FDA/DEA/PDMP/UDT: alphabet soup or sensible and integrated risk management?
OBJECTIVE
Both prescription drug monitoring programs (PDMP) and urine drug testing (UDT) are recommended as parts of an ongoing risk management approach for controlled substance prescribing. The authors provide an editorial and commentary to discuss the unique contributions of each to promote better clinical decision making for prescribers.


METHODS
A commentary is employed along with brief discussion comparing four states with an active PDMP in place to three states without an active PDMP as it relates back to findings on UDT in those states from a laboratory conducting liquid chromatography tandem mass spectrometry.


CONCLUSIONS
The commentary focuses on the place of both tools (UDT and PDMP) in risk management efforts. The argument is made that relying on a PDMP alone would lead to clinical decisions that may miss a great deal of problematic or aberrant behaviors.
Millennium Research Institute, San Diego,California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.
Steven D
SD
Passik
Millennium Research Institute, San Diego, California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.
Kenneth L
KL
Kirsh
Director of Policy and Advocacy, American Academy of Pain Management, Sonora, California.
Robert K
RK
Twillman
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D002853:Chromatography, Liquid; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000652:urine; D016903:Drug Monitoring / Q000379:methods* / Q000592:standards; D006801:Humans; D055118:Medication Adherence; D009293:Opioid-Related Disorders / Q000175:diagnosis* / Q000517:prevention & control / Q000652:urine; D061214:Patient Safety; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D015813:Substance Abuse Detection / Q000379:methods* / Q000592:standards; D053719:Tandem Mass Spectrometry; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards; D016482:Urinalysis
D000701:Analgesics, Opioid; D015415:Biomarkers