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Is there urine testing for volume of cbd oil intake

A urinary test procedure for identification of cannabidiol in patients undergoing medical therapy with marijuana

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Abstract

Marijuana is classified by the Drug Enforcement Agency (DEA) as Schedule I, drugs having no accepted medical value. Twenty-three states and the District of Columbia have legalized medical marijuana. This conflict inhibits physicians from prescribing marijuana and the systematic study of marijuana in medical care. This study concerns the use of the clinical laboratory as a resource for physicians recommending cannabidiol (CBD) to patients, or for patients using medical marijuana. Marijuana containing delta-9-tetrahydrocannabinol (THC) is psychoactive. CBD is not psychoactive. CBD is reported to have medical benefit for seizure control, neurologic disorders including multiple sclerosis, neuropathic pain and pain associated with cancer. Use of opiates leads to increasing dosage over time that may cause respiratory depression. The Medical Board of California has termed this a serious public health crisis of addiction, overdose, and death. Is it feasible that CBD might alleviate persistent, severe pain and therefore diminished opiate use? Further study is needed to determine medical effectiveness of CBD including the effect on concurrent opiate therapy due to competition for receptor sites. This study is the application of a gas chromatography mass spectrometry procedure adapted for use in our laboratory, to detect CBD in urine. The intended use is as a tool for physicians to assess that marijuana being used by a patient is of a composition likely to be medically effective. A law ensuring physicians freedom from federal prosecution would provide confidence essential to formal study of medical uses of marijuana and treatment of clinical problems. Detection of CBD in a urine sample would be a convenient test for such confirmation.

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Introduction

Marijuana is classified by the Drug Enforcement Administration as a Schedule I controlled substance. Marijuana is complex, having some 480 natural components and more than 100 cannabinoids. Of the cannabinoids, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two most prevalent cannabinoids, respectively. The plant, marijuana, and its components are classified as Schedule I. Exceptions are the synthetic cannabinoids, dronabinol (Marinol), a Schedule III compound, and nabilone, which is Schedule II. A Schedule I controlled substance is defined by the Drug Enforcement Administration as a substance having “no currently accepted medical use in the USA, a lack of accepted safety for use under medical supervision, and a high potential for abuse”. A few examples of drugs included in the Schedule I list, in addition to marijuana, are heroin, lysergic acid diethylamide, 3,4-methylenedioxym-ethylamphetamine (ecstasy), and peyote. Paradoxically, 23 states and the District of Columbia 1 have recognized that marijuana has therapeutic benefits and have considered the risk for abuse as an acceptable level of risk. Additionally, 17 states have approved CBD for medical use. This change in the legal status has been substantially driven by voter referendum rather than by scientific studies that have been described as “thin and conflicting”. 2 Effectively, this means that these initiatives have been the result of personal choices rather than systematic law based on a substantial body of accepted medical evidence.

Legalization has been heterogeneous. 2 The uncertainties of both law and marijuana products inhibit physicians from recommending marijuana for medical care of patients and inhibit the systematic study of the use of marijuana in medical care. 3 The physician’s position is problematic in this conundrum, which has been called a “natural experiment”. 4

However, as Leung 5 has depicted by two case scenarios, it is inevitable that marijuana has already entered into the practices of physicians, whether disclosed by patients or not. The number of patients entering into the practices of physicians may increase since it is likely “marijuana use will rise under legalization”. 4

In the interests of supporting physicians and their patients in the use of medically effective forms of marijuana, 6 as distinguished from recreational interests, we have adapted a gas chromatography mass spectrometry (GC/MS) procedure for the detection of CBD in urine. The intended use is as a tool for physicians to determine the major components of marijuana being used by a patient and whether that composition is primarily THC, CBD, or a combination of THC and CBD.

Materials and methods

The assay adapted for use in our laboratory was reported by Bergamaschi et al. 7 The sample is voided urine without preservative. The volume for testing is 2 mL. Samples are tested undiluted and diluted 10×. The method employs overnight (minimum 12 hours) hydrolysis by B-glucuronidase buffered with potassium phosphate at pH 6. This hydrolysis accounts for Phase II metabolism of CBD to CBD-glucuronide or CBD sulfate. The hydrolysis is followed by liquid–liquid extraction into hexane. The extract is concentrated, followed by derivatization by N,O-bis (trimethylsilyl) trifluoroacetamide (BSTFA) to produce the trimethylsilyl derivatives.

