I have a patient with cancer who is actively using cocaine. We will do random urine screens on this patient. How long does cocaine remain in the urine? — Ruth C. Gholz, RN, MS, AOCN, and colleagues at the Cincinnati VA Medical Center

Once cocaine is smoked, inhaled (snorted,) or injected, it can appear as its metabolite, benzoylecgonine, and can be detected in the urine for 2 to 4 days. The actual time is difficult to determine because of the differences among individuals and in how rapidly the drug is metabolized, which depends on weight and other factors. In general, I would expect a cancer patient with significant comorbidities and overall physical deterioration to be on the longer period of detection. — Donald Fleming, MD