As a pharmaceutical expert with a focus on drug interactions and toxicology, I am well-versed in the complexities of drug testing and the various substances that can affect the results. It is important to understand that drug tests, particularly those for benzodiazepines, are designed to detect the presence of these specific medications or their metabolites in a person's system. However, there are instances where other drugs can interfere with the test and produce a false positive result.

Benzodiazepines are a class of psychoactive drugs that are commonly used for their sedative, hypnotic, anxiolytic, muscle relaxant, and anticonvulsant properties. They include medications such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and many others. When it comes to drug testing, the assays used are often designed to detect a broad range of benzodiazepines, which can sometimes lead to false positives.

**False Positives for Benzodiazepine Testing:**


1. Cross-Reactivity: Some drugs have chemical structures that are similar to benzodiazepines, which can lead to cross-reactivity in the test. This means that the test may mistakenly identify these drugs as benzodiazepines.


2. Metabolites: Certain drugs are metabolized into compounds that can be mistaken for benzodiazepine metabolites by the test. This is particularly true for drugs that are structurally similar to benzodiazepines or their metabolites.


3. Drug Interactions: Some drugs can interact with the test reagents in a way that produces a positive result for benzodiazepines, even though the individual has not taken a benzodiazepine.


4. Test Sensitivity: The sensitivity of the test can also play a role. Highly sensitive tests may detect very low levels of substances that are not benzodiazepines but are structurally similar enough to trigger a positive result.

**Specific Drugs Associated with False Positives:**

- **Selective Serotonin Reuptake Inhibitors (SSRIs)**: As mentioned in the provided information, sertraline (Zoloft) has been associated with false-positive benzodiazepine test results. This is likely due to its structural similarity to benzodiazepines and the way it is metabolized.

- **Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)**: Oxaprozin (Daypro) is another drug that has been linked to false positives. NSAIDs are a diverse class of drugs, and it is possible that other NSAIDs may also produce similar results.

- Antifungal Medications: Some antifungal drugs, particularly those that are azole derivatives, have been reported to cause false positives due to their structural similarity to benzodiazepines.

- Antibiotics: Certain antibiotics, especially those that are metabolized into compounds with structures similar to benzodiazepines, can also lead to false positives.

- **Herbal Supplements and Over-the-Counter Medications**: Some supplements and over-the-counter medications contain ingredients that can interfere with drug tests, leading to false positives.

It is crucial for healthcare providers and individuals to be aware of these possibilities when interpreting drug test results. Confirmation tests, such as gas chromatography-mass spectrometry (GC-MS), are often used to verify initial positive results and to rule out false positives.

In conclusion, while benzodiazepine tests are designed to be specific, there are several factors and substances that can lead to false-positive results. Understanding these factors and the proper use of confirmatory testing is essential to ensure accurate diagnosis and treatment.

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A search of false positive benzodiazepine screenings showed the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft, others) and the non-steroidal anti-inflammatory drug (NSAID) oxaprozin (Daypro, others) to be associated with, or possible causes of, these false-positive results.read more >>