Urine Drug Testing in Pain Medicine

Urine drug testing (UDT) is a useful diagnostic tool in a number of medical disciplines, including pain management and addiction medicine. It also can be useful in the primary care setting. When used in a therapeutic model of patient-centered care, UDT provides valuable information to assist the practitioner in diagnostic and therapeutic decision making around a number of issues.
A study that audited medical records to assess the management of chronic pain patients in family practices found that only 8% of physicians utilized UDTs. UDTs are used infrequently in the tertiary care oncology center. In the authors’ experience, the use of UDTs in a non-cancer pain practice is more common, but sometimes is utilized in a punitive manner to “catch” the patient with an inappropriate positive or negative UDT and dismiss the patient from the practice.
By using UDT in a patient-centered fashion, both patient and physician interests are maintained. The medical review officer-based model of testing in the clinical setting can lead to mistrust and a deterioration of the doctor-patient relationship. Clinical testing can enhance the doctor-patient relationship when the results are used to improve communication. A patient-centered model of UDT should be used to improve quality of care. This paper discusses why urine is the biological specimen of choice for drug testing; who, when and why to test; testing methods; and, most importantly, interpretation of results.

Read the full whitepaper here: http://mytopcare.org/wp-content/uploads/2013/07/Heit.pdf

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