The detection method is a GC/MS procedure performed on an Agilent 6890 GC (gas chromatography) coupled with an Agilent 5973 Mass Selective Detector (Agilent Technologies, Santa Clara, CA, USA). The GC is equipped with a Zebron ZB-5 capillary column (5% phenyl–95% dimethylpolysiloxane liquid phase), 15 m, 0.25 mm internal diometer, 0.25 µm film thickness (Agilent Technologies). The GC uses a temperature ramp of 160°C–250°C at 25°C/min held for 1 minute. Quantitation occurs using the internal standard method.

The following ions are used to quantitate and identify (qualify) the compounds: internal standard (CBD-D3): quantitation: 393, qualifier: 461; CBD: quantitation: 390, qualifiers: 458, 443. The linearity of the assay is 2–100 ng/mL. The limit of detection of the assay is 2 ng/mL. Results are normalized to urine creatinine determined using the Jaffe method.

Two different groups were studied. Group I consisted of specimens from individuals who were submitted for drug screening and confirmation if positive. Forty depersonalized samples were randomly selected from the confirmed positives. The study of the samples in this group was intended to demonstrate that the assay for urine CBD was negative for individuals using THC-rich marijuana. Group II consisted of the study of 15 volunteers who used CBD or CBD-rich marijuana as follows: 12 marijuana using volunteers who agreed to a one time use of a CBD-rich oil capsule; one volunteer used a CBD-rich, THC-poor cigarette; one volunteer used a commercially produced CBD-rich oil capsule; one volunteer used commercially produced herbal (hemp) extract. The study of samples in this group was intended to demonstrate that the assay for urine CBD was positive for individuals known to use CBD-rich marijuana. All samples were also tested for THC by assaying for the metabolite, carboxy-THC.

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A single volunteer was studied to develop a time profile of the detection time of urinary CBD postdose.

Results

All (40) urine samples in the Group I tested negative for urine CBD. It is likely that this group represented individuals who had used marijuana for recreational purposes. All (40) tested positive for the THC metabolite, carboxy-THC.

The Group II consisted of 15 volunteers dosed with CBD-rich marijuana in different forms: oil, capsule, and cigarette. Urine samples were collected 2 hours postdose. All volunteers tested positive for CBD. Thirty-five urine samples were provided by these 15 volunteers; all urine samples (35) tested positive for CBD. Fourteen out of the 15 volunteers tested positive for carboxy-THC as well as CBD.

This was indicative that the CBD preparation used contained THC and CBD, or there was residual marijuana present from previous marijuana used by the participant. One volunteer smoked a CBD-rich, THC-poor cigarette. This volunteer (1) tested positive for CBD and negative for carboxy-THC, indicative that the cigarette was CBD-rich and low in THC.

One volunteer dosed morning and night for 6 consecutive days. Urine samples were collected 2 hours postdose. All samples (12) tested positive for CBD and carboxy-THC, indicating that the herbal preparation contained CBD and THC. These results indicate that the assay is reliable and useful for identifying the absence or the presence of CBD. In combination with an assay for carboxy-THC, the major cannabinoids present in marijuana used were disclosed.

A time profile was developed for a single volunteer following dosing. Urinary CBD was detected for a 24-hour period ( Figure 1 ).

Twenty-four-hour Time Study, single individual, following a single dose of CBD oil capsules.

Notes: Peak urinary level achieved approximately 3 hours postdose. Urine continued to test positive at 24 hours postdose CBD quantitative result corrected for creatinine concentration.

Abbreviation: CBD, cannabidiol.

The results indicate that the assay is applicable to medical marijuana. The study is limited by a small number of individuals studied and also by an absence of information as to the concentration of CBD and THC present in marijuana used by a majority of the volunteers.

Discussion

Patients coming to a physician bring their medical problems as well as their lifestyles including the use of marijuana. It may be helpful in the therapeutic management of patients being treated with marijuana or marijuana extracts, for the physician to have knowledge of the major cannabinoids present in the marijuana used by the patient. This information may not be forthcoming from the patient and the patient who discloses marijuana use may not have specific information with regard to the cannabinoid content of the marijuana used. This assay, particularly in combination with an assay for the THC metabolite, informs the physician of the principle cannabinoids present in the marijuana used. This information may be helpful to the physician in seeking the balance of benefits vs risks 6 for a patient using, or wishing to use marijuana for medical therapy. The patient using marijuana for relief of chronic pain may have an altered response to opioids prescribed for pain relief. Opioid sparing has been reported and there may be opportunity to achieve lowered dosage of opioids or avoiding the use of opioids. This is important since opioid therapy may have serious consequences up to and including death due to respiratory depression. Marijuana receptors are not present in the brainstem where the center for respiration is located and for this reason marijuana does not cause respiratory death. 8 The presence of CBD or the combination of CBD and carboxy-THC in voided urine is consistent with primary medical intent for use of marijuana. Presence of carboxy-THC is consistent with either primary recreational intent or medical intent. It remains for the physician to determine the significance of marijuana use in medical management of the patient with consideration of the cannabinoids present in urine.

