Opioids or opiates are any narcotic alkaloids from immature pods of the Papaver somniferum (opium poppy).  These are considered to be the world’s oldest recognized drug.  This was discovered and used even during the prehistoric eras in the Mediterranean area. The ancient Romans and Greeks believed this drug as the ultimate panacea and it appeared in their Greek pharmacopeia as early as the 5^th century BC. With the expansion of Islam, opioid use was spread from Turkey to the other parts of the world. It was the Arab traders in the 8^th century BC who introduced this to the Indians and Chinese. When the Chinese emperor prohibited the smoking of tobacco in 1644, the Chinese changed to opium smoking. When the Arabs traded with Vienna, they also introduced opium to the Europeans.

At present, opioids are used to treat moderate to severe pain, severe diarrhea, and anxiety with shortness of breath, cough suppression and opioid dependence (buprenorphine and methadone). Unfortunately, these drugs are one of the most commonly abused drugs worldwide. The opioids stimulate the brain to release “euphoric” chemicals that would eventually lead to dependence and abuse.

Opioid Drugs

Opioids are classified into four general classes:

1. Endogenous opioid peptides, those that are produced naturally by the body
2. Opium alkaloids
3. Semi-synthetic opioids
4. Fully synthetic opioids

These drugs are used to manage acute pain and are effective in alleviating severe, persistent disabling pain associated with degenerative conditions (rheumatoid arthritis) and cancer. Cough suppression and severe diarrhea especially those related with irritable bowel syndrome are also prescribed these drugs.

Opioids are relatively safe for use under supervision from physicians. They should not be taken together with other medications and substances that would depress the CNS like antihistamines, benzodiazepines, barbiturates, general anesthetics or alcohol since it will increase the probability of respiratory depression that is life threatening.

List of Opioids

Since opioids are narcotic drugs that can lead to abuse and dependence, drugs classified under these are regulated by the FDA.

Opioids List of Natural or Opium Alkaloids

These drugs are naturally-occurring opioids that are alkaloids from the opium poppy’s resin.

• Morphine
• Codeine

Opiods List of Semi-synthetics

These are opioids that are manufactured from the opium alkaloids and are lipid-soluble. They mimic the structures of the natural opiates. When drug tests for opiates are done, these medications are not detected with the exception of dimethylmorphine because it is immediately metabolized into morphine.

• Acetylmorphone
• Buprenorphine
• Heroin
• Codoxime
• Desomorphine
• Diacetylmorphine
• Ethylmorphine
• Hyrocodone (Hycodan)
• Hyrdomorphone (Dilaudid)
• Meperidine (Demerol)
• Nalbuphine
• Naloxone
• Oxycodone (Percodan)
• Pentamorphone
• Thebacon

Opiods List of Synthetics

These drugs are wholly man-made and have chemical structures that are distinct from opium alkaloids. As with the semi-synthetic opioids, these drugs are not detected in drug tests for opiates.

• Fentanyl (Sublimaze)
• Methadone (Dolophine)
• Propoxyphene (Darvon)
• Pentazocine (Talwin)

Endogenous Opioids

These opioids naturally produced in the body and are used as neurotransmitters and influence body functions such as thirst, hunger, moods, pain reactions and immunity. Endogenous opioids include:

• Endorphins
• Enkephalins
• Dynorphins
• Endomorphins

Endorphins are manufactured at the hypothalamus and pituitary glands during strenuous activities, pain, orgasm and excitement. They work as intrinsic pain relievers and resemble natural opiates in their capacity to generate a sensation of well-being and analgesia. Enkephalins, on the other hand, are pentapeptides that play a role in processing noxious stimuli directed to the body.

Dynorphins are produced in several areas of the brain such as the spinal cord, hippocampus, medulla, hypothalamus, midbrain and the pons. How they act would depend where they were released. Basically, they are modulators of pain, preserve homeostasis by controlling appetite and the circadian rhythm, temperature regulation and weight control.

Endomorphins are heavily distributed in the upper brainstem and the brain particularly in the cortex, nucleus accumbens, amygdala, hypothalamus, thalamus and dorsal root ganglia. These endogenous opioids control arousal and sedative behaviors, responses that are related to stress, reward and vigilance.

Opioid Analgesics

An opioid analgesic is a powerful pain reliever that produces an effect on the central nervous system in order to relieve pain. Some of these narcotic analgesics are used before or in the course of the surgical procedure to enhance the effects of the anesthetics. This type of analgesic is the mainstay for therapy of acute severe pain and chronic pain caused by cancer because of its effectiveness in pain control.

The opioid analgesic is more effective if given at regular intervals before the pain becomes intense. If the pain is unrelieved, the dose should be increased gradually or an additional drug (e.g. NSAID) may be incorporated. When the amount of pain decreases, the dose should also be reduced accordingly. If tolerated, the narcotic analgesic should be substituted with a non-opioid type.

Frequent side effects felt by users are nausea and vomiting, drowsiness, miosis, dry mouth, urinary retention, orthostatic hypotension and constipation (sometimes fecal impaction). Less common reactions would include confusion, delirium, hallucination, hives, hypothermia, itch, bradycardia or tachycardia, increased intracranial pressure, muscle rigidity, flushing and biliary spasm. Patients taking higher doses of opioid analgesic should be monitored closely for respiratory depression and fatal overdose. In cases like this, the antidote (nalaxone) is given intravenously.

Some individuals who are on prolonged narcotic analgesic therapy tend to develop tolerance and would need higher doses for the effects to be felt. Others develop dependence and would experience withdrawal symptoms once the drug is stopped. The dose of the drug is usually reduced gradually to prevent such from happening.

