my daughter is an addict She needed to have her wisdom teeth pulled. The day after she had them out, she went for drug testing. They found a small amount of opiates in her system that were not there the day before surgery. They said it was the novocain. Can this be true?
Are there any opiates found in novocain?
Question posted by fisherwoman1co on 14 Sep 2011
Last updated on 22 June 2017 by Leon Weems
After her oral surgery, she was given Ibuprofin 800, but prior to that she was using orajel for about a week. Could this have caused the same result?
Fisherwoman... Novacaine is in no way an opiate. It is strictly a local anesthetic. Local anesthetics are of two classes... the esters and the amides. Novacaine and cocaine are of the ester type. Lidocaine which is another well known local anesthetic which is from the amide family. There are many others... more from the amide family than from the ester family but novacaine and lidocaine are the two most popular. Dentists routinely use epinephrine with the novacaine to make it last longer and to decrease bleeding. Epinephrine is a strong stimulant of the sympathetic nervous system which increases heart rate, blood pressure, cardiac output, along with many other effects. This might be why a drug test might show minute ants of cocaine after having epi mixed in with the novacaine. Cocaine also causes rises in BP, HR, although clearly not the class of drug as epi and not nearly as strong nor does it have the euphoria that cocaine has.
Cocaine is also a local anesthetic, not a narcotic, of the ester type as is novacaine, hence another reason why it might show up in a lab test when novacaine is used... both of the ester family.
Dzoobaby is right re that some people call cocaine an opiate... even knowledgeable people who should better... so this lab may classify cocaine as a narcotic because it is mind altering... but... I really don't think so... but who knows... this lab may define it as that.
Hope this helps u to understand a few things about local anesthetics and why your daughter's test may have revealed the results that it did.
I personally would contact the lab, tell them what your daughter had, novacaine... and I am 99.9% sure epinephrine was used if it was wisdom teeth removal because novacaine without epinephrine only last 30 minutes... with epinephrine it lasts almost 11/2-2 hrs. Tell the lab all of what your daughter had combined w/ the info u learned in these answers which are 100% accurate... the chief of the lab should then be able to tell u why she showed up with opiates n her bloodstream. I don't mean to be nosey or disrespectful but do you thing your daughter could have used opiates with her friends, etc... please don't be offended but I felt like it was something that I should also interject.
Take care and good luck. Please let us know what you found out...
May God Bless you and your family...
I wondered if they were telling her that narcotics were found in her system rather than the word opiates. I hate the word "narcotic" especially in reference to medications because narcotic usually implies something illegal. People, especially law enforcement, tend to use the word "narcotic" for any drug that alters the mind. Therefore they would consider cocaine a narcotic but cocaine is NOT an opioid. Some people use narcotics and opiates or opioids interchangeably but that isnt true. Opioids are derivatives of the poppy plant either natural derivatives or synthetic derivatives. Narcotics are not just opiates, other drugs can be considered narcotics. I think it is an antiquated term and I hardly ever use it. I agee about the novacaine and epi. Any dental procedure they usually use novacaine with epi or lidocain with epi. Many people think they are allergic to novacaine because they had a racing heart during a dental procedure.
I used to hear this one all the time but I would tell them it is not an allergy, it is a reaction to the epinepherine. Plain lidocaine wont do that. Very, very few people are ever allergic to lidocaine or epinepherine for that matter. I wondered too if she has slipped a bit in her recovery if they truly found "opiates". That is why I wondered if they said "narcotics" or if they used "opiates". If it were opiates, nothing she received should show as an opiate but if they used the phrase "traces of narcotics" they could have been referring to a positive for cocaine which lidocaine or novacaine can sometimes show a false positive for cocaine. Great answer you gave! You explained much better than I did! :)
Sorry it took so long to get back to you... have a new py and have been working hard training her. I agree with all you say in your last post. And the allergic to epinephrine thing is one of my biggest soapboxes!!! And Dentists tell patients this... and they are supposed to be educated... imagine them telling a pt. that they are allergic to epi bcuz it makes their heart race... give me a break... it must be something that ALL of them learned in dental school!!!
Thanks for the compliment. Dzoo, your answers are always so good..thanks for caring and being there for so many people that need to know certain things... anyway... bedtime... Good night and God Bless...
I know how you feel about the novacaine /epi thing. People would come in for cataract surgery and tell us that they were allergic to "caines" and the anesthesiologist would question them and it was ALWAYS a dentist who told them this because they got a racing heart during a procedure with epi. We would them use plain lidocaine and marcaine and they would do just fine-Take that crap off your chart-you arent allergic-its a reaction not an allergy! lol
Dzoo... I KNOW!!! lol
Have a great rest of the day. Pup
Amino Esters (test positive)
-Novacaine (Procaine) no longer used in the US
-Cocaine (benzoylmethylecgonine) is controlled internationally by Single Convention on Narcotic Drugs (Schedule I, preparation in Schedule III).
Amino Amides (test negative)
-Lidocaine (Xylocaine) is also used as a diluent to street drugs such as cocaine and heroin
-Marcaine or Sensocaine (Bupivacaine)
-Epinephrine (adrenaline or adrenalin) is added to injectable forms of a number of local anesthetics, such as bupivacaine and lidocaine, as a vasoconstrictor to slow the absorption and, therefore, prolong the action of the anesthetic agent
Novacaine will show up as traces of cocaine sometimes but that is not an opiate. It might be considered a narcotic depending on who you talk to. Some use the word narcotic to refer to any mind altering substance and some use it to mean the same as opiates but opiates are derivatives of the poppy plant which would be morphine, codeine, and other pain meds. Is it possible they gave her something for pain afterward? Or did they use the word narcotics rather than opiates?
- Novocain uses and safety info
- Novocain information for Healthcare Professionals (includes dosage details)
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