Patients who abuse cocaine often abuse ethanol at the same time. Cocaethylene is a metabolite formed when both drugs are taken at the same time. Patients who abuse both cocaine and alcohol concurrently are at increased risk for traumatic injury.
Signs et al identified cocaethylene in urine of 88% of ED patients positive for both cocaine and ethanol.
A patient positive for cocaine should also have benzoylecgonine detectable on confirmatory tests.
Urine Cocaine & Benzoylecgonine
Urine Cocatheylene
Urine Alcohol
Interpretation
none
none
none
none
none
none
present
ethanol
none
present
none
uncertain, possibly both
none
present
present
both
present
none
none
cocaine
present
none
present
both
present
present
none
both
present
present
present
both
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