How long does a urine drug screen remain positive?

From the Guidelines

A drug screen for cocaine typically remains positive for 2 to 4 days after consumption, as indicated by the most recent and highest quality study 1. The duration for which a drug screen remains positive varies depending on the specific substance.

• For cocaine, detection can range from 2 to 4 days, as supported by the 2021 study 1.
• Other substances like amphetamines and methamphetamines remain detectable for 2-5 days.
• Opioids like heroin and prescription painkillers are usually detectable for 1-4 days.
• Benzodiazepines can be detected for 3-7 days for short-acting types and up to 30 days for long-acting varieties.
• Alcohol is typically detectable for only 12-24 hours in standard urine tests. These timeframes can vary significantly based on several factors including metabolism, body mass, hydration levels, frequency of use, and the specific testing method employed, as noted in various studies 1. Urine tests are most common but blood, saliva, and hair tests may have different detection windows, with hair tests potentially showing drug use for up to 90 days. For accurate information about a specific situation, consulting with a healthcare provider is recommended, considering the potential for false-positive results and the importance of interpreting test results in the context of an individual's complete medical history 1.

From the FDA Drug Label

Although oxycodone may cross-react with some drug urine tests, no available studies were found which determined the duration of detectability of oxycodone in urine drug screens However, based on pharmacokinetic data, the approximate duration of detectability for a single dose of oxycodone is roughly estimated to be one to two days following drug exposure.

The duration of a positive drug screen for oxycodone is approximately one to two days following drug exposure, based on pharmacokinetic data 2.

From the Research

Detection Times for Various Substances

• Amphetamine:
  • Using a cut-off value of 1000 ng/mL, urinary samples can be positive for up to 5 days after intake of the drug 3
  • At the lower 300 ng/mL cut-off, amphetamine will be detectable one day longer 3
• Marijuana (THCCOOH):
  • Detectable for 2-4 days after smoking one marijuana cigarette using a screening cut-off of 50 ng/mL 3
  • More frequent use will be detectable for almost 1 month, exceptionally 3 months 3
• Cocaine:
  • An intravenous dose of 20 mg cocaine can be detected for 1.5 days using a cut-off of 300 ng/mL 3
  • Street doses are detectable up to 1 week, and extremely high doses up to 3 weeks 3
• Heroin:
  • Rapidly metabolizes to 6-acetylmorphine and morphine, with a detection time of 1 to 1.5 days for relatively low doses (3-12 mg) administered via i.v., IN or i.m. route using a cut-off of 300 ng/mL 3

Factors Influencing Detection Times

• Dose and route of administration 3
• Metabolism and characteristics of the screening and confirmation assays 3
• Cut-off values used for the screening and confirmation assays 3

Importance of Confirmatory Testing

• Immunoassays can give false-positive and false-negative results, so all results are considered presumptive until confirmatory testing is performed 4, 5
• Confirmatory testing, such as gas chromatography-mass spectrometry, is necessary to confirm the presence of a substance 4, 5