Can Trazodone Show Up As Fentanyl On A Urine Drug Test?

In our latest question and answer, our pharmacist discusses whether or not trazodone can cause a false-positive for fentanyl on a drug test.

Question

Can taking trazodone 100mg a night, which I am prescribed, pop up as fentanyl on a urine drug screen 12-panel test? Just curious because I keep popping positive for the sober living house I'm staying in. I had it sent to the lab as I am very adamant I have not been using Fentanyl or heroin or any kind of drug like that for over a month now. Thank you for your time. Hope to hear an honest truthful answer. God bless and thank you.

Asked by Zack On Aug 10, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 10, 2022
Last updated Aug 10, 2022

Key points

  • False positives for fentanyl are less likely to happen compared to other opioid drugs due to its distinct molecular structure.
  • Most commonly used urine drug panels don't include fentanyl, but there are specific tests for it.
  • Trazodone has been reported as causing false positives for both amphetamines and fentanyl, but just how common this is is not known.

Answer

Hi Zack and thanks for reaching out to us! I'm so sorry to hear about the problems you're having with fentanyl showing up as a 'false-positive' on your drug tests.

We've written more extensively about what drugs can cause a false positive for fentanyl, which can be found here.

The main takeaway from that article is that even though false-positive results for fentanyl are relatively uncommon compared with other opioids due to the somewhat unique molecular structure of the drug, they have been reported.

In fact, the drug you mention in your question, trazodonehas been linked to false-positive results.

Trazodone False-Positives

Trazodone has been linked to causing false-positives for several drugs, most commonly, amphetamines. One of the most widely cited journal articles on urine drug screenings, produced by the Mayo Clinic, specifically lists trazodone as well-known for causing amphetamine false-positives

Fentanyl

As mentioned fentanyl, when compared to other opioids, isn't as likely to show up on a drug test as a false positive. Fentanyl has a distinct molecular structure and actually requires specific tests for it. It isn't included on your standard urine drug panel (SAMHSA panel).

Nevertheless, trazodone has been reported to cause false positives for fentanyl on some more comprehensive urine drug screenings, but just how common this is, isn't known.

Trazodone is listed in the documentation of several testing protocols relating to potential drugs that could cause fentanyl false-positives. One such example is on a document from North Dakota Workforce Safety & Insurance, which is a provider of worker's compensation insurance in North Dakota:

Trazodone False Positive Reference

WSI Treatment Policy

Trazodone as a causative agent for fentanyl false-positives can be found in similar documentation elsewhere (e.g. Michigan Opioid Collaborative).

What To Do

If you feel you have received a false-positive result, it is important to let your drug tester know of all the medications you are taking. If a drug has been well-documented as causing false-positives, they may offer you additional tests.

Also, there are more specific drug tests out there than urine drug screenings, which can be unreliable simply based on how they work (they rely on antibody reactions). One such test that is more specific is known as gas chromatography-mass spectrometry. This type of test identifies specific compounds in a sample and is far less likely to produce false positives.

Final Words

Thank you again for reaching out and please feel free to do so again in the future!

References

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

Recent Questions