Opioid analgesics are usually taken orally but if the treatment therapy is prolonged, then a skin patch is used. For acute pain, these medications can be given intravenously or intrathecally.

Opioid Receptors

Opioid receptors are G protein-coupled receptors that use opioids as signal generating molecules (ligands).  There are three major opioid receptors (mu, kappa and delta) that are found all through the CNS predominantly in areas linked to perception of pain (brain, spinal cord) and the GI tract. The mu receptor has affinity to morphine, kappa receptors are more partial to partial agonists such as pentazocine and the delta receptors have high affinity for enkephalins (endogenous).  When the narcotic analgesics or opioid drugs attach to these receptors, the perception of pain is blocked.

Pert and Snyder from John Hopkins School of Medicine located two areas of the CNS where the opioid receptors are prevalent – spinal column and the medial thalamus (brain). Pain is first detected by the spinal column and the signals are concentrated at the medial thalamus. Opioids slow down the rate the pain messages are transmitted thus the sensation is reduced and the euphoria that comes with its use.

Opioids are classified into three different types based on how they affect the receptors. Opioid agonists are those agents that unite with receptors and instigate a physiological reaction. An example of this type is morphine. The opioid antagonist, on the other hand, has an opposite effect; it inhibits the effect of the agonists. A partial agonist has both antagonist and agonist characteristics. It binds to a receptor that induces pain relief (agonist) and to an additional receptor that will not initiate a physiological effect (antagonist).

Opioid antagonist drugs compete for binding with opioid receptors. They have higher affinity to the receptors compared with the agonists. However, they do not activate the receptors thus inhibiting the body from reacting to opiates and endogenous endorphins. These drugs are used as antidote for opioid overdose. Examples of opioid antagonist drugs are naltrexone and nalaxone.

Opioid Dependence

Dependence to opioid is basically a group of behavioral, cognitive and physiological episodes with unpredictable intensity wherein the use of opioids takes a higher priority than other activities, sometimes including ADLs. The user cannot stop using the drug and has the strong desire to take it with or without medical prescription.

Most of the abused opioids are prototypes of the mu agonists. The activation of these receptors cause euphoria (“high”) and when the levels are increased rapidly, it generates an intense but brief “thrill” or “rush”. The chronic use of opioids would result to tolerance and dependence. Individuals with opiate addiction usually use more opiates to avoid the unpleasant effects of withdrawal and not the gratifying sensations felt with first use.

Dependence or opioid addiction requires a long-term care and treatment plan. This is important to lessen the social and health effects of the condition and improve the social functioning and well-being of the person involved.

Opioid Withdrawal

Opiate withdrawal includes an assortment of symptoms that come about after significantly decreasing the dose of the opiate drug or stopping it abruptly after a prolonged and heavy usage. The system requires enough time to recuperate and compensate for the loss of the drug, thus withdrawal symptoms occur. Symptoms may differ depending on the extent of the dependence.

Opioid Withdrawal Symptoms

Symptoms are felt at different stages based on the last use:

Beginning symptoms are felt less than eight hours from last use and will peak within 36 to 72 hours. The patient will feel fear of withdrawal, anxiety, diaphoresis, cravings, chills, rhinorrhea, yawning and lacrimation.

Twelve hours from last use (peak: 72 hours) patient will experience piloerection, dialted pupils, anorexia, irritability, anxiety, dysphoria, mild to moderate insomnia, restlessness, mild tachycardia, slight hypertension, tremors and abdominal cramps.

From 24 to 36 hours from last use (peak: 72 hours) patient will suffer abdominal cramps, myalgia, diarrhea, muscle spasms particularly at the lower extremities, nausea and vomiting, severe insomnia and violent yawning.

Resolution of the physical symptoms would generally be around five to ten days. Psychological symptoms such as insomnia or dysphoria, however, would take about weeks or months to resolve.

Opioid Withdrawal Treatment

Therapy would involve supportive care and the use of medications. Generally clonidine is the customary drug used to reduce autonomic hyperactivity syndrome such as agitation, anxiety, sweating, rhinorrhea, myalgia and cramps. The major disadvantage of this medication is the resulting hypotension. Medications for vomiting and nausea are also given.

It has been found out that Buprenorphine (Suptex) works better compared to other opioid antagonists in managing withdrawal symptoms. It can cut down the duration of detox.

For the first three months, behavioral therapy and counseling is done. Abstinence is critical during these days, thus, in-patient management is recommended for close monitoring. Long-term treatment is crucial in order to prevent any relapses.

Opioid Conversion

There are times when physicians need to switch from one opioid to another or from one route of administration to another in order to meet the medical needs of the patients and the response to the drug. Accurate conversion is subject to a several factors such as drug dosage, physiologic differences in the metabolism of the drug and cross-tolerance with other opioids. Conversion must allow for other factors such as the level of residual drugs, the length of time to attain a steady-state level in the blood and the response of the patient to the drug.

Opioid Abuse

Opioid abuse takes place when the obsessive use of opioids would harm the health of the user and affects the social functioning. Individuals become addicted to opioids because of the swift, forceful euphoric sensation that is followed by a calm and comfortable drowsiness.

Risk factors that would increase the chance of abusing opioid use would include gender (males more prone), age (young adults), abuse of other drugs, and positive psychological disorder.

Opioid Addiction Treatment

Opioid dependence treatment would include a rehabilitation program where the opioid abusers are placed in a controlled environment for at least six to twelve months. There might be a necessity to detoxify the patients first before undergoing behavioral therapy. In a detoxification center, the withdrawal symptoms are managed safely.

