Testing

Urine drug testing (UDT) encompasses a variety of tests that can be very useful in patient care. For example, UDT can be used to document adherence to the agreed-upon treatment plan, to aid in the diagnosis of drug addiction or diversion, or for patient advocacy.

In 2009, the American Pain Society and the American Academy of Pain Medicine convened an expert panel that developed Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. The panel concluded that UDT has a central role in monitoring patients receiving chronic opioid therapy to avoid its potential harms. Specifically, the panel recommended that UDT should be used periodically in all treated patients who are at high risk for abuse or diversion, and that UDT should also be considered even for patients who do not have known risk factors in order to confirm adherence to the chronic opioid therapy plan of care. In our opinion, UDT should be considered in all patients, including those without apparent elevated risk, as part of the protocol of practices, especially when controlled substances, such as opioids, are prescribed. The literature is clear that when aberrant behavior alone is used as a trigger for UDT, a significant proportion of patients who would benefit from this technology will be missed. Therefore, a consistent clinical approach in performing UDT will optimize the use of this technology for both patient and practitioner alike.

Clinicians often lack training in the appropriate use of UDT. Because of this, UDT is often underused or used inappropriately in clinical care. Determining the appropriate use of UDT can involve complex decision- making processes. Before ordering UDT, clinicians should be clear about their reasons for using it, as well as its potential benefits, limitations, and challenges related to interpretation of results. Ideally, UDT should be done as part of a consensual process between clinicians and patients, with full explanation to and for the benefit of the patient.

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  1. Urine Drug Screening - A Practical Guide for Clinicians - The goal of this paper is to provide clinically relevant information that can be used to interpret urine drug screens for commonly abused drugs, including alcohol, amphetamines, benzodiazepines, opioids, marijuana, and cocaine.
  2. Urine Drug Testing in Clinical Practice - This monograph provides clinicians with the necessary knowledge to incorporate UDT into clinical practice, with an emphasis on its use as a safety and monitoring tool for patients who are being prescribed opioids for chronic pain.
Testing Labs
  1. QUEST DIAGNOSTICS (This Lab is out of network in CO and NV and is product specific in GA and VA)
  2. Prescription Drug Monitoring - State Monitors: The 'State Monitors' are intended to be educational resources to help physicians navigate their state's legislative and regulatory guidelines on the use of prescription and therapeutic drug monitoring. The documents are not intended to impart any legal advice, and readers are encouraged to review this information with qualified legal counsel before taking any action relative to controlled substance prescribing and clinical drug testing.

    Prescription Drug Monitoring Consultation Hotline - Use this phone number to reach a Toxicologist or to get information on how to reach a representative for a particular geographic area. 1-877-40-RX TOX (1-877-407-9869). For assistance with prescription drug monitoring results or to arrange a consult with a toxicologist, our Toxicology Specialists are available M-F, 8am - 6pm EST.

    This link is to the Quest Diagnostics PDM (Prescription Drug Monitoring) landing page which provides easy access to additional information such as videos, test ordering, health trends etc.

  3. DYNACARE LABORATORIES (Dynacare Laboratories which are owned by LabCorp, are located in Wisconsin and are affiliated with Froedtert & Medical College of Wisconsin)
  4. LabCorp - Laboratory Corporation of America (This Lab is product specific in CT)
  5. Contact a LabCorp Rep

    Contact a LabCorp Toxocologist

  6. Clinic and Hospital Affiliated Labs
    • If you are a provider affiliated with a hospital system, please contact the clinic where you practice or your affiliated hospital lab to get more information on urine drug testing from your specific hospital system.

  7. For 2015 Drug Testing Codes, please click here.