Drug testing is the most common method used to detect if a person has taken med-ication recently. Many businesses, government agencies, and healthcare facilities require prospective employees to be screened for drugs. In addition, employees might be required to undergo random drug testing or drug testing under special circumstances (such as medication unaccounted for in their work area).
Testing for drug overdose or poisoning is best done with blood. The immedi-ate levels found can determine what treatment should occur. Screening to
deter-mine if someone is using drugs inappropriately is commonly done with urine testing. Urine testing can detect drugs used days or even a week before the test is performed. As false positive and false negative results can occur, caution should be used when interpreting the results. When asked if they are taking any kind of medication, individuals should include prescription, over-the-counter, and herbal remedies. For example, traces of diphenhydramine (Benadryl)—a commonly used antihistamine medication—will be found in urine and will cause the person to test positive for methadone.
Whenever the result of a urine test is found to be positive for drugs, the per-son should undergo another test for that specific medication to confirm the results. The second test is used to identify a false positive that might be gener-ated by the first test. Again, urine testing is done but the request is to screen only for the specific drug identified in the first test. Blood levels may also be obtained to determine immediate use of drugs.
Drug testing only gives evidence that the individual has used or been exposed to a drug but does not indicate any pattern of drug use or the degree of depend-ency. Table 4-1 shows the length of time that traces of popular drugs remain in the body. The most commonly misused and abused drugs are listed in Table 4-2.
Drug Days Detectable in Urine
Alcohol Less than 1 day
Amphetamines Up to 1–3 days Barbiturates Up to 1 day short acting
2–3 weeks long acting
Cocaine Up to 2–4 days
Methadone Up to 3–5 days
Marijuana
Single use Up to 3–5 days Chronic use Up to 29 days Opioids—Short-acting Up to 3–4 days
PCP 2–4 days
Table 4-1. Days substances remain in urine.
Drug Description
Xanthines A class of drugs that include caffeine and are used in coffee, tea, chocolate, and colas. These drugs affect the central nervous system (CNS). Most frequently abused drug.
Nicotine Used in tobacco products. This drug affects the central nervous system (CNS). One of the most frequently misused and abused drugs.
Ethyl alcohol Used in distilled spirits and beverages. This drug affects the central nervous system (CNS). One of the most frequently misused and abused.
Anticholinergics A class of drugs that includes Robinal, which is referred to as the “date rape” drug. This drug affects the central nervous system (CNS).
Steroids A performance enhancing drug that affects the central nervous system.
Amphetamines A class of drugs that includes dextroamphetamine, “dexies,” and methamphetamine (commonly referred to as “speed” and “crystal meth”). This drug affects the central nervous system (CNS).
Pentazocine Creates a morphine-like effect. Also known as Talwin. This drug affects the central nervous system (CNS).
L-dopa Used to alleviate some of the symptoms of Parkinson’s disease.
This drug causes an alteration in feelings, thoughts, and perceptions.
Cocaine A leading drug resulting in visits to the emergency department.
This drug can cause tachycardia (fast heart rate), increased blood pressure, chills, fever, agitation, nervousness, confusion, inability to remain still, nausea, vomiting, abdominal pain, increased sweating, rapid breathing, large pupils, and advance to CNS hemorrhage, congestive failure, convulsions, delirium, and death.
Heroin A leading drug resulting in visits to the emergency department.
Heroin is a pro-drug and is converted in the liver to morphine with the same side effects.
Morphine A leading drug resulting in visits to the emergency department.
Morphine is an opioid narcotic analgesic. Side effects include sedation, decreased blood pressure, increased sweating, flushed face, constipation, dizziness, drowsiness, nausea and vomiting.
Table 4-2. The most commonly misused and abused drugs as reported by the National Surveillance Agency Drug Abuse Warning Network (DAWN).
Drug Description
Acetaminophen Commonly known as Tylenol. A leading drug resulting in visits to the emergency department. This medication is commonly used in overdoses and can cause serious kidney problems and death.
Aspirin A leading drug resulting in visits to the emergency department.
Aspirin abuse can cause gastric (stomach) irritation which can lead to ulcers and subsequent gastric hemorrhage (bleeding).
Alprazolam Known as Xanax, is an antianxiety and antipanic agent. Several of the side effects include episodes of violent and aggressive behavior, seizures, delirium, and other withdrawal reactions.
Marijuana/hashish These are cannabis drugs that seem to act as a CNS depressant.
The effects are mental relaxation and euphoria and decreased inhibitions.
Diazepam Commonly known as Valium it is used for short-term relief of anxiety symptoms. Side effects include drowsiness, fatigue, and ataxia (muscular incoordination). Overdose can result in somno-lence (sleepiness), confusion, diminished reflexes, and coma.
Ibuprofen This is a commonly used nonsteroidal anti-inflammatory drug.
Side effects and overdose can result in gastrointestinal bleeding or a metabolic acidosis.
PCP/PCP combinations PCP is a hallucinogenic drug that can cause violent and aggressive behavior.
Lorazepam Commonly known as Ativan. This causes an alteration in thoughts, feelings, and perceptions.
Benzodiazepines This medication can cause an alteration in thoughts, feelings, and perceptions.
Amitriptyline Commonly known as Elavil. This medication is a mood elevator and can cause an alteration in thoughts, feelings, and perceptions.
Clonazepam Commonly known as Klonopin. This medication is used to inhibit seizure activity. Side effects can be mild drowsiness, ataxia, behavioral disturbances that are manifested as aggression, irritability, and agitation.
d-propoxyphene Commonly known as Darvon. This is an opioid analgesic that can cause an alteration in sensory perception which includes euphoria, dizziness, drowsiness, hypotension, nausea, and vomiting.
Table 4-2. (continued)