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Trends in drug use from urine drug testing of addiction treatment clients

Kenneth L. Kirsh, PhD, Howard A. Heit, MD, Angela Huskey, PharmD, CPE, Jennifer Strickland, PharmD, BCPS, Kathleen Egan City, MA, BSN, RN, Steven D. Passik, PhD


Objective: Urine drug testing (UDT) can play an important role in the care of patients in recovery from addiction, and it has become necessary for providers and programs to utilize specific, accurate testing beyond what immunoassay (IA) provides.

Design: A database of addiction treatment and recovery programs was sampled to demonstrate national trends in drug abuse and to explore potential clinical implications of differing results due to the type of testing utilized.

Setting: Deidentified data was selected from a national laboratory testing company that had undergone liquid chromatography tandem mass spectrometry (LCMS/MS).

Patients/Participants: A total of 4,299 samples were selected for study.

Interventions: Descriptive statistics of the trends are presented.

Results: In total, 48.5 percent (n = 2,082) of the samples were deemed in full agreement between the practice reports and the results of LC-MS/MS testing. The remaining 51.5 percent of samples fell into one of seven categories of unexpected results, with the most frequent being detection of an unreported prescription medication (n = 1,097).

Conclusions: Results of UDT demonstrate that more than half of samples yield unexpected results from specimens collected in addiction treatment. When comparing results of IA and LC-MS/MS, it is important to consider the limits of IA in the detection of drug use by these patients.


addiction, urine drug testing, relapse, monitoring

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