Aside from these, opioid dependence treatment would also include the use of medications that would help reduce the unpleasant withdrawal symptoms. Methadone, Buprenorphine and Buprenorphine + nalaxone are the common drugs being used.

References:

http://www.inchem.org/documents/pims/pharm/pimg023.htm

http://www.nida.nih.gov/researchreports/prescription/prescription2.html

http://www.who.int/substance_abuse/activities/treatment_opioid_dependence/en/index.html

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Nicotine, an alkaloid found in the leaves of tobacco plant, is an exceptionally addictive substance and is the active component of tobacco smoke. The crucial question for smokers and healthcare workers is:  How long does nicotine stay in your system? Tobacco leaves contain around two to seven percent nicotine.  Nicotine  imitates the effects of the neurotransmitter acetylcholine and has serious effects on the autonomic nervous system.  It can cause paralysis and respiratory failure even at doses that are below 50 mg. [2]

The tobacco plant is  a member of the Solanaceae family. [4] Biosynthesis of nicotine occurs in the roots. It is carried to the leaves for storage. The purpose of nicotine is to help protect the plant from insects.

Five percent of tobacco plant’s dry weight is nicotine. Depending on the brand, one cigarette may have eight to twenty milligrams of nicotine. The typical inhaled dose is about 3 mg [2]. But only about one milligram is  absorbed by the body. Even at this dose, nicotine affects the central nervous system and can cause:

• constriction of blood vessels,
• tachycardia,
• tachypnea (very rapid breathing),
• hyperglycemia,
• nausea.

In the United States, nicotine is a widely used and addictive drug. According to the National Household Survey on Drug Abuse, approximately 62 million individuals from age twelve and up are cigarette smokers – that’s about 29% of the US population.

Worldwide, around one-third of the adult male population smokes. Everyday around 80,000 to 100,000 children  start smoking and almost half of them are from Asia.

How long does Nicotine stay in your system?

Once nicotine is inhaled, it is quickly absorbed into the system due to the high blood flow in the lungs. It  only takes around ten seconds to reach the brain. Nicotine is metabolized in the liver and further breakdown occurs in the lungs and the kidneys.

The main metabolites produced are nicotine N-oxide and cotinine (major indicator of nicotine presence). Generally, it takes about 72 hours from the last use for other nicotine by-products to leave the system. Yet cotinine remains in the system for as long as four days.  Cotinine can also remain for several months, depending on how much tobacco was smoked and the length of time the user has smoked.

How long does Nicotine stay in your blood?

The length of time nicotine remains in the blood stream depends on the amount consumed and the frequency of consumption. Nicotine can stay for 48 hours.  Beyond this time it is not detected either in the blood or urine. However, the cotinine metabolite can leave traces for about 7 days. There are some people who have anomalies in their genes that trigger the slow metabolism of cotinine. They need to stop smoking for at least a day or more to clear the nicotine metabolites from their system. Cotinine levels must be less than 10 ng/ml for an person to pass the blood tests. This is just one part of the answer to the question, “How Long Does Nicotine Stay in Your System?”

How long does Nicotine stay in your urine?

The length of time it takes for nicotine and its metabolites to stay detectable in urine depends on the user’s rate of metabolism, height, weight and the how much water is consumed in a day. On average, nicotine can be detected in the urine for as long as three days. Passive smokers have nicotine traces for about fifteen to twenty days.

How long does Nicotine stay in your saliva?

Most of the nicotine will be excreted from the system within twenty minutes after smoking. Nonetheless, it can be detected in the saliva for approximately 24 hours after the last smoke. Its metabolite, cotinine, can be detected for as long as 4 to 7 days depending on the amount of nicotine consumed. For heavy smokers, it may be detected up to seven to fourteen days.   You are beginning to see how challenging it is to adequately answer the question of How Long does Nicotine Stay In Your System.

Nicotine Effects

Once nicotine is absorbed, it will stimulate the adrenal glands. This causes the adrenal glads to secrete epinephrine or adrenaline. The sudden increase of this hormone is likely to promote glycogenolysis as well as tachycardia, tachypnea (rapid breathing) and blood pressure increase.

Moreover, nicotine inhibits insulin release causing slight hyperglycemia and appetite suppression. Nicotine can act as a stimulant and enhance the activity of the brain, improving concentration, memory and cognitive processes.

Dopamine release is enhanced  and it causes pleasurable sensations and a calming effect in most smokers.

However, unlike other substances, nicotine has a dual effect on the body. It will function as a stimulant or a sedative depending upon how it is consumed. A stimulating effect is achieved if the smoker draws in short, brisk puffs which produce low blood levels of nicotine and stimulates the release of dopamine and norepinephrine. On the other hand, slow deep puffs increase the level of nicotine in the blood and reduce the transfer of nerve impulses causing a sedating and calming effect due to the release of serotonin.

Studies have shown that women are more prone to develop cancer if they smoke. Moreover, women smokers may experience early menopause compared to those who don’t smoke. This is because nicotine alters the amount of circulating estrogen. If these women are taking oral contraceptives, chances of developing cerebrovascular and cardiovascular diseases are increased. [5]

Nicotine Addiction

Regardless of the risk linked with cigarette smoking, people all over the world are continue to smoke. Many attempt to quit but most of them are unsuccessful. Nicotine is as addictive as cocaine or heroin.

Nicotine has neurophysiologic action on the reward center of the brain or the mesolimbic dopamine system, particularly at the nucleus accumbens (dopamine-rich section). Aside from dopamine, endorphins and corticosteroids are also released which reduces fatigue. It also affect the user’s cognitive processing and results in the desire to repeat the experience over and over again, hence becoming an addiction.

