Drug population in one thousand geographically distributed urine specimens

Hundreds of drugs and other substances are excreted in urine. In a comprehensive drug screen, it is impossible to identify every detectable substance. In order to delineate the most commonly detected drugs, approximately 1000 urine specimens from geographically distributed clinical laboratories were analyzed for drug substances. Twenty-nine (29) clinical laboratories submitted up to 76 consecutive urine specimens found to be positive for substances other than nicotine and caffeine. Specimens were analyzed by thin layer chromatography and special procedures for salicylates, benzoylecgonine, PCP, benzodiazepines, and cannabinoid metabolites. Every specimen was also tested for opiates, PCP, and cannabinoid metabolites by an enzyme immunoassay procedure. The total number of drugs detected in 1000 specimens was 3014, an average of three drugs per specimen; and 110 different drugs were identified. Of these, 50 drugs accounted for 95% of the total detected; 21% of the specimens contained cannabinoid metabolites, and 4% of the specimens contained cocaine and/or benzoylecgonine. Most of the specimens were routine, and only 4% originated from comatose patients.