Benzodiazepine or simply benzos is one name for minor tranquilizers that come in different generic and brand names. You might also have consumed them as ‘downs’, ‘nerve pills’ or ‘tranks’. Most of them show up in ordinary tests while others don’t. However, specifically done urine, saliva, hair and blood tests can be used to detect various types of benzos.
The detection time varies for the various specimens. An all- inclusive conclusion for commonly used benzos gives a blood test up to 24 hours of detection after use. Saliva has a window of up to 2.5 days or 60 hours. In urine, benzos will hang around for up to 10 days and up to 4 weeks for a hair test.
If you are out of the detection time for any of the test, you should be home safe. This is actually easier to understand than it looks. To give you an even clearer picture, we will explain exactly what happens to benzos from the moment it enters your system, when it is excreted, to the time that you can consider yourself ‘safe’.
Benzos have quite a number of routes of administration. These modes play a great role on the onset of action and how long the effects last.
When orally ingested, they are excellently absorbed into the gastro-intestinal tract. Following an intravenous injection, they are quickly dispersed in the brain and the central nervous system. Intra-muscular injection slows the uptake of certain BZDs like diazepam and chlordiazepoxide and hastens others like lorazepam and midazolam. Lorazepam works best when placed under the tongue.
Once in your system, BZDs require two phases of metabolism. Their fat soluble nature makes them not readily excreted by kidneys. This calls for further hepatic (liver) metabolism.
Phase 1 is where they are broken down into either inactive metabolites or into active ones. The inactive metabolites are formed by short to intermediate acting benzos; their effects and excretion are also short lived. A good example is midazolam.
Phase 2 involves changing of the active compounds into water soluble metabolites that can be readily excreted into bile and urine. The active compounds have the same qualities as their parent drugs. For example, diazepam, a long acting BZD produces active metabolites oxazepam, desmethyldiazepam and temazepam. This necessitates further metabolism. They definitely take longer to excrete since they lead to further drug action in the body.
Once metabolized, the drug is absorbed into the bloodstream then into the brain, causing a calming effect to the entire body.
The onset of action varies from one type of benzos to another and so does the peak concentration. Some benzos may kick in within 15 minutes while others may take up to 1 hour. A list of common benzos, their peak concentrations and onset times can be found here.
BZDs are almost entirely excreted in urine. However, small amounts are also excreted in breast milk, sweat, saliva, faeces and hair follicles.
While several factors affect the half-life (time taken by the system to eliminate half a dose) of any type of benzo, the average for long acting benzos is 40 to 250 hours. The inter-mediate ones take about 12 to 40 hours while the short-acting BZDs range between 1 and 12 hours. There are numerous, types of benzos available. This table provides the half-lives for the commonly clinically prescribed ones.
As the body eliminates the metabolites, they remain detectable in urine, blood, saliva and hair in different amounts and for varying amount of time.
BZDs and their various metabolites are easily distributed in the body and since they are fat soluble they attach in the fatty tissues in the body e.g. the central nervous system, around organs and below the skin. After prolonged use, accumulation can occur and lead to symptoms of overmedication.
When use is discontinued, benzos do not remain ‘stored’ in the fatty tissues. This is according to Professor C Heather. They are released a little at a time when their blood concentration goes down, metabolized and excreted. Even the long acting benzos should have no remnants by the end of about 30 days.
What Are Drug Tests Looking For?
Parent drugs are not detected in tests. Since benzos are complex compounds, the most reliable method used to test for the metabolites is the immunoassay method. No single immunoassay has the ability to detect all benzos. To narrow down, the drug tests are class specific. They usually target Oxazepam, a short to intermediate acting benzo and also a common metabolite of many others e.g. Diazepam, Prazepam and Temazepam.
To counter possible cross-reactivity with non-benzodiazepine compounds, further testing is done to confirm results. Other similarly structured metabolites can also be detected. The rest require specialized tests.
It is the most commonly used type of drug test for benzos. Samples that give metabolites of 200ng/ml (US) and 300ng/ml (UK) of are subjected to further testing. Confirmation is done using mass spectrometry with 100ng/ml as the cut-off level for a positive result.
- Short acting ones can be detected for up to 24 hours after use.
- Intermediate ones will be detected up to 1-2 days after use.
- Long acting benzos like Diazepam will be detected in urine 5-8 days after use.