Addiction to nicotine is actually a physical dependence. When a smoker stops smoking, “nicotine craving” is brought about. Individuals react in different ways when nicotine is withdrawn from the system, it may be severe. This is the reason why most smokers have a hard time quitting.

Nicotine Drug Test

Urinal Drug Test

There are economical drug test strips that can detect cotinine in the urine through immunoassay. These inexpensive strips are not very sensitive and could only detect 200 ng/ml cotinine levels within two to five days.  More precise urine tests are available through GC-MS that can detect cotinine levels of 5 ng/ml. In addition,  “Ion Pair Reversed-Phase Chromatography” has a detection cut-off of 200 ng/ml. Both tests have longer detection time, from seven to ten days. However both tests are more expensive and the time required to obtain the tests is longer.

Nicotine Hair Test

Hair tests can detect both nicotine and its metabolite, cotinine, through GC-MS. The detection cut-off for this procedure is approximately 2 ng/ml nicotine. This test determines the amount of drug molecules that were permanently trapped inside the hair follicles. The standard test can cover at least 90 days from last nicotine use.

Blood Test for Nicotine

Nicotine presence can be detected in the blood for a short period only (about 48 hours) . However,  its metabolite, cotinine, can be detected up to about three weeks from the last use and the cut-off detection levels is 200 ng/ml. The amount of nicotine and the length of nicotine use does affect the detection time of nicotine in the bloodstream.

If you are a serious smoker, you can easily see how it is a health hazard. There is help for you to quit. There are many ways your body can be tested for the presence of nicotine. As you see, the issue of how long does nicotine stay in your system is not a simple one. Yet, there are many physicians and researchers and social workers who are interested in finding the best answers and in helping you to quit smoking so you will have better health. You will also be less likely to harm your children with second hand smoke, too.

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Cocaine (crack, snow, flake, and blow) is derived from the coca plant, Erythroxylon coca. It is a central nervous system (CNS) stimulant that has a local anesthetic effect. In the streets, cocaine comes in the form of a powdered hydrochloride salt which is dissolved in water and then injected or snorted. Yet the most critical question that people ask is, “How long does cocaine stay in your system?”

According to the National Survey on Drug Use and Health, in 2009 alone, around 4.8 million young Americans (from age 12 and up) had used cocaine in its various form and that a million had used it at least once before the 2009 survey was made. The 2010 “Monitoring The Future” study revealed that 1.6 percent of the students in the eighth grade, 2.2% in the tenth grade and 2.9% in the twelfth grade had used cocaine in its various forms. In addition, one percent in the 8^th grade and 10^th grade and 1.4% on the 12^th grade had used it at least once.

In the U.S, about 14% of adults have tried cocaine at least once. Statistics show that out of 40 adults at least one has tried it during the past year.  The biggest age group for cocaine use is 18-25 among young men.  Eight percent of young men in this age group have used cocaine in the last 12 months.

Cocaine can be administered through three different routes: injecting, smoking and snorting (inhaling powdered cocaine through the nose).  The duration and intensity of the effects depend on how the drug was administered.

The faster absorption into the bloodstream yields the most intense effect but it has a lesser duration.  Snorting the cocaine produces a “high’ that would last for fifteen to thirty minutes while smoking it reduces the duration to about five to 10 minutes. This is why users usually take them in short intervals but with increases in the dosage to prolong the “high” feeling.  When the leaves are chewed the affect is reduced pain, fatigue and hunger or thirst.

When inhaled, around 25 – 50 mg of cocaine is absorbed and even after a few seconds, the effects are felt by the user.  Sensations such as excitement, increased strength, euphoria and reduced hunger are felt for about an hour followed by a “crash” into depression. To avoid the negative sensation, users consume more of the drug which is likely to eventually lead to cocaine addiction.

How long does cocaine stay in your system?

Cocaine normally stays in the system for approximately 48 hours. Although the method of administration and the dose administered affects how long it takes for the body to metabolize this drug. When coca leaves are chewed, absorption time is around 30 minutes. If the drug is snorted, the peak effects are likely to manifest within the next 20 minutes and are maintained for roughly an hour. Injecting the drug directly to the bloodstream allows the user to feel the full effects within 3.2 minutes. This route is considered to be the one with greatest health threat. Cocaine is estimated to be in the system for around 72 hours since its initial intake.

However, cocaine drug test is designed to detect the metabolite of cocaine, benzylecgonine.  When cocaine is metabolized in the body it undergoes hydrolysis.  The process of hydrolysis leaves a by-product known as benzoylecgonine.  It is that metabolite which is the decisive component that indicates the use of cocaine. This metabolite remains in the system for at least a month following intake.

How long does cocaine stay in your urine?

The length of time cocaine stays in the urine depends on several factors like:

• the potency of the drug,
• the amount taken in,
• the frequency of drug use,
• the general health of the user,
• the age,
• the gender,
• the user’s drug tolerance and
• the user’s metabolic rate.

If a single nasal cocaine dose is snorted, it can be detected inside 4 to 10 hours and around 24 hours subsequent to a single oral dose. Injected cocaine can be detected in the urine even 20 hours or more from use.  The cocaine metabolites (benzoylecgonine, ecgonine methyl ester and coca ethylene) are detected until 60 hours from last single use or 22 days after continual use.

If the test result shows a benzoylecgonine to cocaine ratio that is below 100:1, it indicates positive cocaine use within ten hours or less before the urine sample was collected and tested. The accurate dose and exact time of use are not determined by this test procedure.

How long does cocaine stay in your blood?