Other confounding factors for the physician include the diverse forms of marijuana used and the variable potency of the marijuana cannabinoids in the different products. The potency of the psychoactive component of marijuana (THC) has increased over time. The physician’s position in this conundrum is problematic. The physician may not prescribe marijuana since that is illegal. In states where legalized, the physician may provide a recommendation that the patient “qualifies” for medical marijuana therapy. Such a recommendation is only a stipulation that the patient may, in essence, self-prescribe. The patient will select the marijuana used from many offerings, perhaps guided by a dispensary. An assay for CBD is an added resource for physicians to identify a marijuana form that may be medically valuable. Further, CBD, although pharmacologically active, is not psychotropic. Strains of marijuana in which CBD is the major cannabinoid have been named Hippie’s disappointment. Such a strain is also known as Charlotte’s Web, named after a young child with intractable seizures alleviated by CBD. Reports of medical benefit include seizures, multiple sclerosis, neurologic disorders with spasms and neurologic pain, pain associated with cancer, rheumatoid arthritis, fibromyalgia, Crohn’s disease, and other autoimmune disorders. Marijuana provides control of nausea and stimulation of appetite in immunosuppressed patients. Migraine headaches, insomnia, and glaucoma are benefitted by medical marijuana.

Marijuana may have anti-inflammatory and neuroprotective properties.

Unfortunately, properly conducted clinical trials are limited. The preponderance of reports are anecdotal or small studies. Patients have used, and will continue to use marijuana for relief of their medical problems. They will seek marijuana from legal dispensaries that predominantly provide psychotropic forms of marijuana. Perhaps 90% or more of these offerings are primarily for recreational use. Patients and physicians need facts to inform their choices among marijuana products. Formal study is needed in the clinical management of patients including evaluation of anti-inflammatory effectiveness, as well as pain alleviation. Use of opiates for chronic pain has led to increasing dosage over time; this may cause respiratory depression that can be fatal. In recognition of dangers associated with opiate treatment of chronic pain, the Medical Board of California offers physicians a course 9 in the use of opiates for severe persistent pain for what the Medical Board termed a serious public health crisis of addiction, overdose, and death. Is it feasible that the use of CBD or an optimal concentration of CBD and THC might have significant value in alleviating persistent, severe pain and therefore a diminished need for opiate use, either totally or in lower dosages? It is a responsibility that the medical community holds to provide such a benefit should studies determine marijuana can effectively relieve such pain with opioid sparing. The need for additional study is further indicated by reports of CBD competition for opiate receptor sites. 10

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Limitations of this study include its small size and the lack of knowing the concentrations of the cannabinoids, THC, and CBD in the marijuana used.

Conclusion

This CBD assay is reliable, and is performed on standard laboratory equipment. The assay is suitable as a convenient test to provide an assessment as to whether CBD is a cannabinoid in marijuana currently being used. Coupled with as assay for urinary carboxy-THC, testing discloses the principle cannabinoids and whether that composition is CBD only, THC only, or a combination of CBD and THC. The physician is provided information that enables a judgment as to the value of marijuana therapy in the patient. Legislative changes, as distinguished from a policy preference by the Department of Justice, that ensured that physicians complying with state laws were not at risk for Federal prosecution would provide confidence; a confidence that is essential to increased formal study of medical uses of marijuana as well as use of medical marijuana as an effective agent for clinical problems.

Legislature that distinguishes medical marijuana from recreational marijuana would inure to the benefit of patients and society as a whole. 11

Acknowledgments

Dr Wertlake made a presentation of interim results with abstract at the annual meeting of the American Association for the Advancement of Science, Pacific Region (San Francisco State University, June 15, 2015) and a poster presentation of interim results and abstract at PAINWeek, 2015 (September 2015, Las Vegas, NV).

Does CBD Show on a Drug Test? Everything To Know

As CBD becomes more widespread and accepted, it’s raised many questions on if CBD will show up on a drug test. Given CBD’s association with cannabis, many make the mistake of connecting CBD with marijuana.

So does CBD show up on a drug test? What about if CBD oil shows up on a drug test? The answer is a bit complicated.

How CBD oil affects a drug testing screening mainly depends on the type of CBD product, but there’s a lot more to unpack. Let’s take a look at how CBD can affect a drug test and if you can fail.

Does CBD Show Up On A Drug Test?

