title: Predictive Value of Positive Drug Screening Results in an Urban Outpatient Population.
abstract: Urine drug testing (UDT) has become an essential component in the management of patients prescribed opioid analgesics for the treatment of chronic non-malignant pain. Several laboratory methods are available to monitor adherence with the pharmacological regimen and abstinence from illicit or unauthorized medications. Immunochemical screening methods are rapid and economical, but they have limitations, including lack of specificity, and confirmatory methods are often necessary to verify presumptive positive results. We analyzed the results of confirmatory assays in an outpatient setting to determine the predictive value of presumptive positive urine drug screen results using an automated immunoassay for eight common drugs or drug classes. Positive predictive values (PPVs), in descending order, were as follows: cannabinoids (100%), cocaine (100%), opiates (86.8%), benzodiazepines (74.6%), oxycodone (67.6%), methadone (44.1%) and amphetamines (9.3%). The number of positive barbiturate results was too small to be included in the statistical analysis.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Florida College of Medicine and UF Health/Jacksonville, Jacksonville, FL 32209, USA roger.bertholf@jax.ufl.edu.
authors.forename: Roger L
authors.initials: RL
authors.lastname: Bertholf
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Florida College of Medicine and UF Health/Jacksonville, Jacksonville, FL 32209, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32611, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Reisfield
mesh_terms: D000662:Amphetamines / Q000032:analysis / Q000652:urine; D000701:Analgesics, Opioid / Q000032:analysis* / Q000191:economics / Q000652:urine*; D001463:Barbiturates / Q000032:analysis / Q000652:urine; D001569:Benzodiazepines / Q000032:analysis / Q000652:urine; D002186:Cannabinoids / Q000032:analysis / Q000652:urine; D059350:Chronic Pain / Q000188:drug therapy; D003042:Cocaine / Q000032:analysis / Q000652:urine; D004353:Drug Evaluation, Preclinical / Q000379:methods*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007118:Immunoassay; D008691:Methadone / Q000032:analysis / Q000652:urine; D053610:Opiate Alkaloids / Q000032:analysis / Q000652:urine; D010098:Oxycodone / Q000032:analysis / Q000652:urine; D011446:Prospective Studies; D053719:Tandem Mass Spectrometry
chemical_list: D000662:Amphetamines; D000701:Analgesics, Opioid; D001463:Barbiturates; D002186:Cannabinoids; D053610:Opiate Alkaloids; D001569:Benzodiazepines; D010098:Oxycodone; D003042:Cocaine; D008691:Methadone