This is important because we often have to give an anesthetic to a pt who uses cocaine.
Author: Mate Jarai
The length of time cocaine stays in a person’s system depends on the dosage, how often a person uses it, and other factors.
Cocaine has a shorter half-life than many other drugs, which means that the body metabolizes it fairly quickly. Within a few hours, the dose is half that of the initial dose. And within a few days, the body has completely eliminated cocaine.
This means that a person will enter withdrawal shortly after stopping cocaine and that a blood, saliva, or urine test will only show the presence of cocaine for a few days. Because cocaine can linger in the hair longer, a hair test may be positive for months or years.
Cocaine has a short half-life of around 1 hour. This means that, within an hour of taking a dose, the body will have metabolized half of the original dose. Within a few days, the body metabolizes all of the cocaine, and it is no longer in the system at all. Other sources, however, state that the initial half-life can be several hours.
The exact time it takes to eliminate cocaine depends on several factors. These include the size of the dose, the speed of a person’s metabolism, and whether it is the first time a person has taken cocaine or they are a frequent user.
The mechanism by which a person takes cocaine also matters. Topical cocaine for example, has a shorter half-life than other methods of administration, such as snorting.
The half-life of cocaine determines how quickly a person will stop feeling high or begin feeling withdrawal symptoms. New cocaine users may find that the high weakens within a couple of hours, while habitual cocaine users may already begin feeling withdrawal within a few hours after their last dose.
The length of time cocaine stays in the body and causes effects differs from the length of time it will show up on a drug test.
This is because drug tests look for cocaine metabolites. These are the chemicals the body produces when breaking down cocaine. A person may no longer be feeling high. However, they can still test positive on a drug test due to these cocaine metabolites.
Whether a person tests positive for cocaine depends on several factors, including the type of drug test. The metabolite cutoff level will also determine the odds of a positive test. Different manufacturers determine different cutoffs. Smaller cutoff numbers mean a person is more likely to get a positive result.
Urine cocaine test
Urine tests may test for cocaine itself or its metabolite, benzoylecgonine. A urine test can directly test for cocaine for a day or less but will detect cocaine metabolites for a few days — usually 1–2 days.
Prolonged use, large doses, and very pure cocaine may have a slightly longer detection window.
Blood cocaine test
A blood cocaine test looks for cocaine or its metabolite in the blood plasma. This test has the shortest detection window.
This window is just a few hours for cocaine itself and 5.5 to 7.5 hours for cocaine metabolites. Therefore, a blood cocaine test is really just a test to measure if someone is currently under the influence of cocaine, not whether they have recently used it.
Hair cocaine test
Metabolites of cocaine remain in the hair the longest. This is because the body does not get rid of the hair. It just keeps growing, making it possible to detect cocaine months after use.
For example, a 2022 paper reports on data finding evidence of cocaine use in the hair 6 months after use. However, evidence of drug use may take up to 7–10 days to appear in the hair.
Hair cocaine testing poses some reliability issues. People with short hair or who cut their hair, for instance, can expect a shorter positive testing window since they may cut out the portions of the hair that will test positive.
It is also possible for the hair to become contaminated with cocaine through direct exposure, even if a person does not use cocaine.
Saliva cocaine test
Saliva tests for cocaine can measure the presence of cocaine for 24–48 hours after a person’s last use. The purity and quantity of the cocaine, as well as a person’s metabolism, determine how long it is present in the system. People who take repeated doses of cocaine may take longer to metabolize it.
The process by which the body metabolizes cocaine helps break it down. The metabolites created by the metabolization process travel to the urine, hair, saliva, and bloodstream, eventually leaving the body.
The liver plays an important role in metabolizing cocaine. This also means that cocaine overdoses or prolonged use can damage the liver.
Cocaine metabolism begins when a chemical in the blood plasma called plasma butyrylcholinesterase (BChE) breaks down cocaine into a chemical called ecgonine methyl ester (EME). Next, enzymes break cocaine down into benzoylecgonine. This is the chemical most cocaine tests look for.
A person’s natural levels of BChE may influence the rate at which their body breaks down cocaine. Lower levels of this chemical may increase the risk of overdose and other negative cocaine effects.
Cocaine is a stimulant drug, which means that it increases activity in the central nervous system. This can make a person feel more energetic and may also cause anxiety or aggression.
Cocaine poses many risks, including:
- cocaine use disorder
- nausea and vomiting
- high blood pressure
- rapid heart rate
- sleep difficulties
- loss of appetite
Long-term use of cocaine may cause:
- damage to the heart and liver
- lung damage from smoking
- damage to the nose from snorting the drug
- organ failure
- weight loss or malnourishment
- conditions such as HIV from injecting cocaine
Cocaine use can result in overdose and, ultimately, death.
A person who needs to know how quickly cocaine leaves the body may need help for their cocaine use. This is because cocaine exits the body quickly, and a person who is unable to abstain for a few days or who has concerns about withdrawal may have an addiction.
Some other signs a person might need help include:
- They are unable to quit cocaine despite trying.
- They use cocaine to feel “normal.”
- Cocaine has caused serious relationship, financial, legal, or workplace difficulties.
- A person has experienced health issues associated with cocaine.
- A person uses cocaine to manage the symptoms of a mental health condition or to mask physical pain.
Drug addiction is a medical problem — not a personal failing. It requires medical treatment, including support to deal with withdrawal symptoms and manage any issues such as depression or relationship concerns that contribute to a person’s cocaine use.
A person may find relief through:
- medical detox
- medical support for any underlying health problems
- support groups
- comprehensive inpatient treatment.
A family doctor or mental health professional can help a person find the assistance they need.
Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is struggling with addiction, you can contact the following organizations for immediate help and advice:
- Substance Abuse and Mental Health Services Administration (SAMHSA): 800-662-4357 (TTY: 800-487-4889)
- National Suicide Prevention Lifeline: 800-273-8255
Cocaine is a powerful and addictive drug that can damage a person’s health and well-being. Its short half-life also means that a person who quits using cocaine can expect to experience withdrawal very quickly.
People concerned about cocaine drug testing should avoid cocaine for as long as possible. It is also important to consider that, if cocaine may interfere with a drug test for work or school, this could be a sign that a person has become dependent on cocaine and needs treatment.
A compassionate, knowledgeable health provider can help a person find treatment. Recovery is possible, and a person can enjoy a better quality of life.