The use of urine drug testing to monitor patients receiving chronic opioid therapy for persistent pain conditions.
Urine testing is a practical, inexpensive, and valuable tool in general medical practice for patient guidance, treatment planning, and dosage determination in opioid-treated chronic pain patients. (Table 2) However, UDTs are under-utilized in clinical practice. In a recent survey among 248 primary care practitioners, only 6.9% reported obtaining this test before prescribing opioids and only 15% performed urine toxicology tests on patients already prescribed opioids. Since the UDT is mainly done for the benefit of the patient, the test results should not be the only means to detect substance abuse or monitor treatment compliance. Katz et al suggested that behavioral monitoring and UDTs for patients receiving chronic opioids creates a more comprehensive monitoring system than either alone. Inappropriate testing and overreliance on laboratory results would detract from the clinical management of and damage the clinical relationship with the patient. Therefore, training and education about the benefits and limitations of drug tests are essential to help staff members understand the importance of using test reports appropriately. This would also help the practitioners' concerns of iatrogenic addiction or relapse of previously addicted patients.
Substance Abuse Division, Dept Psychiatry, Rhode Island Hospital, Providence 02903, USA. ttellioglu@lifespan.org
Tahir
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Tellioglu
D000437:Alcoholism / Q000652:urine; D000701:Analgesics, Opioid / Q000627:therapeutic use* / Q000652:urine*; D002908:Chronic Disease; D006801:Humans; D007118:Immunoassay; D010146:Pain / Q000188:drug therapy*; D013048:Specimen Handling
D000701:Analgesics, Opioid