Iin an editorial that will accompany the print version of the study, Kennon Heard, M.D., and Carrie D. Mendoza, M.D., both of the Rocky Mountain Poison and Drug Center, wrote that this number of cases in a single system suggests that niacin overdosing may be fairly common to try to evade urine drug tests.
With tens of thousands of Web pages discussing this misguided use of niacin, "we expect there will be many more cases of niacin toxicity in the next few years," Drs. Heard and Mendoza added.
"With the proliferation of urine drug testing by prospective employers and various government agencies, more patients with niacin toxicity may present to emergency departments," Dr. Mittal and colleagues wrote.
Both adults -- a 23-year-old man who abused cocaine and a 22-year-old woman who abused marijuana -- took niacin before scheduled pre-employment urine drug tests. They were seen in the emergency department for niacin's characteristic skin flushing and burning in one case and itchy erythematous rash in the other, but the reactions resolved spontaneously.