A single dose of cocaine can be detected in the blood as soon as even after a few minutes from intake to around five to 6 hours later. Benzoylecgonine has a half-life of around 6 to 7 hours. This would mean that this cocaine metabolite is still present in the urine after about 72 hours. But keep in mind the length of detection time is affected by many factors.

Cocaine Testing

The different tests used to determine the presence of cocaine does not really examine the presence of the drug itself but of its marker metabolite, benzoylecgonine. There are several tests used to determine this marker:  blood, urine, hair, saliva tests and even sweat patch test.

Urine test for cocaine

This preferred cocaine testing method since this is cheap and could detect recent use of cocaine – within seven days. The client needs only to provide adequate amount of urine sample for testing. The amount of bezoylecgonine, a cocaine metabolite that would produce a positive result would be 300 ng/ml. A follow-up drug test will be required to verify the initial result.  A urine sample with 150 ng/ml result confirms positive cocaine use.

Hair test for cocaine

A single dose of cocaine would turn up in the hair sample as early as eight hours or  in seven to ten days after use. These metabolites can stay in the strands for a prolonged period of time (90 days) until the hairs are cut. There are times that the hair becomes contaminated with cocaine from the external environment.  A good hair wash might remove some external contaminants but not all.  Since the test examines the amount of cocaine metabolites inside the hair shaft, those external contaminants have no effect on the result.

A standard hair test that includes GC-MS confirmation requires about 60 mg or more hair (90-120 strands) since the hair has different types (coarse, thin). At least a length of 1.5 inches (3.9cm) of hair that is cut near the scalp is needed for the test.

Blood test for cocaine

Even though this testing procedure is the most invasive and expensive option, it is considered to be the most accurate. A blood sample is drawn from a syringe and sent to the laboratory for analysis. Presence of the marker metabolite could be detected within a few minutes and until around five to six hours from use.

Sweat patch test for cocaine

A recent innovation that could detect the presence of cocaine or its metabolites is by using a patch. The patch is placed on the skin (like a band-aid) and stays there for 14 days. The patch is designed to detect the presence of cocaine through the perspiration. It is usually worn on the upper arms after careful cleansing of the area. After 7 to 10 days, the patch is taken off and sent to the laboratory for analysis using the GC-MS system. There are many factors that can affect the accuracy of this test, thus careful handling is necessary.

False NEGATIVE results of cocaine Tests

There are times when false negative results are received. There are many reasons why this would happen. Too much intake of water and the utilization of detox kits are some of the reasons.

False POSITIVE results of cocaine tests

It has been reported that some drugs like lidocaine and amoxicillin can cause false-positive results in a cocaine test. Aside from that, intake of too much coffee, kidney and liver infection, diabetes and tonic water can alter the results, as well.

Cocaine Effects

Cocaine can interfere with dopamine re-absorption, increasing its serum levels. This neurotransmitter is linked to movement and pleasure. The increased levels of serum dopamine would cause euphoria lasting for around 30 minutes. During this time, the user is hyper-stimulated, mentally alert and not showing any signs of fatigue.  Aside from these, users may also have the following effects of cocaine: constriction of blood vessels, elevation of body temperature, tachycardia, pupil dilation and increased blood pressure.

Regular use of cocaine would result to the following outcomes: arrhythmias, myocardial infarction, angina, respiratory failure, seizures, headaches, stroke, nausea and abdominal pain. Due to the suppression of appetite, the chronic user becomes malnourished.

However, each route of cocaine administration will manifest different effects of cocaine.

• Snorting causes chronic runny nose, loss of the sense of smell, hoarseness, difficulty in swallowing and nosebleeds.
• Cocaine ingestion causes reduction of oxygen supply to the intestines which could cause severe gangrenes on the bowels.
• Injection of cocaine could cause severe anaphylaxis or increased risk for HIV or hepatitis.

Cocaine Facts

Here are some facts about cocaine that most people do not know:

• The first Spanish explorers in South America observed that the natives were chewing coca leaves to keep exhaustion at bay.
• Albert Neiman (1860) was able to separate cocaine from these plants and discovered their anesthetic effects.
• Around the 1880’s, Angelo Mariani produced a wine (Vin Mariani) for medicinal purposes that contained 6.5mg cocaine per ounce and 11% alcohol.
• Sigmund Freud, in 1884, proposed the use of cocaine in the treatment of addiction for morphine and alcohol plus other various illnesses – this led to the addiction of his patients to cocaine!
• John Pemberton manufactured Coca Cola in 1884 which contained caffeine and cocaine, however, cocaine was removed from the ingredients in 1906.
• It was in 1914 when the Harrison Narcotic Act was passed and made cocaine illegal.
• Crack cocaine became a salient drug problem when it was introduced in 1985.
• There are two forms of cocaine: crystalline and powder. Crack is the crystal rock that has not been defused by acid.
• To get a kilogram of cocaine, at least five hundred kilos of coca leaves are needed.
• To maximize their profits, the dealers would add lactose, cornstarch, lidocaine, sugar or talcum powder to dilute it and increase the quantity to be sold.
• Over 400,000 newborn babies in the US are addicted to cocaine at the time of their birth.

Cocaine Withdrawal Symptoms

The problem with cocaine is the need to increase the dose over time in order to achieve the matching high and maintain the level of cocaine in system. The constant increase would result to a more severe withdrawal or “crash” and could manifest as:

• Severe depression
• Intense cocaine craving
• Anxiety
• Irritability
• Mood swings
• Paranoia
• Exhaustion
• Insomnia

Withdrawal symptoms can last for months as the brain works to stabilize the dopamine levels and produce the appropriate amounts. Increased appetite as well as weight gain are common and noticeable.  As the removal of cocaine in system is gradually completed, the user might spend more time sleeping until the symptoms slowly fade away over time.

