Creating Creatinine: How to Pass a Urine Drug Test

Abstract

Here we report on a patient that consumed recreational drugs, successfully passing a urine drug screen (UDS) by consuming a marketed detoxification product. After some exploration of the product consumed, there proved to be a viable mechanism by which the UDS outcome can be manipulated. The UDS relies on urine meeting specific concentration criteria to validate the sample. Dilute samples may mask the tested drugs as they fall below a concentration threshold for detection. Common UDS require a specific gravity with a reference range of 1.003-1.035 and a urine creatinine concentration above 20 mg/dL. Participants are told not to drink fluid for 4-5-hours pre-test to allow urine to concentrate above these thresholds. The 21-year-old female we describe along with each UDS had lab drawings on two separate occasions in which both measurements revealed elevated serum creatinines of 1.8 mg/dL. She had ingested QCarbo Maximum Strength Same-Day Cleansing Formula™, a marketed detoxification product, the day prior to the lab draws. The product recommended that the consumer ingest a large volume of water to “flush” the drugs from the body. This resulted in dilution of her urine to cause the drug levels to fall below the detectable range, while still exceeding the urine creatinine concentration to provide a valid test. Although she was unaware that this product increased both serum and urine creatinine, this proved successful. She passed the test and was awarded the position.