Dispelling myth of  cocaethylene in urine test from alcohol and cocaine use

Seems folks who have been learning from Hair Razor Detox that cocaine use during alcohol consumption use crests a metabolite called cocaethylene that is screened for in Hair test. 

  They then get confused and spread it all over the internet wrongfully  that this is a general case and is tested for in urine. IT IS NOT .

  

First what is Cocaethylene  ?

Metabolic production from cocaine

Cocaethylene is the byproduct of concurrent consumption of alcohol and cocaine as metabolized by the liver. Normally, metabolism of cocaine produces two primarily biologically inactive metabolites—benzoylecgonine and ecgonine methyl ester. The hepatic enzyme carboxylesterase is an important part of cocaine's metabolism because it acts as a catalyst for the hydrolysis of cocaine in the liver, which produces these inactive metabolites. If ethanol is present during the metabolism of cocaine, a portion of the cocaine undergoes transesterification with ethanol, rather than undergoing hydrolysis with water, which results in the production of cocaethylene.^[1]

cocaine + H₂O → benzoylecgonine + methanol (with liver carboxylesterase 1)^[4]

benzoylecgonine + ethanol → cocaethylene + H₂O

cocaine + ethanol → cocaethylene + methanol (with liver carboxylesterase 1)^[5]

 

        NOW the ISSUE AT HAND IS  WHAT IS TESTED FOR IN URINE VS  HAIR !

 

A hair screen presents more metabolites for cocaine than any drug . 

 The cocaine part of Hair Test are 

Cocaine 

Major metabolites

benzoylecgonine (BE) 

 Eecgonine methylester(EME) 

Minor metabolites

Cocaethylene (CE) ( created by presence of alcohol) 

Norcocaine  ( NCoc )  ( minor metabolite )

3 isomers of hydroxycocaine (p-OHCoc, m-OHCoc, and o-OHCoc) found higher in body hair vs head

p-hydroxybenzoylecgonine (pOHBE), and m-hydroxybenzoylecgonine

Hydroxycocaines as percent of cocaine did not appear to be affected by cocaine concentrations, but were shown to increase with cocaethylene concentrations  (1)

not all Hair test screened for these   the most common are 

 Cocaine 300 pg/mg

 Benzoylecgonine 300 pg/mg

 Cocaethylene 300 pg/mg 

 Norcocaine 300 pg/mg

• Detection Period: The detection period for cocaethylene is similar to that of cocaine, which is relatively short, usually up to a few days. 

URINE SCREENS

 

Quest urine alcohol test 

Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are the alcohol (ie, ethyl alcohol, ethanol) metabolites measured in this test.  (  AS YOU SEE NO COCAETHYLENE )

 

  https://www.questdiagnostics.com/healthcare-professionals/clinical-education-center/faq/faq158#accordion-c9280a9c2c-item-af9f1f7cc3

 

 no separate test for Cocaethylene

Cocaine is a common drug of abuse. To detect its use, a screening detection concentration for the cocaine metabolite benzoylecgonine is commonly set at 150 ng/mL and its confirmatory cut‐off is set at 100 ng/mL. (2)(3)

 their are other metabolites used such as

enzoylecgonine (BE)   ( up to %40 of the metabolites) 

 

 ecgonine methyl ester and six minor metabolites (norcocaine, benzoylnorecgonine, m-hydroxycocaine, p-hydroxycocaine, m-hydroxybenzoylecgonine, and p-hydroxybenzoylecgonine) accounted for approximately 18%,

 

 Anhydroecgonine methyl ester was present in trace amounts (0.02% dose) in specimens collected after smoked cocaine

anhydroecgonine methyl ester tho not common in urine test show when cocaine was smoked such as crack 

 

 However the only one used in a standard urine screen is BE

HOW IS ALCOHOL FOUND IN URINE ?

Urine analysis can test for alcohol use by detecting the presence of  Ethyl Glucuronide (EtG), a metabolite found in alcoholic beverages. The test can show ethanol ingestion within the previous 3-4 days

Ethyl glucuronide (EtG) is a metabolite of ethanol which is formed in the body by glucuronidation following exposure to ethanol, usually from drinking alcoholic beverages. It is used as a biomarker to test for ethanol use and to monitor alcohol abstinence in situations where drinking is prohibited, such as by the military, in alcohol treatment programs, in professional monitoring programs (health professionals, attorneys, airline pilots in recovery from addictions), in schools, liver transplant clinics, or in recovering alcoholic patients.^[1][2] In addition to its use to monitor abstinence and detect drinking, EtG also has potential for monitoring the amount of alcohol use over time because it can be detected in hair and nails, though the effectiveness of this has not yet been proven.^[3][4]

• Detection Period: ETG can be detected in various biological samples such as urine, blood, and hair for an extended period, sometimes up to 80 hours or more after alcohol consumption.

  
  

• ONLY the main metabolite benzoylecgonine (BE) is screened in a urine test.  If they want to test for alcohol it is standard practice to look at ETG.

