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Ask Family Physician Your Own Question
Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12816
Experience:  Emergency Medicine and Family Practice for over 26 years
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I was the one asking about my husband taking a tylenol 4

Customer Question

I was the one asking about my husband taking a tylenol 4 pill instead of taking his lortab pill and I had one more question? He took the pill this morning before he left to work at 7:45 and he had his drug test at 1 today, will that make a difference in
in the volume of it showing up on his drug test? The only concern is when he went he didn't tell them he took the Tylenol his just gave his prescription and his pills for the lortab he has? Does he need to say something to his employer?
Submitted: 1 year ago.
Category: Medical
Expert:  Family Physician replied 1 year ago.

He doesn't need to say anything to his employer. DOT rules require any lab confirmed positive to be reported to the MRO. The MRO will contact him to interview him. Anything he tells the MRO can be used to make the decision. Since the presence of codeine could be from taking codeine OR from eating poppy seeds, unless the level was very high (unlikely), then unless there is clinical evidence of abuse - the MRO would have to report as negative.

Customer: replied 1 year ago.
I know I am asking tons of question but he is worried sick because of this, he has never had a problem when testing and this one time he is worried sick.. He wants to know what he needs to tell MRO if he is contacted? Does he just tell them that is was an honest mistake or what? He is making himself sick over this and just has to ease his mind.. He's been randomly tested for 23 years and never a problem so this is a big deal to him...
Expert:  Family Physician replied 1 year ago.

Since any information provided to the MRO could be provided to the employer - telling the MRO that he made a "honest mistake" could be detrimental.

http://www.transportation.gov/odapc/part40/40_135

Since codeine from poppy seeds (a muffin, pastry etc) would appear in urine exactly the same a codeine from a pill - the MRO could not prove that the codeine did not come from poppy seeds.

If the level is above 15,000 ng/ml - very high levels, the MRO must report it as positive unless there is a valid medical explanation - poppy seeds would not explain this high of a level. Before admitting to taking codeine - he should ask what the level was. Unless the level is above 15,000 - poopy seeds would be considered a potential cause.