Specimen validity testing in urine drug monitoring of medications and illicit drugs: clinical implications.
OBJECTIVE
To discuss the importance of specimen validity testing (SVT) in urine drug testing (UDT) and the clinical role it plays in identifying efforts to subvert the UDT process.


METHODS
A discussion of the clinical impact of SVT is presented.


RESULTS
A discussion of pH, specific gravity, creatinine, and oxidation for monitoring the adulteration of UDT samples is presented along with the clinical significance of such tests.


CONCLUSIONS
SVT has a significant place in healthcare efforts to measure patient adherence, behavior, and honesty in communication with clinicians. SVT is typically ordered by treating clinicians who use the results to make therapeutic decisions regarding specific medical problems of their patient, including those related to medication and illicit drug use. In the absence of SVT, a healthcare provider may fail to identify a patient's adulteration of their urine sample in an attempt at deceiving the provider. Moreover, the presence of some underlying medical conditions may obfuscate the UDT results.
Millennium Research Institute, San Diego, California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.
Kenneth L
KL
Kirsh
Johns Hopkins University School of Medicine, Baltimore, Maryland.
Paul J
PJ
Christo
Georgetown University School of Medicine, Washington, DC.
Howard
H
Heit
Millennium Health, San Diego, California.
Katherine
K
Steffel
Millennium Research Institute, San Diego, California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.
Steven D
SD
Passik
D015415:Biomarkers / Q000652:urine; D016903:Drug Monitoring / Q000379:methods* / Q000592:standards; D006801:Humans; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013048:Specimen Handling / Q000592:standards; D015813:Substance Abuse Detection / Q000379:methods* / Q000592:standards; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000652:urine; D016482:Urinalysis / Q000592:standards
D015415:Biomarkers