Toxicity From the Use of Niacin to Beat Urine Drug Screening
Niacin (vitamin B3) is promoted for rapidly clearing the body of drugs of abuse, such as cocaine and cannabis, and is alleged to interfere with urine drug screening. We present 4 cases of such novel use associated with significant adverse effects. Two cases had isolated skin manifestations, whereas the other 2 presented with life-threatening manifestations, including nausea, vomiting, dizziness, hepatotoxicity, metabolic acidosis, and hypoglycemia evolving into hyperglycemia. One patient also had profound neutrophilia and QTC-interval prolongation. All patients improved after cessation of the drug use and supportive treatment. Health care providers should be aware of these potential adverse effects of niacin and of the misguided use of this vitamin by patients seeking to interfere with urine drug screening.
Supervising editor: Richard C. Dart, MD, PhDFunding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.Publication dates: Available online April 5, 2007.Reprints not available from the authors.
PII: S0196-0644(07)00074-1
doi:10.1016/j.annemergmed.2007.01.014
© 2007 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Refers to article:
- Consequences of Attempts to Mask Urine Drug Screens , 11 May 2007

