UDT – Urine Drug Testing

Urine drug testing has been an essential tool for clinicians who seek to verify adherence to prescribed opioid regimens and to detect the use of illicit or unauthorized licit drugs. Urine testing remains the most common method of drug testing and despite its limitations, it is the dominant matrix used for these purposes. Urine testing provides for the ability to detect higher concentrations of excreted drug metabolites, some of which may be detectable in the urine for prolonged periods of time. Urine drug test results indicate whether an individual used the drug at a point prior to the provision of the sample. The urinary concentration of a drug or metabolite is subject to significant individual variation due to differences in rates of absorption, metabolism, excretion, drug half-life, urinary pH, how much drug was used, dosing frequency, and health status. Subsequently, it cannot be used as a measure of drug impairment. Unlike oral fluid testing, urine samples can be subjected to tampering and adulteration. ACLS Labs’ urine drug monitoring solutions offer an extensive menu of test options.

With the UDT testing, physicians can:

  • Track patient medication compliance, and make decisions regarding future outcomes.
  • Monitor for potential medication induced adverse effects and drug interactions.
  • Evaluate potential patient diversion and illicit drug use.
  • Evaluate recent drug use in new patients.
  • Evaluate and monitor therapy with controlled substances, and be able to make decisions based on the results.
  • Provide informed consent by communicating current and future therapy trends specifically designed for each individual.

WHY TO TEST

  • Evaluate Patients & Monitor Adherence
  • Support Assessment & Diagnosis
  • Identify Use of Undisclosed Substances
  • Uncover Diversion

WHOM TO TEST

  • New Patients Already Receiving a Controlled Substance.
  • Patients Who Are Resistant to Full Evaluation.
  • Patients Who Request a Specific Drug
  • Patients Who Display Aberrant Behavior
  • Patients in Recovery

WHEN TO TEST

  • When Meeting a Patient for the First Time
  • When Starting Treatment With a Controlled Substance
  • When Making Major Changes in Treatment
  • Support Decision to Refer
  • As a Component of Treatment Agreements
  • Any Aberrant Drug-related Behavior Observed
  • Third-party Reports About Aberrant Drug-related Behaviors.

URINE DRUG MONITORING GUIDELINES

An emerging consensus among many professional organizations, as well as state guidelines, recommend routine and random urine drug monitoring as a part of treating patients on chronic opioid therapy (COT).

Below is an overview of published clinical guidelines supporting routine urine drug monitoring of patients on chronic opioid therapy.

 Periodic & random drug monitoringTreatment agreements should include drug monitoringDrug monitoring prior to the initiation of opioid therapyDrug monitoring should be based on risk stratification
2012 Expert Consensus
Recommendations
American Pain Society/American Academy of Pain Medicine
American Society of Interventional Pain Physicians
Department of Veterand Affairs - Department of Defenses
American College of Occupational and Environmental Medicine