Cocaine detection during toxicology screening of a university medical center patient population.

The frequency of detection of cocaine and/or its major metabolite, benzoylecgonine, during toxicology screening of a university medical center patient population was evaluated by retrospective review of the results of the 2,200 toxicology screens performed during 1986 on either urine or urine in conjunction with blood. Of these screens, 234 (10%) were positive for cocaine and/or its metabolite--a substantial increase from the 1% noted for the year 1978 at this medical center. Men and women were represented equally with the most common age range being 21 to 30 years for both. Most adults (64%) were located on either the obstetrics or the trauma services. In 37 instances cocaine was detected in neonates, presumably due to transplacental transmission. Cocaine and/or its metabolite were found either alone or in combination with other drugs with about equal frequency. The most common other drugs were ethanol, morphine, amphetamine, methamphetaine, and phencyclidine. Cocaine detection increased throughout the study period with 68% of positives occurring from July through December 1986. Analysis of cocaine and/or benzoylecgonine should be an integral part of toxicology screening performed on a university medical center patient population.