Definition of Toxicology screen:

A toxicology screen refers to various tests to determine the type and approximate amount of legal and illegal drugs a person has taken.

How the test is performed:

Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after swallowing the medication, using stomach contents that are obtained through gastric lavage or after vomiting.

For information on giving a blood sample from a vein, see venipuncture.

For information providing a urine sample, see clean catch urine sample. In some circumstances, you may need to provide the urine sample in the presence of the nurse or technician to verify that the urine sample came from you and was not tampered with.

How to prepare for the test:

No special preparation is needed. If able, tell your health care provider what drugs (including over-the-counter medications) you have taken, including when and how much.

This test is sometimes part of an investigation for drug use or abuse. Special consents, handling and labeling of specimens, or other special procedures may be required.

How the test will feel:

Blood test:

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Urine test:

A urine test involves normal urination. There is no discomfort.

Why the test is performed:

This test is often done in emergency medical situations. It can be used to evaluate possible accidental or intentional overdose or poisoning. It may help determine the cause of acute drug toxicity, to monitor drug dependency, and to determine the presence of substances in the body for medical or legal purposes.

Additional reasons the test may be performed:

• Alcoholism
• Alcohol withdrawal state
• Altered mental state
• Analgesic nephropathy (kidney poisoning)
• Complicated alcohol abstinence (delirium tremens)
• Delirium
• Dementia
• Drug abuse monitoring
• Fetal alcohol syndrome
• Intentional overdose
• Seizures
• Stroke secondary to cocaine
• Suspected sexual assault
• Unconsciousness

If the test is used as a drug screen, it must be done during a certain time period after the drug has been taken or while forms of the drug can still be detected in the body. Examples are below:

• Alcohol: 3 to 10 hours
• Amphetamines: 24 to 48 hours
• Barbiturates: up to 6 weeks
• Benzodiazepines: up to 6 weeks with high level use
• Cocaine: 2 to 4 days; up to 10 to 22 days with heavy use
• Codeine: 1 to 2 days
• Heroin: 1 to 2 days
• Hydromorphone: 1 to 2 days
• Methadone: 2 to 3 days
• Morphine: 1 to 2 days
• Phencyclidine (PCP): 1 to 8 days
• Propoxyphene: 6 to 48 hours
• Tetrahydrocannabinol (THC): 6 to 11 weeks with heavy use