Implementation of multiple risk assessment and monitoring strategies appears to lower the rate of inappropriate UDT results in a clinical setting as in the experience of this private pain specialty practice.
Since the mid-1990s, chronic opioid therapy (COT) for the treatment of non-cancer-related chronic pain has become an essential aspect of modern medical practice in many parts of the United States. Urine drug testing (UDT) has become “an essential feature of pain management, as physicians seek to verify adherence to prescribed opioid regimens and to detect the use of illicit or unauthorized licit drugs.” A recent position paper by the American Pain Society on COT calls for UDT on high risk patients and for clinicians to consider UDT on patients who are not considered high risk or who have shown medication aberrant behaviors. Other authors argue for UDT to be done on all patients on COT. Some type of monitoring is essential for patients on COT and UDT is an increasingly important tool in this regard.
Practitioners who prescribe COT are responsible for performing due diligence in identifying, monitoring, and managing risk factors as they determine which patients to treat. Practitioners need objective data, in addition to “gut instinct,” to determine whether their risk assessment techniques are reliable and valid. They need to know they are treating patients who have the ability and willingness to handle medications appropriately. One recent editorial opined that physicians must acquire basic knowledge of sub-stance abuse and become proficient in screening and assessing risk.
Read the full article here: http://www.practicalpainmanagement.com/treatments/pharmacological/opioids/urine-drug-testing-evaluation-risk