Testing Reckless Drivers for Substance Abuse

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Abstract
The urine tests used by Brookoff et al. (Aug. 25 issue)1 detected neither cocaine nor the active component of marijuana, delta-9-tetrahydrocannabinol, but did detect their metabolites, benzoylecgonine and COOH-delta-9-tetrahydrocannabinol. Urine tests for cocaine and marijuana have been designed specifically to recognize the metabolites rather than the parent compounds, because the metabolites can be detected longer after drug use, thus increasing the sensitivity of the test for detecting any abuse. Neither metabolite is psychoactive,2,3 but both may be detected for at least one to three days after occasional use, at times when parent-drug levels and impairment have become undetectable.2-4 And, as the authors note, these metabolites can be detected for much longer periods after long-term use.1-4 The conjunction of reckless driving and a positive urine test for cocaine or marijuana may suggest a high probability of concurrent drug intoxication. But the positive test establishes only previous drug use, not the presence of an intoxicating drug at the time of the specimen collection.

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