Cocaine Metabolite, Screen and Confirmation, Urine

CPT: 80307
Updated on 5/28/2019
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Test Includes

Cocaine metabolite. Confirmation by MS is automatically performed on positive samples at an additional charge.


Special Instructions

Chain-of-custody documentation is required for samples submitted for preëmployment, random employee testing, and forensic purposes. For other applications, use the standard request form. Please mark chain-of-custody test number on the request form.


Expected Turnaround Time

1 - 4 days

1 - 4 days



Specimen Requirements


Specimen

Urine


Volume

20 mL


Container

Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory.


Collection

Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes.


Storage Instructions

Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate.


Causes for Rejection

Quantity not sufficient for analysis; improper specimen (serum, plasma, blood); incomplete chain-of-custody documentation; incomplete specimen identification; improper or missing tamper-evident seals


Test Details


Use

Detect cocaine use


Methodology

Initial testing by immunoassay; confirmation of positives by mass spectrometry (MS). See drug profiles for multidrug testing.


Additional Information

Cocaine is a highly abused drug that is most frequently detected in the urine as the metabolite benzoylecgonine and usually as part of a multiclass drug profile. In preëmployment drug testing, the presence of cocaine (benzoylecgonine) should be confirmed by MS.

Cocaine is a central nervous system stimulant. It usually appears as a fine crystal-like powder that is the hydrochloride or sulfate salt and, as such, is “snorted” (inhaled through the nose). When mixed with sodium bicarbonate and converted to free base, it appears as hard pieces called “crack,” which can be smoked. This is currently a very prevalent form of the drug.

The effects of the drug begin within minutes and peak within 15 to 20 minutes. These effects include dilated pupils, as well as increased blood pressure, heart rate, breathing rate, and body temperature. The dangers of cocaine use vary, depending on how the drug is taken, the dose, and the individual. Some regular users report feelings of restlessness, irritability, anxiety, and sleeplessness. In some people, even low doses of cocaine may create psychological problems. People who use high doses of cocaine during a long period may become paranoid or experience what is called cocaine psychosis. This may include hallucinations of touch, sight, taste, and smell. Cocaine itself has a half-life of one to two hours while benzoylecgonine has an estimated half-life of seven to nine hours. Benzoylecgonine is detectable in urine within two to three hours and for a period of two to three days after a single use.


References

Chow MJ, Ambre JJ, Ruo TI, et al. Kinetics of cocaine distribution, elimination, and chronotropic effects. Clin Pharmacol Ther. 1985; 38(3):318-324. 4028628
Cone EJ. Validity testing of commercial urine cocaine metabolite assays: III. Evaluation of an enzyme-linked immunosorbent assay (ELISA) for detection of cocaine and cocaine metabolite. J Forensic Sci. 1989; 34(4):991-995. 2760594
Cone EJ, Menchen SL, Paul BD, et al. Validity testing of commercial urine cocaine metabolite assays: I. Assay detection times, individual excretion patterns, and kinetics after cocaine administration to humans. J Forensic Sci. 1989; 34(1):15-31. 2918277
Cone EJ, Mitchell J. Validity testing of commercial urine cocaine metabolite assays: II. Sensitivity, specificity, accuracy, and confirmation by gas chromatography/mass spectrometry. J Forensic Sci. 1989; 34(1):32-45. 2918287
Gawin FH, Ellinwood EH Jr. Cocaine and other stimulants. Actions, abuse, and treatment. N Engl J Med. 1988; 318(18):1173-1182. 3283549
Karch SB. The history of cocaine toxicity. Hum Pathol. 1989; 20(11):1037-1039. 2680890
Mittleman RE, Wetli CV. Death caused by recreational cocaine use. An update. JAMA. 1984; 252(14):1889-1893. 6471319
Zuckerman B, Frank DA, Hingson R, et al. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med. 1989; 320(12):762-768. 2784193

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
074443 Cocaine Metabolite, Qual, Ur 714857 Cocaine (Metab.) ng/mL 3393-6
Reflex Table for Cocaine (Metab.)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071324 Cocaine Metabolite Confirm,Ur 777169 Cocaine (Metab.) 3393-6
Reflex Table for Cocaine (Metab.)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071324 Cocaine Metabolite Confirm,Ur 071779 Benzoylecgonine GC/MS Conf ng/mL 16226-3
Reflex Table for Cocaine (Metab.)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071324 Cocaine Metabolite Confirm,Ur 070474 Documentation N/A
Reflex Table for Cocaine (Metab.)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071324 Cocaine Metabolite Confirm,Ur 739245 Cocaine Holding N/A

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