Yes, CBD can show up on a drug test, but that’s only if the drug test screening tests for the cannabinoid CBD. However, that’s never heard of because it’s not something employers or law enforcement look for by default. Drug tests are designed to look for illicit substances, like THC, narcotics, steroids, etc.

Since CBD is federally legal and doesn’t impair or artificially improve athletic performance, there is no reason organizations need to test for CBD. It would be a waste of time and money.

Does CBD Oil Show Up On A Drug Test?

While CBD itself doesn’t trigger a drug screen, the CBD oil you use might do so. In this case, the issue isn’t CBD, but if THC is present or not. Some hemp CBD extracts, such as full-spectrum CBD oil, contain up to 0.3% THC that a drug test may show positive for THC.

However, don’t worry because you can easily avoid that awkward situation if you choose a broad-spectrum CBD oil.

How to Not Fail a Drug Test Using CBD Oil

Since CBD isn’t a concern, the issues about drug testing come from any THC your oil might contain. While hemp CBD extracts can legally carry up to 0.3% THC, there are plenty of THC-Free options.

THC content – if any – depends on the CBD oil you choose. There are three possible options:

  • Full Spectrum
  • Broad Spectrum
  • CBD Isolate

All of these CBD products differ in fundamental ways.

Full-spectrum (“whole-plant”) CBD oil is the densest option. Manufacturers try to extract and retain all the cannabinoids and terpenes from the host plant. Granted, a significant amount is lost during extraction, but the diversity remains.

Having so many other critical compounds is vital for the “entourage effect” – a synergistic relationship where cannabinoids and terpenes complement each other. The process helps increase CBD oil’s potency.

Unfortunately, full-spectrum contains up to 0.3% THC , so it’s best to avoid these types of CBD products if you don’t want to risk failing a drug test.

Full-spectrum extracts also carry the complete flavor profile of their source plant. Many people like it, but for some, the “hempy” taste is hard to overcome, even when mixed with food or drinks.

CBD Isolate

CBD Isolate is the complete opposite of full spectrum. While the latter extracts and keeps as much as possible, the former is processed to remove everything but CBD.

Although this leaves behind a product that contains up to 99.9% CBD, don’t let these numbers fool you. Isolate may offer incredibly high purity, but the lack of terpenes and other cannabinoids wipes out the critical entourage effect.

Consequently, isolates are less effective than full-spectrum.

But it’s not all bad news. Many people prefer isolates because they contain no THC. They’re also flavorless, making it easy to mix with juice, smoothies, dressings, and more. Flavor-focused vendors may also prefer isolate in their edibles.

Broad-Spectrum

Broad-spectrum CBD oil is a happy medium between THC-laced full-spectrum and THC-free (but rather hollow) CBD isolate.

Like full-spectrum, the broad-spectrum oil extraction process aims to keep every cannabinoid and terpene except THC, making it THC-Free. With compounds to fuel the entourage effect and no THC to trigger a drug test, broad-spectrum offers the best of both worlds.

Admittedly, you’ll still notice the “hempy” flavor. But it’s a small price to pay for being able to have your cake and eat it too.

So the best way to pass a drug test when using CBD oil is to avoid products with THC. Sounds pretty straightforward, but this is where “buyer beware” should always be at the back of your mind.

Unfortunately, the CBD industry’s lack of regulation means labels can still be deceiving. When shopping around, you have to keep a sharp eye on minor details. We’ll cover these tips and tricks shortly.

For now, let’s see why THC could still make its way into allegedly “THC-free” products.

Factors That Can Lead to A Positive Drug Test with CBD Oil

Even if you choose a THC-Free product, that’s no guarantee. A company can follow the correct extraction process yet still ship a product with detectable levels of THC.

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There are three main ways this can happen.

Using A CBD Product That Has THC

Using a CBD product containing THC, such as full-spectrum CBD, is the most common way to fail a drug test. Despite THC being found in minor amounts, it definitely can trigger a positive for THC.

Many manufacturers still claim their products are THC-Free when they do, so it’s crucial to buy CBD from a reputable company.

Mislabeling of CBD Products

Mislabeled CBD products were (and likely still are) a huge issue. When the Food and Drug Administration tested several CBD products , about 70% contained more or less CBD than advertised, while some didn’t have any CBD.

Even worse, many of these products “contained a significant amount of THC.” This is a huge problem considering CBD oil is famous for treating certain forms of childhood epilepsy. Inadequate or deceptive labeling means some parents could be accidentally giving THC to their kids.

You’re also going to have a hard time telling an employer that you consume no more than 0.3% THC when a drug test seems to say otherwise.