Benzos with reduced cross-reactivity like lorazepam and clonazepam cannot be detected using immunoassays. If taken on their own and not in a cocktail of other classes of benzos they won’t be detected in the test.
Benzos and their metabolites are detectable in saliva up to 48 hours after use. The acidic nature of benzos makes them not to partition well with oral fluids. Hence saliva test uses much lower cut-off levels compared to those of a urine test.
1ml of saliva is mixed with 3ml of a buffering agent. This is done to ensure there is enough volume of specimen for screening and confirmation test. Sample subjected to immunoassays screening with a positive cut-off level of 20ng/ml. Confirmation of the screens is done via mass spectrometry with a cut-off of 0.5ng/mL
Benzos can be detected in blood 6-48 hours after use, this applies to casual users. The widow extends for chronic use and can be detected 72 hours after use. This is due to drug accumulation in the system. The test requires 1ml of specimen. Liquid Chromatography/Tandem Mass Spectrometry is used to detect the drug levels. 50ng/mL is the cut-off level required for a positive to be declared.
A hair test gives a longer detection period compared with the rest. Benzos can be detected in hair at least 7 days after initial dose. This is essentially the time taken by a testable hair strand to grow out of the scalp. A sample from the head hair will test positive up to 4 weeks after use. Chronic use can further lengthen the detection time.
How To Pass Drug Tests For Benzodiazepine
To pass a urine test, you need to lower the drug concentration to levels below the 200ng/mL cut off. This can be done by following the steps outlined here: https://thcdetox.biz/story_5.html
To pass this test, you need to lower drug concentration level to below the 20ng/mL detectable limit. For more information on this, read this: https://thcdetox.biz/blog/home-remedies-pass-saliva-drug-test/
Lowering the drug concentration to levels below 50ng/mL is the only sure way to pass this test. This can be done by accelerating the excretion of the drug from your body. To do this, follow the instructions in this article: https://thcdetox.biz/blog/pass-blood-drug-test/
This is a hard test to beat. The only upside being that without hair then there won’t be a test sample. A clean shave will do the trick. Nevertheless, you can detoxify you hair by the procedures explained in this article: https://thcdetox.biz/blog/how-to-pass-a-hair-drug-test/
On the other hand, if you have the patience and the guts, you can also go the natural way. These home remedies might just do wonders for you.
- Griffin, C. E., Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine Pharmacology and Central Nervous System–Mediated Effects. The Ochsner Journal, 13(2), 214–223. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/
- Gudin, J. A., Mogali, S., Jones, J. D., & Comer, S. D. (2013). Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use. Postgraduate Medicine, 125(4), 115–130. http://doi.org/10.3810/pgm.2013.07.2684
- Mena Raouf, Pharm. D. (2016). Benzodiazepine Metabolism and Pharmacokinetics Retrieved from http://paindr.com/wp-content/uploads/2015/10/Revised-BZD_-9-30.pdf
- New South Wales Government. (2013). Benzodiazepines Retrieved from http://www.health.nsw.gov.au/mentalhealth/Factsheets/Pages/benzodiazepines.aspx
- Professor C Heather Ashton DM, FRCP. (2010). No Evidence that Benzodiazepines are “Locked up” in Tissues for Years Retrieved from https://benzo.org.uk/ashanswer.htm
- Redwood Toxicology Laboratory.(2014). Laboratory Testing Reference Guide Retrieved from https://supremecourt.nebraska.gov/sites/default/files/Programs/CIP/events/redwood/LAB_Reference_Guide.pdf
- Substance Abuse and Mental Health Services Administration. (2012). Clinical Drug Testing in Primary Care. Retrieved from https://store.samhsa.gov/shin/content/SMA12-4668/SMA12-4668.pdf
- Sure Screen Diagnostics. (n.d). Best Practice Bulletin 2 Retention Times and Cut-off Levels Retrieved from https://www.surescreen.com/wp-content/uploads/2015/11/TB02.pdf
- The University of Iowa Department of Pathology: Laboratory Services Handbook: (2017). Benzodiazepines. Retrieved from https://www.healthcare.uiowa.edu/path_handbook/handbook/test2932.html
- Vancouver Acute Pharmaceutical Sciences. (2016). Comparison of Benzodiazepines. Retrieved from http://www.vhpharmsci.com/vhformulary/Tools/Benzodiazepines-comparison.htm
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