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The question of ‘How Long Does Alcohol stay in your blood, system, urine?’ is an important one for people who consume it, certainly. But it is also important for health care practitioners and law enforcement officials as well. Alcohol consumption has raised many debates all over the world. Some scientists and health professionals state that alcohol has its benefits. A most important use of alcohol with the highest proof is medicinal. This is listed in the Unites States Pharmacopoeia as a medicine. More than half of the health institutions in the largest US metropolitan area have reported offering alcoholic drinks to their clients.

Studies have reported that individuals who drink alcohol moderately tend to live longer

and are healthier than those who abuse it or abstain from it. Research has also pointed out that a person who abstains from drinking alcohol has a higher risk of developing heart diseases. Also, alcohol should be consumed regularly by one to enjoy its health benefits.

These studies highlight the benefits of moderate consumption of alcohol. But the sad fact is that alcohol misuse is one of the major health problems and has placed an onerous burden on society. Most people believe that alcohol is a stimulant, but in truth it is a depressant. That is why excess consumption of alcohol leads to:

• Short-term memory loss
• Impaired judgment
• Slurred speech
• The inclination to violent behavior

Excessive consumption for a prolonged period would certainly lead to impairment of the major organs, especially the liver and brain.  Some interesting facts about existing alcohol consumption, particularly in Europe. Did you know that the UK is considered to have the highest percentage of binge drinking all over Europe? It is true and many people are alcohol dependent already. Over 31% of men and 20% of women in Great Britain consume alcohol above the weekly limits and some drink more than what is considered harmful (35 units for women, 50 units for men).  Surveys have shown that people miss work because of too much intake of alcohol. Consequently, about 136 million working hours are lost every year. Deaths due to road accidents (17%) and road casualties (6%) are often caused by people driving under the influence of alcohol.

Who Cares How Long Does Alcohol Stay in Your System?

Most governments are getting more stringent with cases dealing with intoxicated driving. Therefore, so many people are concerned with how long does alcohol stay in your system.

The blood alcohol concentration (BAC) is used to determine the level of alcohol concentration in the blood. This is listed as a percentage. The amount of alcohol that can be detected in the breath, urine or blood is 0.08%. If you know the BAC you can determine how much time it will take your body to rid itself of the alcohol content.  Of course, this amount of time is influenced by many other things as well:  gender, weight, amount of alcohol consumed and the time that has passed since the initial drink.

Your body eliminates alcohol through excretion, metabolism, perspiration and evaporation. Around 10% of ingested alcohol is excreted via the kidneys, 1% thru evaporation from the breath, sweat or tears and 98% is metabolized by the liver. A perfectly working liver is capable of metabolizing 10 ml of pure alcohol (1 unit) every hour. Therefore, the alcohol levels in the blood will increase over time since the liver can only metabolize 10 ml each hour. The average time needed for all of the alcohol to be completely eliminated from the system is about 10 hours.

How Long Does Alcohol Stay In Your Blood?

Alcohol is measured by units. One unit is equal to 10 ml of 100% alcohol. That is about 30 ml of whiskey or 236 ml of beer. The average bottle of beer holds 330 ml. [7] Normally, it takes the body an hour to break down a single unit of alcohol. However, there are several factors that can affect this process such as weight, age, gender, metabolic rate, stress levels, strength and type of alcohol, the amount of food ingested and the health of the liver.

If a person drinks 250 ml of wine, it would take three hours for the body to metabolize the alcohol. A 500 ml beer would take about two hours. But a strong 500 ml beer would take much longer since it contains about three units of alcohol. Basically, it would take about twelve hours for the blood to show a negative result on the blood test. But then again, excessive amounts of alcohol intake would take the body longer to completely eliminate it.

How Long Does Alcohol Stay In Your Urine?

Five percent of the absorbed alcohol would reach the kidneys and be expelled with the urine. Since alcohol depresses the function of vasopressin, a hormone that conserves fluid, the alcohol is usually excreted around twenty minutes from ingestion.

Most alcohol tests for urine would detect alcohol about 48 hours after alcohol ingestion. However, with the ETG Urine Alcohol Test, the ethyl glucuronide present in the urine would confirm the ingestion of ethanol three to four days after alcohol was ingested. That is about 80 hours after the alcohol has been metabolized in the liver.

Alcoholic Tests

Alcohol Blood Test

The presence of ethanol in the body can be measured through an alcohol blood test. Since alcohol is easily absorbed into the system, the amount in the blood can be measured a few minutes after it has been ingested. The peak level of alcohol in the bloodstream can be observed an hour after the initial intake. The accepted alcohol blood testing standard is by the use of the gas chromatography, mass-spectrophotometry apparatus (GC-MS) which is capable of identifying and isolating alcohol and other drugs.

A blood sample is withdrawn using a syringe. The sample is then sent to the laboratory for ethanol measurement. The majority of states consider a blood concentration level of between 0.08% and 0.10% to be legally intoxicated. For individuals below 18 years old, a BAC of 0.08% is considered to be intoxication. Blood levels of around 0.08% – 0.40% causes an escalating impairment and possibly depression of the central nervous system. Values more that 0.40% can be lethal.

With many laboratory tests, there are factors that might affect the results of the alcohol blood test:

• Using too much rubbing alcohol when cleaning the area for blood withdrawal
• Diabetics with high levels of blood ketones (diabetic ketoacidosis) might give a false-positive results
• Intake of cough medicines or alcohol-containing herbal supplements

Be sure to inform the technician beforehand if what medications are being taken. And make sure that the disinfectant used is not alcohol-based to prevent the occurrence of false positive results.