Cross-Contamination

With cannabis being semi-legal in the U.S., you’d think this is a positive thing for hemp and “marijuana” advocates. However, it’s proven to be a double-edged sword – and complete nightmare – for hemp producers.

There’s a massive issue with having high-THC and low-THC cannabis chemovars growing in the same state. The layout often leads to cross-pollination, affecting THC levels of industrial hemp.

Hemp farmers have no choice but to destroy any crops exceeding 0.3% THC. If producers don’t consistently test their plants and products, you could receive something with substantially more THC.

How Can You Make Sure That a CBD Product Doesn’t Contain THC?

The best way to make sure that a CBD product doesn’t contain THC is to inform yourself. Checking for THC is easy if you know where to look. Once you know what makes a good CBD product, buying your first one will be a breeze.

Check the Label

Check the label to see if the CBD product is full-spectrum, broad-spectrum, or pure CBD isolate. If it mentions “CBD” but does not mention if it’s full-spectrum or broad-spectrum, then it’s most likely a CBD isolate.

For the most effective results, purchase broad-spectrum CBD over CBD Isolate for the very reasons we talked about earlier.

Also, purchasing broad-spectrum won’t have you asking, “Does CBD show up on a drug test” as it’s THC-Free while containing a spectrum of other cannabinoids and terpenes.

Check Third-Party Lab Reports for THC

Third-party lab reports are a must-have before you buy from a CBD company. Having no lab reports is a huge red flag. Never buy from a company that doesn’t prove what they’re selling.

Full-spectrum results shouldn’t show any higher than 0.3% THC. Isolate and broad-spectrum should show non-detectable levels of THC or “ND.”

Tests are typically categorized by batch and product, so it’s easy to find the information you need.

Below is a picture of a third-party lab report on a full-spectrum CBD oil. As you can see, it contains THC.

Below is an image of a broad-spectrum CBD oil. As you can see, it contains non-detectable levels of THC while containing other cannabinoids, fueling the entourage effect.

Buy from a Reputable Company

For the most part, CBD is an untamed land. We have to have faith that the company we buy from is honest about being “the best.” Of course, this is impossible to quantify or prove, so to truly find the right source, you need to read between the lines.

A reputable CBD company offers some key signs of quality. They don’t all have to be there, but enough to create a well-rounded, potent, safe, THC-free CBD oil.

When you research, look for the following:

  • Updated Third-party lab reports
  • CO2 extracted
  • USDA Certified Organic or “organically grown”
  • No chemical pesticides or herbicides
  • Grown locally or in-house
  • Sustainable farming
  • THC-Free

How Much CBD Will Make Me Fail a Drug Test?

No amount of CBD will make you fail a drug test unless that test is modified for CBD. The real issue is whether your product contains THC.

A CBD oil with small amounts of THC may not be much on its own. But if you consistently consume a full-spectrum product, your body could build up THC and test positive down the road.

The best way to guarantee safety and get the same benefits is through broad-spectrum CBD oil.

How Long is CBD Detectable in Blood?

Blood tests aren’t the primary choice, but they still get used to testing for illicit substances like THC. No test exists explicitly designed for CBD. Unfortunately, this means we can only guess based on THC.

A 2012 study in the Iranian Journal of Psychiatry found THC detectable in the blood for three to four hours. However, this doesn’t mean it’s out of your system – not by a long shot.

Depending on several factors, CBD could remain inside you for days or weeks.

How Long is CBD Detectable in Urine?

According to one 2018 study from Frontiers in Pharmacology , CBD has a half-life of two to five days. However, all this means is you’ll eliminate half of the CBD within that time period.

Although we don’t know how long CBD will show up in a theoretical test, THC can show up anywhere from three to 30 days .

CBD might follow the same range. However, this all depends on things like dosage, metabolism, size, body fat, and more.

How Long is CBD Detectable in Hair?

Hair tests are rarely used for THC, and they’re unheard of with CBD. There haven’t been any studies because it’s not really of interest to researchers.

Follicle tests have the longest range, with THC metabolites detected up to three months after consumption. CBD’s timeframe, however, remains a mystery.

Video to Summarize CBD and Drug Tests

So Does CBD Show Up On A Drug Test?

Again, CBD won’t show on a standard drug test because it’s not a concern for employers or law enforcement. However, choosing the wrong CBD oil, such as full-spectrum CBD oil, could show positive for THC.

Stick with a broad-spectrum as it’s THC-Free to save yourself potential complications down the road. Remember to do your research and know how to read the CBD product labels. Look up the vendor’s reputation and make sure they’ve never had issues with inaccurate labeling.

CBD is a tricky area to navigate, but with the right tools and information, you’ll be able to avoid failed drug tests with CBD oil contaminated with THC.