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The American College of Medical Toxicology (ACMT) has released a position statement
regarding interpretation of urine analysis for the presence of cocaine metabolites. The College
emphasizes that a positive cocaine result on a urine test indicates exposure, but cannot be used
to determine clinical impairment.
Phoenix, Arizona (PRWEB) October 30, 2012 -- The American College of Medical Toxicology (ACMT)
supports the ideal of a workforce unimpaired by substance abuse. Cocaine remains one of the more widely
abused substances in the world, and abuse results in health problems that may carry over to the work
environment, including heart disease, high blood pressure, strokes, and traumatic injuries. Use of cocaine may
lead to missed days of work due to hospitalization or may even result in death. Workplace urine drug testing
programs have had many positive effects, including a decline in absenteeism, workplace theft, and on-the-job
accidents. However, ACMT recognizes that positive urine drug tests for cocaine are sometimes misinterpreted
as representing evidence of being under the influence of cocaine at the time of the test. In a position statement
available on their website, the College emphasizes that a positive urine drug screen does not indicate acute
cocaine intoxication, but rather reflects recent exposure to cocaine.
Testing for cocaine can be fraught with interpretive errors common to other tests. While the urine test for
presence of cocaine is very accurate, interpretation of the results in the context of a problem in the workplace
requires particular skill. The test for cocaine detects breakdown products of the drug for a window of up to five
days since last use. Thus, a positive test on a particular day does not mean that the patient used cocaine that day.
The bottom line, medical toxicology experts caution, is that a positive urine cocaine test alone does not mean
that an individual is currently impaired, or “high on the job”. The entire clinical picture, including the patient’s
vital signs and behavior should be considered before determining if a person is under the influence of cocaine at
a particular point in time.
The ACMT is a professional, nonprofit association of physicians with recognized expertise in medical
toxicology. The College is dedicated to advancing the science and practice of medical toxicology.