Urine Drug Testing Is Still an Invaluable Resource for Primary Care
Authors: Gary M. Reisfield
Journal: Annals of Internal Medicine (2010)

Letters21 September 2010Urine Drug Testing Is Still an Invaluable Resource for Primary CareGary M. Reisfield, MD, Noni A. Graham, MPH, and Mark S. Gold, MDGary M. Reisfield, MDFrom University of Florida College of Medicine, Gainesville, FL 32601.Search for more papers by this author, Noni A. Graham, MPHFrom University of Florida College of Medicine, Gainesville, FL 32601.Search for more papers by this author, and Mark S. Gold, MDFrom University of Florida College of Medicine, Gainesville, FL 32601.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-6-201009210-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We commend Starrels and colleagues (1) for their excellent systematic review and wholeheartedly agree that more rigorous studies are needed to determine the roles of treatment agreements and urine drug testing (UDT) to reduce misuse of prescription opioids. The authors could have emphasized, however, that in addition to reducing opioid misuse, for which they found weak supportive evidence, UDT plays an invaluable role in detecting abuse of and addiction to prescribed opioids, illicit drugs, and nonprescribed controlled substances, as well as diversion of prescribed opioids. The abuse of prescription opioids in the United States has reached epidemic ...References1. Starrels JL, Becker WC, Alford DP, Kapoor A, Williams AR, Turner BJ. Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain. Ann Intern Med. 2010;152:712-20. [PMID: 20513829] LinkGoogle Scholar2. Heit HA, Gourlay DL. Tackling the difficult problem of prescription opioid misuse [Editorial]. Ann Intern Med. 2010;152:747-8. [PMID: 20513831] LinkGoogle Scholar3. Paulozzi LJ, Xi Y. Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type. Pharmacoepidemiol Drug Saf. 2008;17:997-1005. [PMID: 18512264] CrossrefMedlineGoogle Scholar4. Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National Findings. (Office of Applied Studies, NSDUH Series H-34, DHHS Publication No. SMA 08-4343.) Rockville, MD: Substance Abuse and Mental Health Services Administration; 2008. Accessed at www.oas.samhsa.gov/nsduh/2k7nsduh/2k7results.cfm on 10 August 2010. Google Scholar5. Katz NP, Sherburne S, Beach M, Rose RJ, Vielguth J, Bradley J, et al. Behavioral monitoring and urine toxicology testing in patients receiving long-term opioid therapy. Anesth Analg. 2003;97:1097-102, table of contents. [PMID: 14500164] Google Scholar6. Bhamb B, Brown D, Hariharan J, Anderson J, Balousek S, Fleming MF. Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain. Curr Med Res Opin. 2006;22:1859-65. [PMID: 16968589] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gary M. Reisfield, MD; Noni A. Graham, MPH; Mark S. Gold, MDAffiliations: From University of Florida College of Medicine, Gainesville, FL 32601.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Treatment Agreements and Urine Drug Testing to Reduce Opioid Misuse in Patients With Chronic Pain Joanna L. Starrels , William C. Becker , Daniel P. Alford , Alok Kapoor , Arthur Robinson Williams , and Barbara J. Turner Tackling the Difficult Problem of Prescription Opioid Misuse Howard A. Heit and Douglas L. Gourlay Urine Drug Testing Is Still an Invaluable Resource for Primary Care Joanna L. Starrels , Daniel P. Alford , and Barbara J. Turner Metrics Cited byReview of the Current State of Urine Drug Testing in Chronic Pain: Still Effective as a Clinical Tool and Curbing Abuse, or an Arcane Test?Primary care providers' experiences with urine toxicology tests to manage prescription opioid misuse and substance use among chronic noncancer pain patients in safety net health care settingsOpioid Use in Pregnant Women and the Increase in Neonatal Abstinence SyndromeSystematic Evaluation of “Compliance” to Prescribed Treatment Medications and “Abstinence” from Psychoactive Drug Abuse in Chemical Dependence Programs: Data from the Comprehensive Analysis of Reported DrugsUrine Drug Testing in Long-term Opioid TherapyRecommendations for Urine Drug Monitoring as a Component of Opioid Therapy in the Treatment of Chronic Pain 21 September 2010Volume 153, Issue 6Page: 420KeywordsAnalgesicsDrugsHospitalizationsMarijuanaMortalityOpioid addictionOpioidsPrimary care physiciansSystematic reviewsUrine ePublished: 21 September 2010 Issue Published: 21 September 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...