Some people avoid bagels because they’re watching their waistline, but in the case of Elizabeth Eden, she would’ve been wise to avoid eating one the day she gave birth because it almost cost her custody of her child. That’s because consuming a poppy seed bagel for breakfast that morning resulted in a positive opiate test.
“I was in labour,” the Maryland mom said to WVTM13. “I was sitting in the bed. I was having contractions. I was on a Pitocin drip, and the doctor came in and said, ‘You’ve tested positive for opiates.'”
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“I said, ‘Well, can you test me again? And I ate a poppy seed bagel this morning for breakfast,’ and she said, ‘No, you’ve been reported to the state.'”
As a result, Eden’s newborn daughter, Beatrice, was kept on hold at the hospital for five days while a caseworker was assigned to perform a home check-up. Thankfully, once the caseworker learned that Eden’s was a legitimate case of “poppy seed defence,” the file was closed and she was able to take her baby home.
Unbelievable as this sounds, it’s an issue that has been ongoing for at least 25 years, says Dr. Peter Selby, chief of medicine and psychiatry at the Centre for Addiction and Mental Health in Toronto.
“The poppy plant is where we get opiates, which are the naturally occurring chemicals in medications like codeine and morphine.”
A synthetic version is used to make illegal narcotics like fentanyl.
A positive drug test result is not a “false positive,” Selby says. It is indeed detecting trace amounts of opiates. And you don’t even need to consume that many poppy seeds for them to show up in your urine. Studies have shown that eating a poppy seed roll can result in a measure of 539 nanograms per millilitre of morphine two hours after ingestion. At St. Joseph Medical Centre where Eden had her baby, a test will come back positive with just 300 nanograms.
“It depends on how contaminated the poppy seeds are, [how well they were cleaned and processed], how many you consume and how concentrated your urine is at the time of testing,” Selby says. “It’s not enough to say if you only eat five seeds you’ll be fine because all of these reasons can result in a positive test.”
He says that since this is a well-known fact, drug tests generally set the cut-off detection fairly high. In the U.S., for instance, the cut-off for morphine used to be 300 ng/mL but in 1998, the Substance Abuse and Mental Health Services Administration raised it to 2,000 ng/mL for workplace testing to account for these errors.
However, healthcare providers adhere to the old guidelines, which can result in situations like Eden’s.
“The ‘poppy seed defence’ has been used for many years, but the issue is that the [positive test] can be caused by poppy seeds or something else,” Selby says.
“An expert has to look at it and evaluate the clinical matters. If the person has never had a problem with opioids and the test is positive, it requires a very different interpretation from a person with a history of addiction who has been in a treatment program.”
In Selby’s opinion, these drug tests often do more harm than good, citing issues of discrimination and stigma as being their downfall.
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“These tests often only result in pushing people with addictions out of the workforce; they are also often only applied to people based on their race or colour,” he says. “Studies have shown that they don’t work to deter substance abuse rates.”
He says they should be limited to people who work in safety-sensitive jobs and should especially not be applied to pregnant women, who will merely suffer from negative characterization. In the case of Eden, he says it was particularly detrimental as it separated her from her newborn in the early days where bonding is so crucial.
“The bigger story is what place does drug testing have,” he asks. “If someone abuses opiates during their pregnancy, the baby will be born with withdrawal and the mother will be in withdrawal. The test won’t actually help. People need to understand there’s a body of research on how to do this well without stigmatizing women and their babies.”
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