Investigating the incidence of false positive outcomes in drug detection assays

Immunoassays are widely utilized in urine drug screens due to their simplicity, ease of automation, and rapid results, making them the standard for clinical and workplace drug testing, as well as in rehabilitation programs and legal systems. However, the potential for cross-reactivity with both structurally related and unrelated compounds increases the risk of false-positive results. This poses significant challenges for healthcare professionals, especially in populations undergoing routine drug testing, such as those in recovery or court-ordered monitoring programs. The ongoing opioid epidemic in the United States, which has resulted in countless deaths from both prescription and illicit opioids, underscores the critical importance of accurate drug detection methods. This review evaluates specialized drug assays, highlighting their effectiveness and limitations. While immunoassays are highly sensitive, they often lack specificity, increasing the risk of false positives, which can affect clinical and legal decisions. This research also details substances prone to causing false positives, aiding clinicians in making informed diagnostic and therapeutic decisions.