Urinary Toxicology Interpretation
Test Drug | Duration of Detection | Possible False Positives |
Amphetamines | 2–3 days | Amantadine, bupropion, chlorpromazine, desipramine, fluoxetine, labetolol, methylphenidate, phentermine, phenylephrine, phenylpropanolamine, promethazine, pseudoephedrine, ranitidine, thioridazine, trazodone |
Benzodiazepines | 3 days for short-acting Up to 30 days for long-acting | Oxaprozin, sertraline |
Cocaine | 2–3 days with occasional use Up to 8 days with heavy use | Topical anesthetics |
Opiates | 1–3 days | Dextromethorphan, diphenhydramine, fluorquinolones, poppy seeds, quinine, rifampin, verapamil |
PCP | 7–14 days | Dextromethorphan, diphenhydramine, ibuprofen, imipramine, ketamine, meperidone, thioridazine, tramadol, venlafaxine |
Marijuana | 3–7 days with single use 5–7 days with 4x weekly use 10–15 days with daily use >30 days with chronic heavy use | Dronabinol, NSAIDs (ibuprofen, naproxen, sulindac), PPIs |
Opioid and Stimulant Intoxication – Signs and Symptoms
Opioid Intoxication | Stimulant Intoxication (cocaine, amphetamine, etc.) |
Drowsiness Slurred speech Memory impairment Shallow and slow respiration Pupil constriction Coma | Hypervigilance Tachycardia or bradycardia Pupillary dilation Increased or decreased blood pressure Cardiac arrhythmias Psychomotor agitation or retardation Nausea or vomiting |
Opioid Withdrawal – Signs and Symptoms
Grade 1 | Grade 2 | Grade 3 |
Yawning | Mydriasis | Insomnia |
Sweating | Piloerection | Increased pulse |
Lacrimation | Muscle twitching | Increased respiratory rate |
Rhinorrhea | Anorexia | Elevated blood pressure |
Abdominal cramps | ||
Vomiting | ||
Diarrhea Weakness |
Opioid Pain Medication Conversions
NARCOTIC EQUIVALENTS | ||
Analgesic | Oral Dose (mg) | Parenteral Dose (mg) |
Meperidine (Demerol) | 150 | 50 |
Codeine (Tylenol #3 x3) | 100 | 60 |
Hydrocodone (Vicodin x3, Lortab x3) | 15 | N/A |
Morphine (MSIR, Roxanol) | 15 | 5 |
Oxycodone (Percodan x2, Percocet x2, Tylox x2) | 10 | N/A |
Methadone (Dolophine) | 10 | 5 |
Hydromorphone (Dilaudid) | 4 | 0.75 |
Levorphanol (Levo-Dromoran) | 2 | 1 |
Fentanyl | N/A | 0.05 |
Benzodiazepine Equivalencies
Generic Name | Trade Name | Comparative Dose (mg) | Time to Peak Plasma Level (hours) | Half-life (hours) |
Alprazolam | Xanax | 0.5 | 1-2 | 9-20 |
Chlordiazepoxide | Librium | 25 | 1-4 | 24-100 |
Clonazepam | Klonopin | 0.25 | 1-4 | 19-60 |
Diazepam | Valium | 5 | 1-2 | 30-200 |
Flurazepam | Dalmane | 15 | 0.5-1 | 40-250 |
Lorazepam | Ativan | 1 | 2-4 | 8-24 |
Oxazepam | Serax | 15 | 2-3 | 3-25 |
Temazepam | Restoril | 10 | 2.5 | 3-24 |
Triazolam | Halcion | 0.25 | 1-2 | 1.5-5 |