MONITORING TREATMENT -  Urine Drug Testing
UDT General Pointers

General UDT Pointers
  • Typical assays most useful if positive for non-prescribed medications/illicit drugs
  • These assays were designed to detect toxic levels…not prescribed doses
  • Assays may detect semi-synthetic (oxycodone) or synthetic (fentanyl) opioids only at very high doses
Confirming therapeutic adherence often requires more sensitive test 
  • Laboratory-based specific drug identification (e.g., high performance liquid chromatography [HPLC] immunoassay)
There is only weak evidence that UDT actually reduces opioid misuse
  • In various studies up to 46% of patients on opioids in chronic pain clinics had positive urine toxicology screens in the absence of aberrant behavioral issues
A Clinical Guide to Urine Drug Testing by UMDN
ASAM Consensus on Appropriate Use of Drug Testing in Clinical Addiction Medicine
Several references on interpreting UDT that detects CANNABINOIDS (all is not just THC)