Title: Recommendations

Context:
As substance misuse in patients on LOT is more than 30% in some series,[107] UDT and confirmatory  testing is used as an additional method of examining for patient substance misuse and adherence to the  prescribed regimen. UDTs, used in the appropriate way, help to address safety, fairness, and trust with OT.  Availability of accurate and timely confirmatory testing (e.g., gas chromatography-mass spectrometry  [GCMS]) is critical due to the false positive and negative rates associated with UDTs.[53] Interpretation of a  UDT and confirmatory results requires education and knowledge of the local procedures and clinical  scenario. Local education and access to expert interpretation is necessary. UDT results are helpful and can help identify active SUD or possible diversion. Accordingly, clinicians should obtain UDT prior to initiating or continuing LOT and periodically thereafter. When a patient is referred for  SUD treatment or is engaged in on-going treatment there should be close communication between the  SUD and pain management providers. The ideal approach is an interdisciplinary format (see  Recommendation 16). For more information, see Appendix B on UDT and confirmatory testing.

Question: Availability of accurate and timely confirmatory testing (e.g., gas chromatography-mass spectrometry  [GCMS]) is critical due to what?

Answer: the false positive and negative rates associated with UDTs