A case of cocaine detected by drug screening test and mass spectrometry

Abstract

Compared to other illegal drugs, there are very few cases in Japan where cocaine is positive in urinary drug screening. We report the detection of cocaine and its metabolites by mass analysis in the urine and serum of patients with cardiopulmonary arrest who tested positive for cocaine in urinary drug screening. Detection of benzoylecgonine and cocaine, or benzoylecgonine and ecgonine methyl ester is desirable for proof of cocaine. Instrumental analysis denied false positives for cocaine, and it was possible to report to the clinician that day that drug addiction might be a factor leading to cardiopulmonary arrest. It is probable that cocaine could be detected because the time from the onset of symptoms to the start of sample processing was within 1 hour. One of the major factors is that the night shift worker on the day was an engineer who could handle analytical instruments in detail about addiction.