 ETG and Cocaethylene COULD be found in all types of testing However   

Alcohol metabolites  ETG is tested for in urine and Cocaethylene  is tested for in hair test. 

 ETG is used in Urine vs. cocaethylene because it is  found longer in urine .

 

1. https://pubmed.ncbi.nlm.nih.gov/33010562/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573903/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371026/

https://pubmed.ncbi.nlm.nih.gov/9780135/

https://www.sciencedirect.com/science/article/abs/pii/S0379073820303789

Why Do I get Negative results on some home test and positive on others?

 "Why do I get negative results on some tests and positive on others?"

Optimizing Detox and Self-Testing for Consistent Results

In the pursuit to eliminate toxins from our bodies, many individuals turn to detoxification methods and self-testing. However, a common question that often arises is, "Why do I get negative results on some tests and positive on others?" In this article, we will delve into the intricacies of detoxing and self-testing, exploring the factors that can lead to varying results and providing guidance on achieving consistent and accurate outcomes.

Understanding the Threshold Cut-Off

One of the key factors that can lead to differing test results is the threshold cut-off. This cut-off represents the minimum level of a substance, such as a metabolite or toxin, that a test can detect. When you are close to this threshold, even minor variations in your body's composition and activity can affect the outcome of your test.

Factors Affecting Test Results

To ensure reliable and consistent test results, consider the following factors:

1. Timing

Testing at different times of the day can yield varying results. Urine is typically most concentrated in the morning, making it an ideal time for testing. Passing a test in the morning indicates a higher likelihood of passing later in the day after hydration. However, if you fail the morning test, trying again in the evening when you're adequately hydrated may yield different results.

2. Hydration Levels

Maintaining consistent hydration levels is crucial. While it may be tempting to consume excess water, thinking it will help, it can actually dilute the concentration of substances in your urine, potentially leading to skewed results. Stick to your normal hydration levels to maintain consistency.

3. Physical Activity

Engaging in cardio exercises can release stored metabolites into your bloodstream, which may affect test results. It's advisable to avoid cardio activities for at least two days before self-testing to minimize this impact.

Best Practices for Consistency

To achieve consistent and reliable results when detoxing and self-testing, follow these best practices:

1. Self-Test Once a Week

Limit your self-testing to once a week while doing cardio. Frequent testing can lead to variations in results, as your body's composition changes over time from cardio which releases drug metabolites. Waiting a a couple days without cardio allows for a result not impacted by this variable.

2. Choose the Right Time

Select a time for testing that aligns with your goals. Morning testing is recommended for an initial check, and if you pass, you can be confident about subsequent tests later in the day. However, if you test positive results difficulties in the morning, you can opt for an evening test when you're better hydrated. This would also be when you want to test for real.

3. Maintain Hydration

As mentioned earlier, consistency in hydration is vital. Stick to your normal hydration levels and avoid excessive water consumption before testing to ensure accurate results and avoid false negative results.

Read This if you have any questions about how to read a THC self test regarding faint lines or anything else.

 In conclusion, achieving consistent and accurate results when detoxing and self-testing requires a clear understanding of the factors that influence test outcomes. By following the best practices outlined in this article, you can optimize your testing process and increase the likelihood of achieving the results you desire. Remember that consistency in timing, hydration, and physical activity is the key to success in this endeavor.

 If you are unable to detox naturally in time for a urine drug test it is always easier to simply substitute with a quality powdered synthetic urine like FAKE IT 

 

 

 

 

How to Tell What Your Urine Drug Test is for

 Urine Drug test, What am I being tested for ?

When you look at a test form it will typically have a code and some abbreviations at top. The code may be of little use as it is only billing code. The abbreviations tell you what type panel and or number of items are being tested.   

 

The Standard for  a Urine test is a 5 panel  

 Amphetamines

Cocaine

Marijuana 

Opiates ( Natural as in Heroin, Morphine, Codeine  ) 

Phencyclidine ( pcp) 

A 4 PANEL    can be a number of things

THC (marijuana), Cocaine, Opiates, Methamphetamine 

OR  

 (AMP) Amphetamine, (BZD) Benzodiazepine, (COC) Cocaine drug test, and (THC) Marijuana

 

OR a 5 panel without THC  in places with no THC testing  like  PA , NV  

 

SO here are some examples of abbreviations on forms

2480 - 7DSP/NO THC/PHN  

This is a 7 panel  test  

DSP stands for " Drug Screen Panel"  sometimes they will say SAP and means Substance Abuse Panel  
 

NO THC is stating NO THC is being screened,  typical if you're in a legal state 

other no THC version include,  - THC or XM  (excludes marijuana ) 
 

 PHN  indicates that they will run additional test for 4-hydroxynorephedrine which is a metabolite of amphethamines and methamphetamine.  This makes clarifies results false positives with need of confirmation screens

 