The blood test will only analyze the presence of alcohol in the system. It will not reveal the length of time alcohol was ingested or if the client has any problems with alcohol use.

Alcohol Breath Test

The amount of alcohol ingested can also be tested through the exhaled air since it is not digested or chemically changed upon absorption. Because alcohol is volatile, some amount of blood alcohol will diffuse across the alveoli in the lungs. Therefore, the concentration of blood alcohol and those in the lungs are equal. The proportion of breath alcohol and blood alcohol is 2,100 / 1. That means that every 2100 ml of alveolar air has an equal alcohol content as with 1 ml of blood.

As the person exhales, the alcohol is detected once it goes into the breath analyzer. So instead of using the invasive blood test procedure, an officer of the law can now instantly test a person for the presence of alcohol in the system. Try to be sure the sample comes from the alveolar air and not from the mouth, stomach or throat. During training the officers learn the proper techniques for obtaining accurate results. For instance, having the user take a couple of deep breaths and exhale them forcefully will help you get the alveolar air from the bottom of their lungs. Most certified individuals observe the client for fifteen to twenty minutes cautiously before performing the test.

An insufficient breath specimen can give incorrect results. So make sure to give clear and simple directions for the user to follow. Remember that these individuals are intoxicated. Nonetheless, some people will try to trick the breath analyzer to get false results in their favor.

ETG Alcohol Testing

The ETG Urine Alcohol Test detects the presence of the metabolite of ethanol, ethyl glucuronide, in the urine sample. Its presence is an indication of alcohol intake for the last four days – eighty hours after its metabolism. This procedure is usually done to monitor intake of alcohol by individuals who are undergoing alcohol treatment and who are legally prohibited to take in alcohol.

The ETG Urine Alcohol Test is very responsive to even the slightest amount of alcohol in the body. It’s so sensitive that even traces of alcohol from other sources can give a false-positive result. Based on a study done by SAMHSA, there are some products that can affect the result of the test. These products include: hygiene products, cosmetics, after shave, antiperspirant or laundry products – anything that contains even a slight amount of alcohol.

ETG Alcohol Facts

Image source: NRTlaboratories.com

Saliva Alcohol Test

This non-invasive test detects alcohol in the saliva. It gives a comparable reading to the alcohol content in the bloodstream. It can effectively determine the alcohol level in the saliva 10 to 24 hours after intake. However, the enzyme (alcohol oxidase) [9],  is easily affected by extreme temperature ranges.

This type of alcohol test is cost-effective and easy to use. To ensure that the tests are accurate, clients are requested not to eat or drink anything for about fifteen minutes before the test is scheduled. The strip’s reaction pad would react to the saliva and change the color indicator. To correctly interpret the results, check the color codes and instructions found inside the box.

As you can see there are many variables to consider when you attempt to assess the alcohol content in a person’s blood, urine, breath, saliva or throughout their system. This is what makes it so critical to be careful when conducting tests. That is the only way you will get accurate results. It is those BAC readings that can be used to interpret how long does alcohol stay in your system.

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Marijuana comes from the dried leaves and flowers of a hemp plant, Cannabis sativa. This is the most commonly used drug in the USA, that is illegal.  Because of its widespread usage, researchers and healthcare practitioners as well as law enforcement officials need to know, “how long does marijuana stay in your system”.

At least one national survey estimated that about  6,000 Americans have tried marijuana for the first time. In addition, more than 25 million people used it last year. When you look world-wide, about 162 million adults smoke marijuana at least once  a year and nearly  22.5 million smoke it daily.  [5]

It is the second most widely preferred mood-altering substance used all over the world – after alcohol. Many people wonder why it is so popular all around the world.  Many studies have been done.

How long does marijuana high last?

The users usually feel the positive high or euphoria of marijuana for at least two to eight hours, after which they would usually feel sleepy. The main reason for this is its main active component, tetrahydrocannabinol (THC), which brings about mind-altering or psychoactive effects. Marijuana’s potency is influenced by how much THC it contains, and that normally differs from one plant to another.

How long does marijuana stay fresh for it to have a stronger or lesser effect?  The longer the marijuana is exposed to light and heat, the lesser its effect will be since THC degrades after a while. The leaves dry out causing the smoke to be more harsh and causing users to cough more often.

Marijuana is usually loosely rolled (joints) and smoked but sometimes a water pipe is used. Some users would cut open cigars and substitute the tobacco inside with marijuana (blunts). Often times these “blunts” and “joints” are combined with other products such as cocaine or phencyclidine to make a more potent product. However, smoking is not the only means of taking in marijuana. Some would brew it like tea, mix it baked goods or chew the dry leaves.

How long does marijuana stay in your system?

Marijuana is one of the most frequently tested drugs in several countries worldwide, especially in the United States. That is why it is important to know, “How long does marijuana stay in your system?”

There are actually several factors that would determine the length of time the drug’s by-products would stay inside the body: how often and how much is used, the general health of the user, the body weight, metabolism and the amount of fluid intake.

Smoked marijuana diffuses into the bloodstream in a matter of seconds, but if ingested orally the absorption will take longer. Once it reaches the blood, it is metabolized rapidly into inert molecules (metabolites: THC). The metabolites can remain in the body for around three to seven days after intake. The terminal half-life of this compound ranges from twenty hours to ten days, depending on the potency and amount of the drug used. Therefore, if you take in around 1 mg of TCH with a half-life of 20 hours, your body will still have 0.031 mg of THC even after four days. The more potent the marijuana used and the more frequent a person uses it, would increase the time the drug is removed from your system. If smoked regularly, the THC lingers in the system for as long as 45 to 90 days. And since the metabolites of marijuana are fat-soluble, it is stored in the major organs in the body wherever fat cells can be found:  brain, kidneys, and the liver. Hence, the more fats cells a person has, the longer it will take for THC to be removed from the system.

