Signs and Drug Tests

Toxicology screens (drug testing) done on blood and urine specimens can reveal the presence of many chemicals and drugs in the body. The sensitivity depends upon the substance itself, when the substance was taken, and the testing laboratory. Blood tests are more likely to detect the presence of an abused substance than urine tests, however, urine drug screens are more frequently done.

Opiates and narcotics are usually present in the urine 12 to 36 hours after the last use, depending on the amount used and the frequency.

CNS stimulants such as cocaine can be detected in urine anywhere between 1 to 12 days, again depending in frequency of use.

CNS depressants such as Valium and Xanax are detected up to 7 days after the last day of use, mostly depending on the substance used and how quickly it is eliminated by the body (half-life).

Most hallucinogens are also detectable in the urine up to 7 days after the last use. However, cannabis can be detected up to 28 days in regular users.

Drug Treatment

Treatment for the person with drug abuse or dependence begins with the recognition of the problem. Though previously "denial" was considered a symptom of addiction, recent research has shown that this symptom can be dramatically reduced if addicts are treated with empathy and respect, rather than told what to do or "confronted."

Treatment of drug dependency involves detoxification, support and abstinence. Emergency treatment may be indicated for acute intoxication or drug overdose. Often, there may be a loss of consciousness and the person may need to be on a mechanical respirator (breathing machine) temporarily. The specific treatment depends on the drug.

Detoxification is the gradual withdrawal of an abused substance in a controlled environment. Sometimes a drug with a similar action is substituted during the withdrawal process to reduce the unpleasant symptoms and risks associated with withdrawal. The process can be managed on an inpatient or outpatient basis.

If depression or other mood disorder exists, it should be treated appropriately. Very often drug abuse develops from efforts to self-treat mental illness.

Support Groups

Many support groups are available in the community. Most of them rely on the 12-Step program used in the Alcoholics Anonymous (AA) groups. Others include Narcotics Anonymous (NA), Ala-Teen, and Al-Anon. These and others can be found in your phone directory. SMART Recovery and LifeRing Recovery are alternatives for those who do not find the 12-step approach helpful.

Expectations (prognosis)

Drug abuse and dependence may lead to a fatal drug overdose. Relapses from drug abstinence may occur and lead to recurrent dependence.

Complications

depression relapse of drug abuse drug overdose bacterial endocarditis, hepatitis, thrombophlebitis, pulmonary emboli, malnutrition, or respiratory infections, caused by intravenous drug abuse Infection with HIV through shared needles Drug-induced loss of inhibitions may lead to unsafe sexual practices, which may result in unwanted pregnancies, sexually transmitted diseases, HIV or hepatitis. Problems with the law Increase in various cancer rates: for example, lung and pharynx cancer are associated with nicotine use, mouth and stomach cancer are associated with alcohol abuse and dependence Problems with memory and concentration are seen with hallucinogen use, including marijuana (THC)

Calling your health care provider

Call for an appointment with your health care provider if you are addicted to drugs and would like to get off of them or you have been cut off from your drug supply and are at risk of withdrawal. Most employers also offer referral services for their employees with substance use problems.

Prevention

Drug education programs may be helpful though none has proved effective in the long term.

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Reviewed: 10/2005