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HelpMayo Test ID COKEU Cocaine and Metabolite Confirmation, Random, Urine
Ordering Guidance
1. For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order COKEX / Cocaine and Metabolite Confirmation, Chain of Custody, Random, Urine.
2. Additional drug panels and specific requests are available. Call 800-533-1710 or 507-266-5700.
3. If urine creatinine is required or adulteration of the sample is suspected, order ADULT / Adulterants Survey, Random, Urine.
Specimen Required
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: 10-mL urine tube
Specimen Volume: 10 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
Useful For
Detecting and confirming drug abuse involving cocaine
This test is not intended for employment-related testing.
Method Name
Gas Chromatography Mass Spectrometry (GC-MS) Confirmation with Quantitation
Reporting Name
Cocaine and metabolite Conf, USpecimen Type
UrineSpecimen Minimum Volume
5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days | ||
| Ambient | 72 hours |
Reject Due To
| All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Clinical Information
Cocaine is a drug of current health concern because of its proliferation among recreational drug abusers.
Freebase and crack increase the potential for major cocaine toxicity. Cocaine use is declining across the nation according to the National Institute of Drug Abuse.
Increasingly, laboratory results are disputed or there are medical/legal overtones. Therefore, physicians are finding an increased need to confirm positive results before informing or confronting the patients.
Reference Values
Negative
Positive results are reported with a quantitative gas chromatography mass spectrometry (GC-MS) result.
Cutoff concentrations:
COCAINE BY GC-MS
<50 ng/mL
BENZOYLECGONINE BY GC-MS
<50 ng/mL
Interpretation
Reports will specifically indicate the presence or absence of cocaine and benzoylecgonine.
The presence of cocaine, or its major metabolite, benzoylecgonine, indicates use within the past 4 days.
Cocaine has a 6-hour half-life, so it will be present in urine for 1 day after last use.
Benzoylecgonine has a half-life of 12 hours, so it will be detected in urine up to 4 days after last use.
There is no correlation between concentration and pharmacologic or toxic effects.
Clinical Reference
1. Baselt RC, ed. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. In: Biomedical Publications; 2014
2. Langman LJ, Bechtel LK, Holstege C. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
To accommodate the need to confirm specifically the presence of cocaine in urine, Mayo Clinic Laboratories offers a single test to identify cocaine and its principal metabolite, benzoylecgonine, by using gas chromatography mass spectrometry.(Chinn DM, Crouch DJ, Peat MA, et al. Gas chromatography-chemical ionization mass spectrometry of cocaine and its metabolites in biological fluids. J Anal Toxicol 1980;4:37-42; Rosado T, Goncalves A, Margalho C, Barroso M, Gallardo E. Rapid analysis of cocaine and metabolites in urine using microextraction in packed sorbent and GC/MS. Anal Bioanal Chem. 2017;409(8):2051-2063. doi:10.1007/s00216-016-0152-2)
Day(s) Performed
Monday, Wednesday, Thursday, Friday
Report Available
2 to 5 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80353
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| COKEU | Cocaine and metabolite Conf, U | 53747-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2922 | Cocaine-by GC/MS | 20519-5 |
| 2902 | Benzoylecgonine-by GC/MS | 16226-3 |
| 20671 | Cocaine Interpretation | 69050-3 |
| 28080 | Chain of Custody | 77202-0 |