How Long Does Marijuana Stay In Your Hair?

The hair cannot cleanse itself internally. Therefore any THC that is stored in the follicles and strands are not removed promptly. The metabolites of marijuana can settle in the hair for months and even up to three years. The hair grows around 0.5 cm a month. It takes about 4 to 5 days from the time THC was absorbed for the hair to grow. For this reason, the metabolites can be a permanent proof of chronic marijuana use. This is the reason why most individuals addicted to marijuana wear their hair cut short or shaved off.

How Long Does Marijuana Stay In Your Blood?

How long the THC stays in the user’s blood depends on the frequency of marijuana use. Persons who smoked marijuana just once in their lives would have traces of the metabolites cleaned out within three to five days. If the user smoked only occasionally, perhaps once a week or every ten days, the metabolites can be detected for up to 10 days.  In regular users, THC remains in the blood for as long as 90 days. Heavy users, on the other hand, can have THC trace in their blood for as long as six months.

How Long Does Marijuana Stay In Your Saliva?

Most drugs leave residues in the saliva for only about 6 to 24 hours from last use. This is why the saliva drug test can only be used effectively if the person has used the drug on the day of the test. Consequently, the detection of marijuana in saliva testing is not conclusive since the residues of the drug do not remain for long.

How Long Does Marijuana Stay In Your Urine?

Individuals who have used marijuana for the first time need one to six days before it is totally excreted from the system. Occasional marijuana users often have residues of the THC metabolite for three to nine days while heavy users or individuals with high fat ratio can test positive in urine exams for approximately thirty days.

Marijuana drug testing

A drug test for marijuana is basically the procedural analysis of any organic sample such as blood, urine, saliva, hair or sweat in order to detect the presence of the main active ingredient of marijuana (THC) or any of its metabolites.

Some medications may give a false-positive result during the test:

• Ibuprofen,
• Riboflavin,
• Promethazine,
• Naproxen,
• Ketoprofen and
• Pantoprazole.
• Individuals with kidney infections,diabetes and liver diseases could also yield a false-positive.
• Foods with poppy seeds like muffins and bagels could also create some problems during the testing procedure, so avoid these foods at least three days before the scheduled test.

Before the test, it would be wise to inform the technician or administrator of the any legal prescription drugs being taken that might affect the results of the test.

Blood Tests

Active presence of marijuana metabolites in the bloodstream is detected through blood tests.  However, urine tests detect only the presence of the non-psychoactive THC-COOH marijuana metabolite.  When marijuana is smoked, the THC level rapidly peaks in just a few minutes after inhalation. It often reaches a level more than 100 ng/ml. After an hour, the level declines sharply thus an unusually elevated THC level is an indication of recent marijuana use. The levels will remain low at 1-2 ng/ml for eight hours without any indications of impairment. Chronic marijuana users who have stopped using the drug for a week are likely to show residual levels of THC of about 1-2 ng/ml.

This test is not performed routinely because it is difficult and invasive. Blood tests are normally done during accident investigations or DUIs to determine if the person was under the effects of the drug at that particular time.

Urine Test

This is the widely used testing procedure for marijuana. This does not measure the psychoactive ingredient of marijuana. However, THC-COOH, an inactive metabolite, can remain in the blood plasma for weeks without signs of impairments. The frequency of drug use influences how long the metabolites will be detectable in the urine sample. This is due to the fact that the metabolite gradually builds up around 100 ng/ml and  takes weeks to drop off to a threshold that cannot be detected in the test.

It takes time for the metabolites to reach the kidneys and excreted through the urine. The user can test negative one to four hours from use and could suddenly test positive with 50 ng/ml level. Unlike the blood tests, an individual tested positive is not presently impaired by the drug.

There are two kinds of urine tests that can test the presence of marijuana.  First is the screening test which uses an immunoassay to determine the parent metabolite. Next the confirmatory test uses  gas chromatography, mass spectrometry or liquid chromatography to verify the specific drug used.

Saliva Test

This procedure is non-invasive, thus, is gaining popularity especially among teenagers.  This test is easy to administer. Yet, to ensure accurate results,  it needs to be processed in the laboratory. This new procedure’s sensitivity to THC is not yet well verified. In theory, the test detects any recent use of marijuana but is effective only for a maximum of 24 hours. There are still no accepted cut-off concentration and standards for this procedure. Results from this particular drug test are not yet acceptable in court.

Hair Test

This is another non-invasive test for chronic, regular marijuana users. When the THC metabolites are absorbed, they will be detected only after seven to ten days from first use. These THC metabolites may stay in the hair strands for about three months – unless the person shaves or cuts the hair short.

The test requires about forty to fifty strands of hair cut from the scalp at the crown region. The procedure tests the hairs 1.5 inches from the root. This particular drug test can determine when the user started using the drug and if use was discontinued. It is not probable to detect one-time use of marijuana with this procedure. Normal hair washing or other hair procedures such as dyeing, bleaching or permanent waving does not reduce the quantitative results. Shampooing the hair would remove the external contaminants only and will not affect the results. Results can only be affected if the hair’s protein matrix is destroyed.

Head hair is the primary choice for this particular drug test. If the user, has no hair or the hair is too short to get viable samples, body hair can be used as an alternative. If this is the case the time frame for the test will be one year since body hair grows relatively slow compared to head hair and would have dissimilar growth patterns. The amount of metabolites on the hair should at least be 0.10 pg/mg for it to be detected.

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