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Daniel Nelson, MD
Daniel Nelson, MD, Doctor (MD)
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Experience:  Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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Can hepatitis C effect the results of a methamphetamine ...

Customer Question

Can hepatitis C effect the results of a methamphetamine test? How long does the drug stay in your system if you have hep C, and cirrohis(?) of the liver?
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Vikas replied 6 years ago.

Hello marq

For what purpose methamphetamine was being taken?

Regards
Customer: replied 6 years ago.
recreational use.
Expert:  Dr. Vikas replied 6 years ago.

Hi marq

Transmission of hepatitis B and C can be a consequence of methamphetamine abuse. Among abusers who inject the drug, infection with HIV and other infectious diseases is spread mainly through the re-use of contaminated syringes, needles, and other injection USED by more than one person.

Under normal conditions, about 30% of amphetamine is excreted unchanged in the urine.

Following oral administration, peak methamphetamine concentrations are seen in 2.6-3.6 hours and the mean elimination half-life is 10.1 hours (range 6.4-15 hours). The amphetamine metabolite peaks at 12 hours. Following intravenous injection, the mean elimination half-life is slightly longer (12.2 hours).

As a rule any drug is eliminated from the body after its last dose in roughly 4 to 5 times its half life.

It is difficult to comment on how long will this drug stay in his system if he has Liver Cirrhosis or Hepatitis but it will be eliminated slowly as compared to normal condition in my view

Regards



Customer: replied 6 years ago.
I was looking for more specific results. Is it possible for this drug to remain in your system and detectable for up to 3 weeks or so with a urine drug test?
Expert:  Dr. Zia replied 6 years ago.
Hi there,

Usually it takes around one to three days for amphetamines such as meth to become undetectable in the urine. Up to 3-5 days at the most. Even with chronic liver disease should not be detectable for up to 3 weeks in the urine.

Kindest Regards
Customer: replied 6 years ago.
Reply to Physician's Post: Have there been studies to prove that it's not possible? If the liver is severely damaged, how can it clean toxins out of your system in 3 to 5 days? Plus, if other medications are taken(blood pressure meds, vitamins, aspirin, etc...)is it possible the results of a drug test could be positive, even if methamphetamin had not been used for 3 weeks? If you have any websites to direct me to, that would be great.
Expert:  Daniel Nelson, MD replied 6 years ago.

A lot of this answer will depend upon your liver function and grade of cirrhosis. Is your total, indirect, or direct bilirubin elevated? Do you have an elevated ammonia level? What were the findings of your most recent liver biopsy? (I hope that your Hepatologist performed this) Do you have elevations of AST, ALT, LDH, or Gamma-GT (GGT)? ... or PT and PTT (blood clotting times)?

If the total and indirect bilirubin, and direct bilirubin for that matter, are normal or close to normal, then this is a good reflection of how well your liver is able to "congugate" chemicals so that they can more easily be eliminated via the urine. Other parametres of your blood chemistry should also be able to provide indications of your liver's capacity to metabolise ... such as ammonia level, medication levels, LDH, among others.

If you have no elevations of bilirubin, AST, ALT, GGT, LDH, ammonia etc ... the capability of the liver to metabolically congugate and metabolise medications and recreational drugs that undergo hepatic metabolism must be reasonably intact. Despite "cirrhosis," the liver is incredibly resilient. The elimination half-life of the methamphetamine will be reasonably close to that expected ... cleared from urine detectable levels within 5 days, based on the 5-panel or 10-panel type screens immunoassays. If Mass Spectroscopy (MS) or Thin Layer Gas Chromatography (GC) techniques are used instead, the level of detection is improved by at least 100%, although there are reports of false positive methamphetamine peaks on certain MS/GC because of the presence of pseudoephedrine or ephedrine (cold and flu remedies, decongestants, weight loss pills) and their respective metabolites. Hair follicle testing and hair shaft testing will be positive for much longer periods depending upon amount used, frequency of use, and chronicity of use ... and also the length of the hair.

If you have hepatic impairment of metabolism or congugation, then the elimination half life will be non-linearly extended, but not predictable without knowing all of your labs and the status of the particular cytochrome p-450 enzymatic system used in methamphetamine breakdown, and the other medications present that use the same cytochrome p-450 enzyme(s), act as substrates, inhibitors, down-regulators, up-regulators ... so IF you have hepatic impairment, the confounding parametres become so complex that the elimination half-life cannot be calculated with any certaintly for blood, urine, or saliva.

So, look at your labs. If there are elevations or perturbations in certain blood tests, especially total and indirect bilirubin, ammonia, ALT, AST, GGT, LDH, PT, PTT, low serum sodium, etc ... then it will be impossible for me to give you a correct answer. If your labs are within normal range, then it is indicative of well-preserved function despite the presence of cirrhotic scarring, and I would safely assume clearance of detectable levels within 5 days by immunoassay (the usual 5 to 10-panel assay).

Thank you for visiting JustAnswer.com's Health Information. I hope that all of your concerns have been addressed and that your experience here was positive and helpful. Please press the ACCEPT BUTTON once your question has been addressed. Your positive feedback is greatly appreciated.

Kindest Regards,
XXXXX XXXXX, MD

Daniel Nelson, MD, Doctor (MD)
Category: Health
Satisfied Customers: 258
Experience: Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
Daniel Nelson, MD and 5 other Health Specialists are ready to help you
Expert:  Family Physician replied 6 years ago.
As a Medical Review Officer, certified in the interpretation of drug tests, I would like to clarify a few issues with a methamphetamine drug test.

I am going to assume that this testing was/is being done by a certified laboratory with GC/MS confirmation. This is the type of testing typically done in the workplace, criminal justice system, and the DOT (truck drivers etc).

Methamphetamine is largely eliminated unchanged by the kidneys. The detection period would not be expected to change signficantly with liver disease.

Metabolism and Excretion

Nearly half of a methamphetamine dose is recovered from urine unchanged. A small percentage is demethylated to amphetamine and its metabolites. The excretion rate of methamphetamine is also increased when urine is acidic.

Amphetamine is excreted as both unchanged amphetamine and as hydroxylated metabolites. Typically, about one-quarter of an administered dose is excreted as unchanged amphetamine, but this varies widely with urinary pH; the drug stays in the body longer when urine is alkaline, allowing reabsorption and thus allowing more of it to be metabolized. In 24 hours, about 80 percent of a dose will be excreted if urine is acidic, while less than half is excreted if urine is alkaline.

A single therapeutic dose of amphetamine or methamphetamine can produce a positive urine for about 24 hours depending upon urine pH and individual metabolic differences. High dose abusers may continue to generate positive urine specimens for 2 to 4 days after last use.

http://www.workplace.samhsa.gov/DrugTesting/Level_1_Pages/HHSMROManual(UsedbeforeNovember1,2004).aspx

The ONLY over-the-counter medication which will cause a false positive is the Vicks® inhaler. Enantiomer analysis is used to differentiate between Vicks and the (illegal) use of methamphetamine.

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