ACLS Drug Testing Program
Before beginning a trial of opioid therapy, UDT can aid in identifying pre-existing substance-use disorders that, unaddressed, might preclude effective pain management.
- UDT serves as an adjunct to a patient’s self-report of recent prescription and illicit drug use, since research has established that, for a variety of reasons, patients may not be forthcoming about all medications/drugs they are taking.
- There is an essential safety role of UDT in identifying medications or substances a patient is using that could interact with prescribed analgesics and have potential for serious adverse events or overdose (such as, prescribing opioids in a patient taking sedative/hypnotics or using alcohol).
- In patients who are not experiencing expected pain relief from particular medications, UDT can suggest pharmacokinetic factors – such as ultrarapid metabolizer phenotypes or cytochrome P450 inducers – that may be responsible for suboptimal analgesia.
- Periodic, and preferably random, UDT may change behaviors, encouraging patient adherence to prescribed medication regimens and thereby increasing the chances that the therapy will improve pain, function, and quality of life.
- UDT results comprise objective data that support clinical impressions of medication adherence and/or abstinence from substances of abuse for legal and workers’ compensation cases, insurers, or family members, so that useful medications may continue to be prescribed.
- Along these lines, UDT records supporting adherence to medication regimens, as well as use of or abstinence from other substances, can provide important information when coordinating care with other providers. For example, it may be important for them to know how adherent a patient is with prescribed regimens.
- In cases of inappropriate UDT results — such as the presence of nonprescribed controlled medications or illicit drugs — that information can be used to initiate a dialogue with the patient to determine the nature of the problem and to explore options for treatment or further evaluation.