Use of Niacin in Attempts to Defeat Urine Drug Testing — Five States, January–September 2006
In addition to its use as a nutritional supplement, niacin (nicotinic acid or vitamin B3) is medically prescribed to treat hyperlipidemia and hypercholesterolemia. Use of niacin in low doses usually leads to few adverse drug reactions (ADRs); however, at larger doses, niacin can cause skin flushing, itching, and occasionally more serious effects ( 1 ). The 2005 annual report of the American Association of Poison Control Centers documented 3,109 reports of exposures to niacin ( 2 ). During 2006, the Rocky Mountain Poison and Drug Center (RMPDC) in Denver, Colorado, received multiple calls regarding ADRs after nonmedical use of niacin. A review of call records indicated various uses of niacin, including attempts to alter or mask results of urine drug tests, although no scientific evidence exists that ingestion of niacin can alter a drug test result. To determine the extent of niacin use in attempts to alter drug test results, reports to RMPDC of niacin ADRs were reviewed for the period January–September 2006. The results identified 18 persons who reported nonsuicidal, intentional, nonmedical reasons for using niacin, including eight who specified altering drug test results as their reason for using niacin. Ten other persons, among an additional 18 who offered no reason for niacin use, were categorized as possible users of niacin to try to alter drug test results because of their ages or the amount of niacin ingested. Clinicians, especially those whose patients include teens and young adults, should be aware of the potential use of niacin in attempts to defeat urine drug tests.
RMPDC serves Colorado, Hawaii, Idaho, Montana, and southern Nevada, a total population of approximately 10 million. RMPDC staff members searched their database for telephone calls reporting niacin exposures during January–September 2006. Calls regarding niacin exposures were divided into six categories: 1) unintentional dosing errors in therapeutic users, 2) ADRs after therapeutic use, 3) pediatric unintentional exposures, 4) suicide attempts, 5) ADRs with no reason given for niacin use, and 6) ADRs after nonsuicidal, intentional, nonmedical use. Data collected included the person’s age, sex, circumstances of exposure, symptoms, and outcome. Persons who gave no reason for niacin use but were aged excluding three adults of unknown ages, was 18 years (range: 15–50 years). Eight of the 18 persons said they took niacin (1,000 mg–8,000 mg) to alter or mask a drug screening; eight others said they took niacin (400 mg–5,000 mg) to “purify, cleanse, or flush” their bodies; and two said they used niacin as a diet pill. Among the 18 persons who gave no reason for niacin use, eight were aged Reported by: C Mendoza, MD, K Heard, MD, Rocky Mountain Poison and Drug Center, Denver Health Medical Center, Colorado.
Niacin is well established as a medical treatment for hyperlipidemia ( 3 ) and available by prescription in 50-mg to 500-mg tablets or capsules. The initial recommended therapeutic daily dose is 100 mg, three times a day, titrated to a maximum daily dose of 1,000 mg ( 4 ). Extended-release niacin tablets and capsules (at 125 mg–1,000 mg) also are available by prescription, usually in a dose of 500 mg at bedtime, to a maximum of 2,000 mg per day. The therapeutic use of niacin often is limited by dermatologic and gastrointestinal ADRs (e.g., tachycardia, flushing, rash, nausea, vomiting, or abdominal pain). These effects usually are self-limited and are more common with dosages >1,000 mg per day, but can occur at any dose. Hepatotoxicity is a rare but serious adverse effect, usually associated with chronic use ( 5 ).
No scientific evidence indicates that taking niacin can alter a urine drug test result. However, readily accessible information on the Internet lists ingestion of niacin as a way to prevent detection of tetrahydracannabinol (THC), the main psychoactive ingredient of marijuana. An Internet search on the words “niacin” and “marijuana” can produce tens of thousands of results.
In addition to sales as a prescription drug, niacin is sold over the counter (in 100-mg to 500-mg tablets) and generally is regarded as a safe nutritional supplement with well-known dermatologic and gastrointestinal ADRs that usually are self-limited and resolve with supportive care ( 1 ). Death from acute overdose has not been reported, and a minimum lethal dose has not been established ( 6 ). However, severe effects in some patients have been reported. A report in press on use of niacin to defeat urine drug tests describes four cases of niacin toxicity that included hepatotoxicity, metabolic acidosis, variations in blood glucose, neutropenia, and electrocardiographic effects ( 7 ). Two of the four patients had life-threatening ADRs; one had taken 5,500 mg of niacin during a 36-hour period, and the other had taken 2,500 mg during a 48-hour period.
