroids. Commonly used over-the-counter (OTC) and prescription drugs do not typically affect the accuracy of a pregnancy test. Mebeverine (Duspatalin Retard 200 mg), an antispasmodic drug, has been described to cause false-positive amphetamine tests. OTC medications that can cause a false positive for benzodiazepine include: 1. Methylphenidate: Used to treat ADHD, methylphenidate (Ritalin) is a well-known cause of false positive tests for amphetamine or methamphetamine, and LSD. Alcohol does not affect the accuracy of pregnancy tests. Infants tend to have more dilute urine, which reaches adult osmolarity around the age of 2 years. If no amphetamines are detected, then the amphetamine result is negative and no further testing is needed. The drug has been linked to false-positive drug test results for amphetamine. Answer (1 of 5): Adderall will pop for amphetamine but not methamphetamine. Tolmetin: What Causes A False Positive For Methamphetamemes? Toxicology. If you believe you have a failed drug test due to taking a prescription drug or consuming one of these products, you do have options. What can a urine drug screening immunoassay really tell us? drbrush, Board Certified Physician. Although the affinity of the antibody for these substances is much lower than for fentanyl, if they are present at sufficiently high concentrations, they can cause a false positive result [24, 25]. Roopa Sethi, MD; Amad Din, MD, MPH; Ryan McAllister, MD; and Andrew Lester, MD. Surgery 45 years experience. Updated March 1, 2021. Methamphetamine is illegal except when it is prescribed by a physician for a very limited number of medical conditions. Common ones include the EIA (Enzyme Linked Immunoassay) test and the CEDIA (Closed Enzyme Donor Immunoassay) test. People taking the HIV medication Sustiva (efavirenz) may obtain false positive drug test results. Baby Soap. 'cross react'), resulting in a 'false positive'. Quantification of urine drug levels Methamphetamine has 2 isomers, d-methamphetamine and l-methamphetamine. They have been shown to trigger a false positive urine result for opiates. Five common medications can cause a false positive for methamphetamine. Category: Medical. A comprehensive literature review was conducted to identify false-positive UDSs associated with all clinic formulary medications, as well as common nonprescription medications. (adsbygoogle = window.adsbygoogle || []).push({}); A drug screen tests for the presence of certain illegal drugs and commonly misused prescription medications. A comparison of the chemical structures of . Desipramine and amantadine causing false-positive urine test for amphetamine. A Retrospective Analysis of Urine Drugs of Abuse Immunoassay True Positive Rates at a National Reference Laboratory. https://www.cdc.gov/nchs/fastats/drug-use-illicit.htm, https://www.samhsa.gov/workplace/resources, https://www.samhsa.gov/sites/default/files/workplace/2010GuidelinesAnalytesCutoffs.pdf, https://www.federalregister.gov/documents/2017/01/23/2017-00979/mandatory-guidelines-for-federal-workplace-drug-testing-programs, https://accesspharmacy.mhmedical.com/content.aspx?sectionid=210267566&bookid=2569#216818178, Amantadine, aripiprazole, atomoxetine, brompheniramine, bupropion, chlorpromazine, desipramine, DMAA, ephedrine, fluoxetine, labetalol, metformin, ofloxacin, phentermine, phenylephrine, phenylpropanolamine, promethazine, pseudoephedrine, ranitidine, selegiline, thioridazine, trazodone, nonprescription nasal antihistamine/decongestant inhalation, Baby wash products, dronabinol, efavirenz, ibuprofen, lamotrigine (on screenings for synthetic cannabinoids), naproxen, niflumic acid, proton pump inhibitors, Ambroxol, amitriptyline, benzphetamine, bupropion, buspirone, cephradine, chlorpromazine, desipramine, diltiazem, doxepin, fentanyl, fluoxetine, haloperidol, imipramine, labetalol, metoclopramide, prochlorperazine, risperidone, sertraline, thioridazine, trazadone, verapamil, ergonovine, lysergol, brompheniramine, imipramine, methylphenidate, fentanyl, sertraline, Diphenhydramine, doxylamine, chlorpromazine, clomipramine, doxylamine, quetiapine, thioridazine, verapamil, Amisulpride and sulpride, codeine, dextromethorphan, diphenhydramine, dihydrocodeine, morphine, methadone, morphine-3-glucuronide, creatinine, dihydrocodeine, levofloxacine, ofloxacine, morphine, naloxone, ofloxacin, petanzocine, psychotropic drugs, quetiapine, rifampicin, tapentadol, tramadol, verapamil, quinolones, quinine, Dextromethorphan, diphenhydramine, doxylamine, ibuprofen, imipramine, ketamine, lamotrigine, MDPV, meperidine, thioridazine, tramadol, venlafaxine.

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