Performing Urine Drug Tests

Why, When and How to Perform Urine Drug Tests

Urine drug testing is an important component of opioid prescribing.

Why to do it:

  • Gives the provider objective information (evidence suggests that patients may not be forthcoming if they are misusing opioids) to support the safety of the patient and of the public.

  • Demonstrates adherence to medication regimen. Is the patient using the substance that we have prescribed to them?

  • Shows any illicit substances used by patient. Is the patient using any substances that he or she shouldn’t be?

  • It can support recovery efforts and help to prevent abuse if patients know that there will be urine drug tests.

  • Urine drug testing is now an evolving standard of care.

How to Discuss Urine Drug Testing with Patients:

  • Some physicians feel that discussing urine drug testing is awkward.

  • Urine drug testing must be framed as a personal and public health issue.

  • Provider should explain that we cannot always tell which patients might have problems with misuse and that all patients on opioids are engaged in this type of monitoring.

When to Perform Urine Drug Testing:

  • Most providers feel that¬†random¬†urine screening provides them with the best possible information.

  • Some providers use urine drug screens only when concerns arise (e.g. the patient reports that he or she is out of the opioid medication early).

  • It is also possible to perform urine drug tests on a regular, scheduled basis.