Recent studies have shown that even low amounts of D9-tetrahydrocannbinol (THC) within a cannabidiol (CBD) product can result in positive 11-nor-9-carboxy-D9- tetrahydrocannabinol (THC-COOH; a metabolite of THC) urine drug screens. One study reported positive drug screening in 2/6 participants after acute administration of vaporized CBD-dominant cannabis flower (10.5% CBD; 0.39% THC) using liquid chromatography tandem mass spectrometry (LC-MS/MS; which distinguishes between THC-COOH and other cannabinoids/metabolites) at a criterion of greater than or equal to 15 ng/mL THC-COOH. Another study found that 7/14 patients who used a hemp-derived CBD extract (0.02% THC) for 4 weeks yielded positive 50 ng/mL drug screens, 6 of which were greater than or equal to 15 ng/mL as confirmed by GC/MS. However, neither of these 2 studies evaluated commercially available products. Therefore, in this study, urine toxicology testing of daily users of retail oral hemp-derived CBD products (less than or equal to 0.3% THC) was conducted using 2 different screening criteria and confirmatory testing techniques.
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