Substance misuse can derail recovery, extend return-to-work timelines, and complicate claims. For adjusters managing complex cases, knowing how commonly abused drugs affect the body, how long they stay detectable, and their associated risks is essential. Here's a practical guide to help you spot red flags and understand the implications.
ALCOHOL
Examples: Beer, wine, liquor
Detection Window:
- 12–80 hours
Health Risks:
- Liver disease
- Cardiovascular disease
- Dependence and withdrawal syndrome
CANNABIS
Examples: THC, Edibles, Delta-8
Detection Window:
- 3–90 Days
Health Risks:
- Respiratory issues
- Cognitive impairment
- Psychological dependence
OPIOIDS
Examples: Heroin, Oxycodone, Fentanyl
Detection Window:
- 1–14+ days
Health Risks:
- Severe dependence
- Overdose
- Death
STIMULANTS
Examples: Cocaine, MDMA, Adderall
Detection Window:
- 2–7 days
Health Risks:
- Psychosis
- Seizures
- Death
DEPRESSANTS
Examples: Benzodiazepines, Barbiturates, GHB
Detection Window:
- 1–30 days
Health Risks:
- Coma
- Respiratory depression
- Death
SLEEP MEDICATIONS
Examples: Ambien, Lunesta
Detection Window:
- 1–3 days
Health Risks:
- Dependence and withdrawal
HALLUCINOGENS
Examples: LSD, Ketamine, Mushrooms
Detection Window:
- 1–14 days
Health Risks:
- Bladder damage
- Respiratory depression
- Psychosis
GABAPENTINOIDS
Examples: Gabapentin, Pregabalin
Detection Window:
- 1–2 days
Health Risks:
- Respiratory depression
- Dependence and withdrawal
SYNTHETIC DRUGS
Examples: K2, Spice, Bath salts
Detection Window:
- 2–7 days (varies)
Health Risks:
- Severe psychosis
- Cardiovascular problems
- Death
OTC/Other
Examples: DXM, Kratom, Inhalants, Caffeine
Detection Window:
- Hours to 9 days
Health Risks:
- Seizures
- Cardiac effects
- Liver problems
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Additional Notes
1. Detection windows vary based on factors including:
- Frequency and amount of use
- Individual metabolism
- Body mass and hydration
- Kidney and liver function
- Drug potency and purity
2. Standard urine drug screens typically test for:
- Cannabinoids (THC)
- Opioids (limited panel)
- Cocaine
- Amphetamines/methamphetamines
- Benzodiazepines
- PCP
- Sometimes barbiturates and methadone
3. Extended panels may be required for:
- Synthetic drugs
- Newer opioids (fentanyl analogs)
- Prescription medications
- Hallucinogens
4. False positives can occur with certain medications and foods
5. Drug scheduling continues to evolve with new legislation and research
- Schedule I: Highest abuse potential, no accepted medical use
- Schedule II: High abuse potential, has medical uses with severe restrictions
- Schedule III: Moderate abuse potential, accepted medical uses
- Schedule IV: Lower abuse potential than Schedule III, accepted medical uses
- Schedule V: Lowest abuse potential among scheduled drugs, accepted medical uses
Information compiled from authoritative sources, including the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Enforcement Administration (DEA), and other clinical and scientific resources current as of 2023.