Can CBD Cause a Positive Drug Screen? - NMS Health (2023)

There has been an undeniable buzz around CBD the past few years and business is booming. One study predicts that by 2025 it will hit 16 billion dollars in the United States. CBD can be found in almost any product now a days – face masks, pills, toothpicks, breath mints, lotions, foods, and drinks. But it may also show up on your drug screen if you are unprepared.

What is CBD?

CBD is short for cannabidiol which is a chemical compound found in the Cannabis sativa plant, also known as marijuana or hemp. It is one of the 113 identified cannabinoids which are naturally occurring in the plant. While it is only one of many compounds in the plant, it has quickly gained attention and popularity, coming in second to only THC.

CBD vs THC

There are two primary species of the Cannabis sativa plant – marijuana and hemp. While marijuana and hemp contain both CBD and THC, there is a much higher percentage of CBD in hemp, and much lower levels of THC when compared to the compound structure in marijuana. Hemp has less than .03% of THC. So, while both these cannabinoids are present in marijuana and hemp, they elicit different sensations.

THC is the main psychoactive compound in marijuana, and it is what is responsible for that “high” feeling. CBD on the other hand, does not have any psychoactive properties and doesn’t induce feelings of euphoria. THC activates the cannabinoid type 1 (CB1) receptors in the brain. This is what causes a euphoric feeling or the high associated with marijuana. On the other hand, CBD is a CB1 antagonist, so it blocks any intoxicating impact caused by the receptors. Taking CBD with THC may inhibit the effects of THC.

Many people have claimed that even though CBD doesn’t get them high, it does help to relieve their symptoms of depression, anxiety, inflammation, and pain. While there are a few studies to back this up, there is more research that needs to be done. The only condition in which the Food and Drug Administration has approved CBD-based drugs for is epilepsy. The drug Epidiolex has been approved for treating two epilepsy conditions, Dravet syndrome and Lennox-Gestaut syndrome, since 2018. In 2020, its use was approved to also treat seizures associated with tuberous sclerosis complex (TSC).

Is CBD legal?

The Agriculture Improvement Act, also known as the 2018 Farm Bill, is responsible for removing hemp from the legal definition of marijuana in the Controlled Substances Act. Due to this change, CBD products, derived from hemp are legal if those products contain less than 0.3% of THC. Any CBD products containing more than 0.3% THC still fall under the legal definition of marijuana and are federally illegal.

The legality of CBD use varies by state. Some states have conditional legality for specific medical purposes such as Alabama, Georgia, Idaho, Iowa, Kentucky, South Carolina, Tennessee, Wisconsin, and Wyoming. Many of these states also have low THC guidelines as well. CBD products in Idaho are legal only if they contain zero THC and are derived from the mature stalks of the plant. In Tennessee, possession of CBD products is legal if they contain less than 0.6% THC. In Alabama, the maximum THC level is 0.3%. Obviously, with all of these different conditions, the world of CBD products is often hard to navigate.

What are the different types of CBD?

• Full-spectrum CBD:This type of CBD contains multiple plant extracts of the cannabis plant including essential oils, and other cannabinoids. The THC concentration must be less than 0.3%, however the concentrations can often be mislabeled or misleading.
• Broad-spectrum CBD:This type is similar to full-spectrum as t contains some additional cannabis plant compounds. However, most broad-spectrum CBD products have zero to trace amounts of THC. It is important to note that a product marked as “THC-free” does not always mean it is entirely free of THC. Even broad-spectrum CBD can result in a positive drug test.
• Isolate:This type is typically harvested fromCannabis sativa. This type is the pure form of CBD and contains no other cannabis plant compounds. CBD isolate is a much more refined product and goes through more processing after the extraction process.

So, could CBD cause a false positive?

In May 2022, Arizona’s largest health system, Banner Health, released a written statement, after a seemingly large influx of positive drug screens. In their press release, they quoted Dr. Steven Dudley, director of the Arizona Poison and Drug Information Center as saying,

“CBD itself will not cause a false positive drug test but people can still test positive for marijuana because there could actually be small amounts of THC in these products, especially if they’re made from hemp [...] We’ve seen multiple reports from the FDA and independent labs that show CBD products containing way more THC than would be explained from legal hemp sources,” Dr. Dudley says. “It can really be the wild west depending on where you purchase your products.”

