Mental Health Book

Chemical Dependency

http://www.fpnotebook.com/

Toxicology ScreeningAka: Urine Tox Screen, Urine Drug Screen

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  1. Protocol: Assess validity of real urine sample
    1. Urine temperature (within 4 minutes of voiding): 90-100 degrees F
    2. Urine pH: 4.5 to 8.0
    3. Urine Creatinine: 20 mg/dl or greater (otherwise artificially diluted)
  2. Preparations: Sedatives and Hypnotics
    1. Alcohol (Ethanol)
      1. Positive: 3 to 10 hours
    2. Barbiturates
      1. Positive: 2 to 6 weeks
    3. Benzodiazepines
      1. Moderate use: 3 to 5 days
      2. Heavy abuse: 3 to 6 weeks
  3. Preparations: Stimulants
    1. Cocaine
      1. Direct: 5 hours
      2. Metabolite (Benzoylecgonine): 2-4 days
    2. Amphetamine or Methamphetamine
      1. Positive: 1 to 2 days
      2. May also detect MDMA
  4. Preparations: Opioids
    1. Codeine
      1. Positive: 1 to 2 days
      2. May be detected as Morphine (metabolite)
    2. Heroin (detected as Morphine on less specific testing)
      1. Positive: 1 to 2 days
    3. Hydromorphone (Dilaudid)
      1. Positive: 1 to 2 days
    4. Methadone (Dolophine)
      1. Positive: 2 to 3 days
    5. Propoxyphene (Darvon)
      1. Direct: 6 hours
      2. Metabolites: 6 to 48 hours
    6. Hydrocodone (e.g. Vicodin)
      1. May be detected as hydromorphone (metabolite)
    7. Morphine
      1. Positive: 1 to 2 days
  5. Preparations: Miscellaneous Agents
    1. Methaqualone (Quaalude)
      1. Positive: 2 weeks
    2. PCP (Phencyclidine)
      1. Positive: 2 to 8 days
      2. False positive with Ketamine
    3. Marijuana (THC metabolite)
      1. General
        1. Second hand Marijuana smoke does not cause a positive result (50 ng/ml or more)
      2. Positive Urine
        1. Use of one joint: 2 days for use of 1 joint
        2. Use three times per week: 2 weeks
        3. Use Daily use: 3 to 6 weeks
      3. Positive Blood: 8 hours
    4. Rohypnol
      1. Positive: 72 hours
    5. GHB
      1. Positive: 6-12 hours
    6. Soma
      1. Detected as Meprobamate (metabolite)
  6. Efficacy: False positives
    1. Amphetamines or Methamphetamines
      1. Pseudoephedrine
      2. OTC Vicks inhaler
    2. Opioids
      1. Poppy seeds (requires high concentration)
      2. Rifampin
      3. Levofloxacin
    3. Marijuana (THC)
      1. Pantoprazole
  7. Efficacy: False Negatives
    1. Oxycodone
    2. Methadone
    3. Fentanyl

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