5111- 9DSP/EXP OPI/NO THC,PPX/OXY/ECS/PHN   

9 Panel - AMP- Amphetamine, BAR- Barbiturates, BZO -Benzodiadepines, COC-Cocaine, THC- Marijuana,MTD- Methadone, MET-Methamphetamine, OPI-Opiates, PCP-Phencyclidine

 Extended opiate - standard opiate panel is for natural such as heron , codeine and morphine , the extended panel included synthetic and semi synthetic opioids like oxycodone, hydrocodone, fentalyne and others

  NO THC 

 PPX -( propoxyphene  Brand names: Darvon,Opioids (narcotic analgesics) , 

OXY -oxycodone, ECS ectacy, PHN amphetamine  

 

THE FOLLOWING HAVE ADD ONS AND VALIDATION TESTING 

SVT or quest code TS (test sure) 

 10SAP  (-THC)  +SVT     

10 panel , no THC , with specimen validity test  SVT 
 

SVT 
Adulterations:  
CR - Creatinine 
GL - Glutaraldehyde 
pH - Acidic or Alkaline 
NI - Nitrite 
OX - Oxidants 
SG - Specific Gravity 

 

 E CUPS

 Point of Collection Testing (POCT) 

  XCup4-4045     4 panel  no THC

Amphetamines 500/250 - Cocaine 150/100 - Opiates/Morphine which includes Codeine, Hydromorphone, & Hydrocodone 2000/2000 -Phen-cylidine (PCP) 25/25

 

 

 

 QUEST  BASE CODE LIST (not all inclusive)

Test List with Test Codes
Clinical Drug Monitoring Test List and Panels

Examples

Quest 32187N

   4 panel drug test for cocaine, amphetamines, opiates, PCP. No THC testing

Quest (65765N)     SAP 4  ( 4 Panel )  SYN OP/6AM/OXY/A5,C15,TS    Extended opiate - NO THC - Test Sure validation

35765N    4 Panel (XM)      4 panel  no THC   with nitrate validation screen

 

 35726N SAP9 #1s w/nit  

This is a quest  9 panel , with added nitrate ( testing for additives or nitrites ) aka spiking agents  

SAP10 50/2K -3+6A/MDA

10 Panel  - 

• Amphetamines (1000 ng/mL screen), Barbiturates, Benzodiazepines, Cocaine Metabolites, Marijuana Metabolites (50 ng/mL screen), Methadone, Methaqualone, Opiates, Phencyclidine, Propoxyphene

with added methaqualone( Quaaludes )  Heroin ( specific from morphine)   and MDA  

with 50ng THC and 2000ng Opiate cutoff

•  

QUEST DOT TEST 

65304N - DOT DRUG PANEL W/TS

AMP / COC/ THC/ OPIATE  (natural  ) heroin morphine) / Opiate semi synthetic (hydromophone) / OXY ( oxycodone ,oxymorphon) / PCP

 with true test validation

 

Sometimes they will list cutoff values for example a typical cocaine cut off is 300 this one is for 150

1373 - 9DSP/EXP OPI2000/AMP500/COC150/ECS/6 AM/PHN 

SO you have 9 panel - standard opiate ( heroin , codeine , morphine ) plus extended opiate ( (Codeine, Morphine, Oxycodone, Hydromorphone, Hydrocodone )

AMP amphetimine cut off 500 - with   PHN  a extra amphetamine screen  -  cocaine cutoff 150 ,  ectacy MDMA, 6 AM  an extra Heroin screen ,  PHN  a extra amphetamine screen 

This is a list of common abbreviations to drugs  

 

Drugs Tested: 
AMP - Amphetamines  

BAR - Barbiturates  

BUP - Buprenorphine  

BZO - Benzodiazepines  

COC - Cocaine  

COT -  Cotinine (nicotine) 

CFCL - Carfentanyl 
EDDP - Methadone Metabolite  

ETG - Ethyl Glucuronide

 

ECS - Ecstasy or MDMA

FEN - FN - Fentanyl  

GAB -  Gabapentin 

GHB -  GAmma Hydroxybutyric acid 

 HYD - Hydrocodone

 
K2 - Synthetic Marijuana  

KET - Ketimine 

LSD 

MCAT/ MDPHP  - Methcathinone  

 

MDMA / XTC - Ecstasy  

MET / MAMP- Methamphetamines  

OPI - Opiate (natural , Heroin , codiene morphine)  
 

MOP - Morphine / Opiates  

MPD -( methylphenidate   aka  Ritalin  )   ritalinic acid (RA)

MEP -  Mephadrone 

MTD - Methadone  
OXY - Oxycodone  

PCP - PZ- Phencyclidine  

PPX - Propoxyphene 
THC -( MAP)  Cannabinoid (Marijuana)  

TRA / TCA -  Tricyclic Antidepressants (Tramidol)  
 

PHN indicates that they will test for 4-hydroxynorephedrine which is a metabolite of amphethamines and methamphetamines 

 6 AM - heroin

 

 

 FAKE IT SYNTHETIC POWDERED URINE  -

 Over 20 years NEVER a Failed test