Cocaine
Metabolites
The
Precipitation of Cocaine Metabolites in Urine of Addicts Undergoing Sauna Bath
Treatment:
Megan
Shields, M.D. Shelley Research Center for Dependency Disorders and Chronic Pain,
West Covina, California
Recent
studies demonstrate that cocaine metabolites may accumulate in the body and that
several days to weeks may be required for their elimination. Treatment outcome
may be enhanced by methods which accelerate the safe and rapid elimination of
drug metabolites. This preliminary study was conducted to determine if a detoxification
program utilizing sauna baths as one component may precipitate the presence of
cocaine metabolites in urine and sweat. Subjects were Caucasian with ages ranging
from 36 to 40 years, and all met DSM-llI-R criteria for cocaine dependence and
ingested cocaine by the smoking route.
Use
ranged from 8 months to 18 years, and subjects reported cocaine use on over 75%
of days in the month just prior to treatment. Three subjects reported last use
of cocaine within 48 hours of admission, and one subject reported last use 25
days prior to program entry. Between the fifth and eleventh day of residential
treatment and continuing daily for up to five weeks, subjects had multiple sauna
baths each day. Urine and sweat samples were collected from subjects every two
to three days during this period and tested for cocaine metabolites. Analysis
was by polarization fluorescent immunoassay which has a 95% sensitivity of 30
ng/ml.
Three
of the four subjects showed a measurable increase in sweat or urine cocaine metabolite
concentrations when sauna baths were initiated. Two subjects showed undetectable
levels of metabolites in urine prior to sauna baths and then demonstrated detectable
levels after saunas were initiated. Metabolites were detectable in sweat and urine
for up to five weeks following the start of sauna treatment. This study suggests
sauna baths and other methods to increase sweating and metabolism may precipitate
the appearance of cocaine metabolites in sweat and urine and, thereby, accelerate
their elimination from the body.
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