Although drug panels only test for the presence of THC and not CBD, it is clear that some CBD products can contain traces amounts of THC - even when they are advertised as containing zero percent THC. This can be a more obvious issue when it comes to full-spectrum and broad-spectrum CBD products which use multiple cannabis plant compounds.

A2017 studyfound that 18 out of 84 CBD products which had been purchased online had THC levels high enough to potentially cause intoxication or impairment. Unfortunately, a large part of the issue is lack of oversight. Since CBD is not federally legal, it does not have the oversight from the federal Food and Drug Administration. Without this oversight there in no standard in place for producing, testing, or labeling CBD products.

Additionally, some concentrations of CBD are still classified as a Schedule 1 drug on the federal level, so for many people, even in states where it is legal, they cannot purchase CBD products locally and in person. Many rely on online retailers to purchase their products. While the option to buy products online may be convenient, it does make it more difficult to examine and vet each product. CBD users should be able to check the label to determine whether the CBD is full-spectrum, broad-spectrum, orCBD isolate to determine the product containsTHC and to confirm whether it has been third-party tested. This can be difficult to accomplish if online retailers don’t make that information readily available.

The dosage and duration of CBD intake can also be a critical factor when it comes to drug testing. Dosing is dependent on if the CBD is full-spectrum or isolate. If a CBD product with trace amounts of THC is used more frequently, THC will build up and stay in the system over longer periods of time. It could take days or weeks to leave the body of a routine user.

This can be a hard situation for hiring managers and employers, as there is no way of definitively knowing if the positive was caused by intentional marijuana use, or due to CBD use. For employees in safety-sensitive positions, a positive drug screen, regardless of its cause, could warrant discharge or an employment offer being rescinded. Employers in other sectors should refer to their own marijuana policies, and the regulations put in place for their state, including employee protection laws. Some employers have begun using drug testing panels which exclude THC when screening candidates and employees due to not only medical and recreational state laws, but also a more relaxed attitude toward off-duty marijuana and CBD use.

Sources

Bonn-Miller, M. O., Loflin, M. J., Thomas, B. F., Marcu, J. P., Hyke, T., & Vandrey, R. (2017). Labeling accuracy of Cannabidiol extracts sold online. JAMA, 318(17), 1708.https://doi.org/10.1001/jama.2017.11909

Full-spectrum CBD may trigger positive THC result. Quest Drug Monitoring. (n.d.). Retrieved June 10, 2022, fromhttps://www.questdrugmonitoring.com/blog/2021/full-spectrum-cbd-may-trigger-positive-thc-result#:~:text=Use%20of%20so%2Dcalled%20%E2%80%9Cfull,study%20published%20in%20JAMA%20Psychiatry

Penn study shows nearly 70 percent of cannabidiol extracts sold online are mislabeled. Penn Medicine. (2017, November 7). Retrieved June 10, 2022, fromhttps://www.pennmedicine.org/news/news-releases/2017/november/penn-study-shows-nearly-70-percent-of-cannabidiol-extracts-sold-online-are-mislabeled

Shahbaz, F., Grandi, V., Banerjee, A., & Trant, J. F. (2020, July 24).Cannabinoids and cannabinoid receptors: The story so far - cell. Cell Press Open Access. Retrieved June 23, 2022, fromhttps://www.cell.com/iscience/pdf/S2589-0042(20)30488-0.pdf

United States Drug Enforcement Administration. (2020, April).Drug fact sheet: Marijuana/cannabis. DEA.gov. Retrieved June 23, 2022, fromhttps://www.dea.gov/sites/default/files/2020-06/Marijuana-Cannabis-2020_0.pdf

When it comes to drug testing, CBD may not be A-OK. Banner Health. (2022, May 10). Retrieved June 10, 2022, fromhttps://www.bannerhealth.com/newsroom/press-releases/when-it-comes-to-drug-testing-cbd-may-not-be-a-ok