my employer does random drug screens i have been informed

The most precise procedure for detection of drugs of abuse in urine is a combination of gas chromatography (GC) and mass spectrometry (MS), abbreviated GC/MS, which provides an exact molecular identification of substances. The local anesthetics used in dentistry are synthetic and structurally not the same as cocaine or crack cocaine and will not be detected as cocaine. The nurse is wrong on this. In fact while GC/MS is a confirmatory test, even the EMIT wcreening test generally used will not cross react with the local anesthetic used at your dentist office.

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In any case you ought to mention in your RDS form if you have had a recent visit to the dentist. Also mention if any other meds like OTC cold medicines are being consumed by you

I have found conflicting information in my search for an answer this weekend. I have two that agree with my company nurse, and now two that disagree. I am being told that it depends on the type of anestheic used. What type, I wasn't told. The initials TAC were used in one reply. Please clarify this dilema in detail for me.

The combination of tetracaine, adrenaline (epinephrine), and cocaine, better known as TAC, was the first topical agent available for analgesia. Cocaine has been replaced with lidocaine in a newer formulation called LET (lidocaine, epinephrine, and tetracaine).

You need to ask your dentist as to what actual anesthetic he is using. If it is TAC then it will show up in the urine test for around 2-4 days after use. Personally I do no think that he would be using it.

The use of TAC is no longer supported by the literature because of general concern about toxicity and expense, and federal regulatory issues involving medications containing cocaine.

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As I said if you have any doubt, mention this at the time of RDS on your test form so that it can be confirmed if needed,

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Dr. Gupta

Edited by GauravMD on January 1 2006 at 8:09am

Thank-you for your prompt reply. Are there actually medicines containing cocaine still being used? And if so, for what? I find this all very disturbing. I will contact my dentist and oral surgeon Monday, or Tuesday, (holiday weekend), to verify the meds given to me.

Relist: I want a different opinion.

Dear Customer (name blocked for privacy),

No cocaine containing medicines are in routine use in the US at present due to extremely strict federal laws and guidelines regarding it. Any physician wanting to even use TAC would have to give in writing to the govt as to why he is using it & not alternatives like LET. Hence this is not easily available to even doctors at present.
Whenever used medically it is restricted to provide local anesthetic effect (like in TAC), and under careful supervision.
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If done correctly, drug testing for cocaine is pretty accurate-no other agent should give a positive result. Most drug tests that check for cocaine use look for benzoylecgonine, a product of the body's metabolism of cocaine that can be detected in urine for around three days after using the substance. According to the guidelines set by the U.S. Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration (SAMHSA), no prescription medications will cause a false positive. Furthermore, studies have shown that even passively inhaling the smoke from crack cocaine will not result in a positive test result.

Source

So while you are quite right to be upset about the conflicting information that you have received, here are the simple facts:

• The only way you would test positive for cocaine is if you have consumed it personally
• most doctors in the US do NOT use cocaine for medical purposes
• if you have undergone a medical procedure in the last 3-4 days, then you should mention the same in your RDS form

Certain rare causes of a possible false positive screening test (NOT GC/MS) could be things like consumption of coca leaf tea, again banned in the US because it has traces of cocaine. Rarely some websites mention that liver, kidney disease, diabetes and consumption of Amoxycilin and Tonic water can lead to a positive screening test (but again not the GC/MS) Source

Please remember to accept the reply if you find it useful. A BONUS and a positive rating would be duly appreciated,
regards
Dr. Gupta