Benzodiazepines (Urine)

Benzodiazepine urine toxicology screen

This is a urine test to check for a type of medicine called benzodiazepine. Benzodiazepines (behn-zoh-di-AZ-uh-peens) are medicines that depress the central nervous system. They are used to sedate patients, help them sleep, prevent seizures, ease anxiety, and relax muscle spasms. You may also hear these medicines called tranquilizers, sleeping pills, and muscle relaxants.   

Examples of common medicines for anxiety, muscle tension, and seizures include:

• Alprazolam

• Chlordiazepoxide

• Clonazepam

• Clorazepate

• Diazepam

• Lorazepam

• Oxazepam

Examples of common medicines for calmness and sleep include:

• Temazepam

• Triazolam

• Flurazepam

• Estazolam

These medicines are also sometimes used illegally. Street names for these medicines include "downers," "benzos," "nerve pills," "candy," and "tranks." Chronic abuse of benzodiazepines can lead to addiction. Using these medicines with other depressants like alcohol can be fatal.

You may need this test if you have symptoms of an overdose even if you have been prescribed one of these medicines. Symptoms of overdose can include:

• Confusion

• Slurred speech

• Loss of muscle control

• Trouble thinking or talking

• Low blood pressure

• Slow or shallow breathing

• Seizure

• Unconsciousness

• Cardiac arrest

You may also have this test if a healthcare provider thinks you are abusing these medicines or using them illegally.

If you have signs as above, you may also have this test as part of a drug screen to check for other commonly abused medicines. These screens often include tests for:

• Cocaine

• Opioids

• Amphetamines

• Barbiturates

• Marijuana

• Phencyclidine

If you are conscious and able to talk, you can give information to help your healthcare providers figure out the right test for you. For example, if you are a victim of sexual assault, you may have this test to see if someone put a benzodiazepine date rape drug, such as flunitrazepam (Rohypnol or "roofie"), into your drink.

You might also be tested if providers think you have taken benzodiazepines accidentally or in a suicide attempt. 

Different benzodiazepines have different doses, ranging from 0.5 to 50 milligrams (mg). Overdoses of 10 to 20 times the prescribed dose of some benzodiazepines can cause a mild coma. They don't cause slow or shallow breathing. Most people recover. But overdoses of fast-acting benzodiazepines, such as triazolam, are more likely to cause breathing problems and even death.

You may also have a glucose test to check your blood sugar. 

A benzodiazepine overdose alone is unlikely to cause coma or severe heart or lung function problems. If you have those symptoms, a healthcare provider may screen for other drugs and test for causes of central nervous system problems that are not caused by medicine or drugs.

You may also have a blood test for benzodiazepines. In some cases, it may be more practical to take a blood sample than a urine sample. Blood tests are also harder for a person to alter in order to hide their drug abuse.

Which tests you have depends on your exam and information that you are able to provide. 

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

A typical benzodiazepine urine test can find benzodiazepines or their break-down products, called metabolites. But this is a very complex test.

A positive test result means that the test found the medicine's metabolite in your urine at the time the urine sample was taken. The amount found is called the threshold concentration. This means there was enough metabolite to measure. It does not mean the amount was enough to show you are actively using the medicine. The time it takes for a substance to show up in the urine varies by medicine. It can show up within minutes of taking the medicine, and it can last for days.

The presence of benzodiazepines varies a lot by each medicine's half-life. Half-life means the amount of time it takes for half of the medicine to be eliminated from the body. Diazepam, for example, can be found for weeks after the last dose.

Although most benzodiazepines show up in standard urine tests, some don't. Alprazolam, clonazepam, temazepam, and triazolam may not be found in many of the common tests. Many benzodiazepine tests can find whether the medicine is present, but they can't give the amount.

A medicine called flumazenil may be used as an antidote to the sedative effects of benzodiazepines. It shouldn't be used in people who have been taking benzodiazepines over a long period to control seizures. In these cases, flumazenil could cause withdrawal that could lead to death. 

This test is done with a urine sample. Follow your healthcare provider's instructions for collecting and storing the sample. In some cases, you may have to provide a sample in the presence of a lab employee.

This test poses no known risks.

Some other medicines can cause a false positive result in benzodiazepine urine tests. These medicines include:

• Tolmetin

• Naproxen

• Etodolac

• Fenoprofen

• Oxaprozin

• Sertraline

You do not need to prepare for this test. But be sure the lab technician and your healthcare provider know all the medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don’t need a prescription and any illegal drugs you may use.