Cocaine is metabolized to which primary metabolite detected in urine drug screens?

• A. Carbamazepine
• B. Codeine
• C. Hydrocodone
• D. Benzoylecgonine

Answer: (D)

Cocaine metabolism and urine drug screening rely on benzoylecgonine as the detectable product because it is the primary metabolite produced and it stays in urine longer than the parent drug, providing a wider window to detect prior use. When cocaine is processed by esterases, it breaks down into benzoylecgonine and ecgonine methyl ester, but benzoylecgonine is formed in larger amounts and is more stable in urine. That's why urine screens for cocaine focus on benzoylecgonine — a positive result more reliably reflects recent cocaine use than the parent compound alone. The other substances listed are distinct drugs and are not metabolites of cocaine, so they would not serve as cocaine metabolites.