Benzodiazepine Urine Toxicology Screen

  • Most urine immunoassays for benzodiazepines are targeted to nordiazpam and oxazepam

  • Below is the benzodiazepine metabolic pathway so you can see which benzodiazepines will return positive on the urine tox screen.

https://governorsinstitute.org/wp-content/uploads/2016/08/benzo_metabolism.png

  • Common long acting benzodiazepines that will return positive include Diazepam, oxazepam, temazepam and chlordiazepoxide

  • Common intermediate acting benzodiazepines that do not metabolize to oxazepam and as a result will return negative on the urine tox screen include Alprazolam, Lorazepam, and Clonazepam.

  • Z-drugs (zolpidem/eszopiclone are not detected by common benzodiazpeine

  • Confirmation testing can be ordered to differentiate specific benzodiazepine.

  • The window of detection depends on multiple factors:

    • Frequency of Use

    • How much is used

    • Specific Substance half-life

      • Long acting typically has a window of detection of 10 days

      • Intermediate acting has a window of detection of 5 days

      • Short acting acting has a window of detection of 2 days

Reference:

1.      Wakeman SE, ed. *Pocket Addiction Medicine*. Wolters Kluwer; 2018:15-100-15-101.

VEMAH Pearls Home

Gambling Disorder

0