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

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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.

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 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.

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