Take time to discuss unexpected results with the patient and refer to preudt information the patient. Think of urine drug screens as akin to hba1c results. We utilized a selection of recent articles on urine. Despite the widespread use of urine drug tests udts, there is little published information on how to correctly interpret the results of these tests. Appropriate use of urine drug testing udt to improve patient care available tests and con.
Correct evaluation of urine drug tests udts is essential for appropriate chronic prescribing of controlled substances. Cloudy or odorous urine is typically a sign of dehydration. Eddp levels, in contrast, are relatively unaffected by the influence of ph and are therefore preferable for assessing compliance with therapy. Pdf with sound analytical methodology, good laboratory practice, and intact specimen chainofcustody, test result interpretation is the final. Specimen validity testing is an important part of every urine drug test. In order to determine if a urine specimen is negative or positive. Blood and urine are the most commonly used fluids in the analysis. Even the routine urinalysis should be a midstream specimen after cleansing the meatus. A urine drug test, also known as a urine drug screen or a uds, is a painless test. Urine drug testing is highly reliable, but false positives can rarely occur for some drugs. Taking these limitations into consideration when interpreting test results will optimize the clinical utility of urine drug testing and will assist clinicians in their clinical decisionmaking in.
Urine drug testing centers for disease control and. Pdf as interest increases in employmentrelated drug testing, the. Another important aspect of creatinine interpretation is its use to monitor abstinence from marijuana. Prior studies indicate that family physicians sometimes misinterpret urine drug test results, and interpretation may be more complex when results include prescription medications. Urine test results give only limited information about when a donor might have taken the substance for which she is positive. Urine culture results philip sloane, md, mph professor of family medicine and geriatrics. The procedure can be discomforting causing mild pains. It analyzes your urine for the presence of certain illegal drugs and prescription medications. Drug testing faqs tests, detection times, and false. Urine drug concentrations national drug court institute. As a screening test, the initial immunoassay is less sensitive and therefore must be interpreted in the.
Family physicians should be familiar with the characteristics and capabilities of screening and confirmatory drug tests. Consider using the cdc mobile app to practice the types of conversations you may encounter with patients. Methadone levels in urine are widely variable depending on factors such as dose, timing of collection, metabolism, and urine ph can even be undetectable. The ethyl glucuronide etg test is widely used to detect the presence in the urine of ethyl glucuronide, a breakdown product of ethanol, the intoxicating agent in alcohol. When considering a cliawaiver, providers should keep in mind that some states have regulations that differ from.
How to correctly interpret a urine drug screen result. While urine drug testing remains the primary strategy for the abstinence monitoring of drug court participants, interpretation of test results continues to be. The length of time a drug can be detected in the urine varies due to several factors, including hydration, dosing, metabolism, body mass, urine ph, duration of use, and a drug s particular pharmacokinetics. Urine drug screening urine drug screens uds are a valuable tool in our management of patients on chronic opioid therapy, however, the results can be misleading and clinical judgment is needed in. Drug testing is the evaluation of urine, blood or another type of biological sample to determine if the subject has been using the drug or drugs in question.
Urine drug testing clinical practice ui health care. For the testing, the doctor can use either a visual exam, dipstick test or microscopic exam when conducting the urine test. Understand the role of urine drug screens in the monitoring of patients on opioids understand the role of urine drug screens for patient on opioid agonist treatment correctly interpret a variety of urine drug screen results. Test b opiates 300 ngml cutoff urine sample that contains oxycodone at 500 ngml will test negative. Important considerations in the interpretation of forensic urine drug. Interpretation of opiate urine drug screens healthpartners. Drugs of abuse urine testing rtl processes over 85,000 urine specimens each. This makes for easy and quick interpretation of the urinalysis results by placing the strip next to the. Urine drug testing is an important part of managing longterm opioid therapy. This means that a result will only be positive if the amount of the drug is above a certain level. Interpreting urine drug test results is complicated, and mistakes can have serious consequences for patient care. The aim of this article was to discuss the interpretation of urine drug tests and their application to pain physician practices. Interpretation of opiate urine drug screens summary urine drug testing is highly reliable, but false positives can rarely occur for some drugs. With the recent increase in deaths caused by opioid overdoses, several federal and state regulations have been.
Family physicians must be familiar with these substances, the methods to detect them, and their effects on urine drug testing. Interpretation of urinalysis results urinalysis is used as a screening andor diagnostic tool to detect substances or cellular material in the urine associated with metabolic disorders, renal dysfunction or. Appropriate use of drug testing in clinical addiction medicine asam. Interpreting urinalysis and urine culture results philip sloane, md, mph professor of family medicine and geriatrics. Always wear gloves whilst messing about with another persons pee. The concentration of the thc metabolite, carboxythc, can fluctuate from daytoday. Inappropriate interpretation of the results and failure to order definitive testing when. Discuss unexpected results with the local laboratory or toxicologist if assistance is needed with interpretation. Interpretation of urine drug testing in pain patients. A urinalysis, or urine test, is a common medical test in which the urine is examined to diagnose and monitor various illnesses. Interpreting urine drug test results nationwide medical. Urine test results give no information about how much what dose of a substance the donor took. Think of urine drug screen results as a test on the providers treatment quality do you need to change care. A positive result indicates that the specific drug or class of drug is present at or above the designated cutoff level.
This improper handling can affect the results of the test, since contamination can occur at any point in the handling. The following is an explanation of redwood toxicology. Incorrect interpretation of test results falsepositive or falsenegative can have signi. In such cases, consent for the drug screen is inferred, and its results may be used. Pdf drugtesting methods and clinical interpretations of test results. Urine test results give no information about impairment. As always, clinical judgment is necessary when interpreting.
Accurate interpretation of drug screen results requires knowledge of the urine metabolites. Half life the amount of time it takes for the drug concentration in the urine or blood to decrease by one half 2. Tests result i enterococcus faecal ig result flag abnormal units reference interval 10, 00025, 000 colony forming units per ml. Interpretation of drug testing results in medicationassisted treatment ncdc, april 2018. Clinical interpretation of urine drug tests mayo clinic proceedings. Urine drug testing udt encompasses a variety of tests that can be very useful in patient care. Urine drug testing is an essential component of monitoring patients who are receiving longterm opioid therapy, and it has been suggested for patients receiving longterm benzodiazepine or stimulant therapy. Those dipsticks make a pretty good catapult for drops of eyeball. Consult with our expert toxicologists and clinical pharmacists available for realtime discussion, results interpretation, education and training on the radar hotline 866 8660605. As always, clinical judgment is necessary when interpreting test results. Interpretation of drug testing results in medication assisted treatment by. Urine samples can be adulterated with other substances to mask positive results on urine drug testing. Interpretation of drug testing results in medication. The urinalysis is a simple and noninvasive test that.
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