Cocaine remains one of the most studied psychoactive substances in modern medicine and toxicology. Lets examine the basics of drug testing for cocaine use as well as cutoff concentration levels and windows of detection for the drug.
What Is Cocaine?
Cocaine is a central nervous system stimulant derived from the leaves of the coca plant. It is classified as a Schedule II controlled substance, indicating both high abuse potential and recognized medical applications. Regarding legal medical use, cocaine is utilized as a topical anesthetic in ear, nose and throat surgery.
Powder cocaine (cocaine hydrochloride) is a white, crystalline powder that’s typically snorted or dissolved and injected. Crack cocaine is a crystallized form that’s usually smoked in a pipe. Street cocaine is often mixed “cut” with cheap substances like talc, sugar, corn starch and caffeine, to provide weight and increase profit margins for dealers. Fentanyl is sometimes added to increase the potency, despite the potential for causing an overdose.
Common routes of administration are intranasal, intravenous, smoking (crack) and oral consumption.
Common street names for cocaine include coke, blow, snow, powder and rock (crack cocaine).
From 2018-2019, the average estimated cocaine use among adults was 2.14%1.
Cocaine’s Affect On The Body
The primary mechanism involves three major neurotransmitter systems. This includes dopamine reuptake inhibition, serotonin reuptake inhibition and norepinephrine reuptake inhibition. This produces stimulant and intense euphoric effects.
Short-term effects include extreme happiness, sexual arousal, enhanced alertness/energy, decreased appetite, increased heart rate/blood pressure, elevated body temperature, sweating and dilated pupils.
Onset of effects can begin within seconds to minutes, depending on the route of delivery, and can last between 5 to 90 minutes. Inhalation has the quickest onset, followed by injection, snorting and lastly ingestion.
A mixture of cocaine and heroin is called a “speedball” and is known to have converse effects due to the opposite effects of the two drugs. Speedballs are thought to be responsible for many deaths including celebrities like Chris Farley, John Belushi and River Phoenix.
When is Cocaine Testing Required?
Workplace requirements are the most likely reason for cocaine testing. It may be tested for when applying for a job or as part of a random test after hiring. The Department of Transportation (DOT) drug testing program, which covers safety-sensitive employees in transportation industries, mandates testing for five specific drug categories which include: marijuana metabolites, cocaine metabolites, amphetamines (includes methamphetamine and MDMA), opioids (includes codeine, morphine, heroin, hydrocodone, hydromorphone, oxycodone, and oxymorphone) and phencyclidine (PCP). Cocaine is also required for most non-DOT drug tests as well.
Other situations that may require cocaine drug testing are law enforcement investigations, substance abuse treatment programs and child custody cases.
What Type of Specimens Are Used for Cocaine Testing?
Cocaine can be detected in various biological specimens. The type of specimen chosen depends on testing factors like purpose, desired detection window, and method availability.
Urine is the most commonly used specimen for cocaine testing. Blood, hair and oral fluid (saliva) can also be tested, although they are rarely used.
What Are The Test Cutoff Levels for Cocaine?
The body metabolizes cocaine into several compounds, with Benzoylecgonine being the main metabolite that drug tests look for. This metabolite actually stays in the system longer than cocaine itself, which is why it’s the primary target for drug testing.
The initial cutoff level for cocaine metabolite for DOT employees is 150 ng/mL2. The cutoff for confirmatory testing is 100 ng/mL.
Cutoffs for non-DOT employees typically mirror these same levels.
How Long Is Cocaine Detectable?
Cocaine can usually be detected in urine for 2-3 days. For chronic users, it may be detected for up to 7 days3. Detection times will depend on several factors like body mass index (BMI), metabolism, organ health, drug potency and frequency of use.
What Factors Can Affect The Detection Window?
Besides the type of specimen being used, there are additional factors which can also have an effect on detection time:
Dosage: Higher doses and more frequent use may lead to longer detection times since the cocaine metabolite has more of a chance to accumulate in the body.
Metabolism: Variations in metabolism can affect how quickly the body processes cocaine. In healthy people with efficient organ systems, it can be cleared from the blood a lot quicker. Whereas unhealthy people with malfunctioning organs may take longer to process and remove from the body. Body mass, kidney health, liver health, age and hydration status can all affect the efficiency of metabolizing psilocin in the body.
It’s important to note that these are general guidelines, and individual cases may vary. Either way, the detection window for cocaine is rather short for urine, blood and oral fluid, making it hard to detect use beyond a few days after use. If there is a compelling reason that somebody is suspected of using cocaine, but their urine, blood or oral fluid test has come up negative, hair testing needs to be considered as a next option due to its increased sensitivity.
How Long Does It Take to Get Results For Cocaine Testing?
If specimens are sent to a laboratory and the results are negative, they should be available within 24-48 hours. If the results are positive, it may take up to 3-5 additional business days due to additional time required for confirmation testing and MRO review to take place.
There are also commercially available rapid test kits which can give results for cocaine drug testing within 5-15 minutes. These tests are normally only used for personal monitoring and not for workplace use.
Additional Factors Affecting Turnaround Time:
–Laboratory Workload: Busier labs may have longer turnaround times due to high volume.
–Test Method: More specialized tests that use hair samples may take longer to process due to the complexity and additional steps in the process.
–Urgency: Some situations (e.g., medical emergencies) may warrant expedited testing.
Conclusion
Cocaine is a commonly used drug around the world. Although it does have a few valid medical uses, recreational use far outweighs its medicinal consumption. If you or someone you know suffers from cocaine addiction, reach out for help as soon as possible.
References
1. DOT Rule 49 CFR Part 40 Section 40.85. (2023, June 6). Retrieved from U.S. Department of Transportation: https://www.transportation.gov/odapc/part40/40-85
2.Mustaquim D, J. C. (2021, April 20). Trends and Correlates of Cocaine Use Among Adults in the United States, 2006–2019. Retrieved from National Institute of Health: https://pmc.ncbi.nlm.nih.gov/articles/PMC10032475/
3.Raouf M, B. J. (2018, April). A Practical Guide to Urine Drug Monitoring. Retrieved from National Institute for Health: https://pmc.ncbi.nlm.nih.gov/articles/PMC6368048/
