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Brief Reports: Xiangyang Jiao, Sonia Velez, Jennifer Ringstad, Valerie Eyma, Daniel Miller, and Melvyn Bleiberg Myocardial Infarction Associated with Adderall XR and Alcohol Use in a Young Man J Am Board Fam Med 2009; 22: 197-201 [Abstract] [Full text] [PDF]

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Re: Methamphetamine on urinalysis, same as amphetamines?

Xiangyang Jiao   (10 March 2009)

Methamphetamine on urinalysis, same as amphetamines?

David P Pomeroy   (6 March 2009)

Re: Methamphetamine on urinalysis, same as amphetamines? 10 March 2009
Xiangyang Jiao, Family Physician Monarch Health Send response to journal: Re: Re: Methamphetamine on urinalysis, same as amphetamines? xyjiao111{at}yahoo.com Xiangyang Jiao	Thank you for the comment. The drug screening test cited in the article is the standard 9-panel urine screening test. It doesn't distinguish between amphetamine with methamphetamine and reports as methamphetamine. There is, however, a more specialized test that can detects only methamphetamine. To my knowledge, methamphetamine is not one of intermediate metabolites of either amphetamine or dextroamphetamine.
Methamphetamine on urinalysis, same as amphetamines? 6 March 2009
David P Pomeroy, Physician Send response to journal: Re: Methamphetamine on urinalysis, same as amphetamines? drdave{at}brainhealthnw.com David P Pomeroy	I appreciated the information in this article, as one who specializes in the diagnosis and treatment of AD/HD. I am curious whether the drug screen urinalysis performed in this case distinguished between amphetamines and methamphetamine; the article noted his sample was positive for methamphetamine. One patient of mine experienced legal problems when a routine urinalsis in the workplace resulted in positives for both amphetamine and methamphetamine; she was taking plain dextroamphetamine for her ADD. The head of the testing laboratory assured me that their test distinguished between these agents, and that a positive methamphetamine result suggested abuse whereas the expected positive for amphetamines in her case would of course be expected. I believe the distinction is important to make, in order to identify what may be a major complicating condition in a patient namely substance abuse involving methamphetamine. In the case cited that is evident for alcohol, but not for methamphetamines necessarily (though the Adderall was being misused). I am unaware whether amphetamines metabolize to methamphetamine in the body, so a "false positive" for methamphetamine may result solely from the use of amphetamines in an appropriate manner. With some drug monitoring systems making the distinction between the two, it seems unlikely. I welcome any comments on the above. David Pomeroy MD Board-certified in Family Medicine