The findings in this report are subject to at least four limitations. First, the data were collected retrospectively from the RMPDC database; although a specific data set was gathered for each case, persons might have misrepresented the circumstances of their niacin use, leading to misclassification, underreporting of dosages, or inaccurate reporting of symptoms. Second, persons who did not cite a reason for using niacin and were aged 8 ) and should familiarize themselves with these effects and counsel their patients accordingly.
- CDC. Niacin intoxication from pumpernickel bagels—New York. MMWR 1983;32:305.
- Lai MW, Klein-Schwartz W, Rodgers GC, et al. 2005 annual report of the American Association of Poison Control Centers’ national poisoning and exposure database. Clin Toxicol 2006;44:803–932.
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486–97 .
- Poisondex ® system. Greenwood Village, CO: Thomson Micromedex.
- Temple BR. Vitamins. In: Dart RC, Caravati EM, McGuigan M, et al, eds. Medical toxicology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2004:1022–3.
- Bloomquist SE, Dart RC. Cardiovascular drugs. In: Dart RC, Caravati EM, McGuigan M, et al, eds. Medical toxicology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2004:645–7.
- Mittal MK, Florin T, Perrone J, Delgado JH, Osterhoudt KC. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. In press. 2007.
- Cone EJ. Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the Internet. Drug Alc Depend 2006;83S:S31–9.
Niacin Flush Detox Method
With drug testing beginning to rise in popularity as a workplace standard, people are starting to look for more and more efficient ways to quickly cleanse their bodies of substances that could make them test positive. Taking niacin has long been a known detox method, but its effectiveness has always been a topic of debate.
Table of Contents
- What is Niacin?
- What Is Niacin Flush Method?
- Does Niacin Flush Method Work?
What Niacin Is
Niacin, otherwise known as Vitamin B3 is compound naturally found in a human body that serves the purpose of metabolizing carbohydrates. When it comes to niacin for drug testing, it is usually talked about niacin pills that can be bought in pretty much any pharmacy.
Niacin pills are usually used as a dietary supplement for people who are suffering from high cholesterol levels or low niacin levels, but it is also often used to increase the health of skin, hair and eyes. A niacin pill has around 500mg of niacin in it and the recommended daily dose is up to 2000mg, to prevent the occurrence of negative side effects.
Negative Side Effects of Niacin Pills
- Skin flushing
- Burning sensation
- Reddening of skin
- Skin lesions or hives
Niacin flush is a method that has been argued to allow a person to successfully clear out traces of metabolites from their body in a shorter amount of time than usual. This is done by increasing the rate at which body breaks down fats, which is where metabolites usually tend to deposit, which in turn allows the person to pass the drug test even though just a short period of time has passed since their last drug use.
The problem with this method is that niacin pills have varying levels of effectiveness from person to person, depending on their height and weight, as well as their metabolism rate. People with higher than average body fat content have reported this method to fail more often than people with lower body fat content.
Another thing to note about this method is that it is not a miracle solution like some people claim and that it has to be done over a period of time, preferably 2 – 5 days for maximum efficiency. This is due to the fact that niacin is very hard on one’s liver and taking large amounts of it (more than 500mg) at once poses a serious health risk.
On the other hand, if the person using this method properly spaces out their dosage (500mg or one pill every 6 hours for 3 or more days) and hydrates plentifully, they pass the drug test in 80% of the reports.
If Taking Niacin Pills
- Always space them out at least 5 hours to prevent overdosing.
- Drink a lot of water, preferably two full glasses with every pill. Also drink as much water, fruit juice, sports drinks or caffeinated drinks during the day, but be careful not to overhydrate oneself.
- Abstain from drugs and alcohol, to prevent negating the effect of niacin pills.
- Eat light meals and stay away from fatty foods.
Does Niacin Flush Work?
Despite the fact that many people claim that this method does not work, it usually stems from the fact that the amount of time that the pills were taken for was not sufficient. Taking a large dose of niacin pills in a short period of time, just before a drug test, often cause serious health problems then help pass said test. Only by giving it time will this method have the expected effect without the negative consequences.
- Jacobson T. A. A “Hot” Topic in Dyslipidemia Management—“How to Beat a Flush”: Optimizing Niacin Tolerability to Promote Long-term Treatment Adherence and Coronary Disease Prevention. Mayo Clinic Proceedings. 2010; 85(4): 365–379. doi:10.4065/mcp.2009.0535. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848425/.
- Kamanna V. S., Ganji S. H., Kashyap M. L. The mechanism and mitigation of niacin-induced flushing. International Journal of Clinical Practice. 2009; 63(9): 1369–1377. doi:10.1111/j.1742-1241.2009.02099.x. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779993/.
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