Urine Drug Testing Is Still an Invaluable Resource for Primary Care
Authors: Joanna L. Starrels
Journal: Annals of Internal Medicine (2010)

Letters21 September 2010Urine Drug Testing Is Still an Invaluable Resource for Primary CareJoanna L. Starrels, MD, MS, Daniel P. Alford, MD, MPH, and Barbara J. Turner, MD, MSEd, Executive Deputy EditorJoanna L. Starrels, MD, MSFrom Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467; Boston University School of Medicine and Boston Medical Center, Boston, MA 02118; and University of Pennsylvania School of Medicine, Philadelphia, PA 19134.Search for more papers by this author, Daniel P. Alford, MD, MPHFrom Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467; Boston University School of Medicine and Boston Medical Center, Boston, MA 02118; and University of Pennsylvania School of Medicine, Philadelphia, PA 19134.Search for more papers by this author, and Barbara J. Turner, MD, MSEd, Executive Deputy EditorFrom Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467; Boston University School of Medicine and Boston Medical Center, Boston, MA 02118; and University of Pennsylvania School of Medicine, Philadelphia, PA 19134.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-6-201009210-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Reisfield and colleagues that UDT is a valuable tool for monitoring patients receiving long-term opioid therapy for chronic pain, but our endorsement of its use in primary care is tempered by its limitations. Urine drug testing can detect use of illicit or nonprescribed drugs that is not disclosed by patients, which is essential to managing the risks associated with prescribed opioids. When ordered and interpreted correctly, UDT can also detect nonuse of prescribed opioids. However, although UDT detects these 2 types of aberrant behavior, current evidence does not support the claim that it can ...References1. 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 Scholar2. Reisfield GM, Webb FJ, Bertholf RL, Sloan PA, Wilson GR. Family physicians' proficiency in urine drug test interpretation. J Opioid Manag. 2007;3:333-7. [PMID: 18290585] CrossrefMedlineGoogle Scholar3. Heit HA, Gourlay DL. Urine drug testing in pain medicine. J Pain Symptom Manage. 2004;27:260-7. [PMID: 15010104] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467; Boston University School of Medicine and Boston Medical Center, Boston, MA 02118; and University of Pennsylvania School of Medicine, Philadelphia, PA 19134.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 Urine Drug Testing Is Still an Invaluable Resource for Primary Care Gary M. Reisfield , Noni A. Graham , and Mark S. Gold Metrics 21 September 2010Volume 153, Issue 6Page: 420-421KeywordsBehaviorDrugsOpiatesOpioidsPrevention, policy, and public healthResearch laboratoriesRisk managementUrine ePublished: 21 September 2010 Issue Published: 21 September 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...