Effect of intranasal cocaine on the urine drug screen for benzoylecgonine

O. S. Reichman, R. A. Otto

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Otolaryngologists have long recognized the value of cocaine as a topical anesthetic and vasoconstricting agent. It is used in nasal surgery and as a vasoconstrictor before examination. As drug abuse has increased, screening for drugs of abuse has become common. This study was designed to determine how medicinal cocaine affects the urine test for the metabolite benzoylecgonine, the most common screening test for cocaine. Group I consisted of 12 patients scheduled for elective nasal surgery. Cocaine was given in our usual preoperative manner as 4 ml of 4% solution on cottonoids. Group II consisted of 30 volunteers in whom approximately 1 ml of 4% solution was sprayed intranasally. In both groups, a urine sample was collected before dosing and at regular intervals afterwards. All samples were negative before application of cocaine and all were positive 24 hours later. The duration of the positive result had some variability, but all were negative by 72 hours. The results show that medicinally used cocaine does make a drug screen positive. Patients should be informed that cocaine is being used and could cause a positive test for several days.

Original languageEnglish (US)
Pages (from-to)223-225
Number of pages3
JournalOtolaryngology - Head and Neck Surgery
Issue number3
StatePublished - 1992

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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