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Urine Drug Tests: Ordering and Interpreting Results.
Am Fam Physician. 2019 01 01; 99(1):33-39.AF

Abstract

Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities of screening and confirmatory drug tests. Immunoassays are qualitative tests used for initial screening of urine samples. They can give false-positive and false-negative results, so all results are considered presumptive until confirmatory testing is performed. Immunoassays for opioids may not detect commonly prescribed semisynthetic and synthetic opioids such as methadone and fentanyl; similarly, immunoassays for benzodiazepines may not detect alprazolam or clonazepam. Immunoassays can cross-react with other medications and give false-positive results, which have important implications for a patient's pain treatment plan. False-negative results can cause missed opportunities to detect misuse. Urine samples can be adulterated with other substances to mask positive results on urine drug testing. Family physicians must be familiar with these substances, the methods to detect them, and their effects on urine drug testing.

Authors+Show Affiliations

Kale N
University of Texas Southwestern Medical Center, Dallas, TX, USA.

MeSH

Analgesics, OpioidAnti-Anxiety AgentsBenzodiazepinesCentral Nervous System AgentsDrug MonitoringFalse Negative ReactionsFalse Positive ReactionsFamily PracticeHumansImmunoassaySubstance Abuse DetectionSubstance-Related Disorders

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30600984

Citation

Kale, Neelima. "Urine Drug Tests: Ordering and Interpreting Results." American Family Physician, vol. 99, no. 1, 2019, pp. 33-39.
Kale N. Urine Drug Tests: Ordering and Interpreting Results. Am Fam Physician. 2019;99(1):33-39.
Kale, N. (2019). Urine Drug Tests: Ordering and Interpreting Results. American Family Physician, 99(1), 33-39.
Kale N. Urine Drug Tests: Ordering and Interpreting Results. Am Fam Physician. 2019 01 1;99(1):33-39. PubMed PMID: 30600984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urine Drug Tests: Ordering and Interpreting Results. A1 - Kale,Neelima, PY - 2019/1/3/entrez PY - 2019/1/3/pubmed PY - 2019/11/8/medline SP - 33 EP - 39 JF - American family physician JO - Am Fam Physician VL - 99 IS - 1 N2 - Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities of screening and confirmatory drug tests. Immunoassays are qualitative tests used for initial screening of urine samples. They can give false-positive and false-negative results, so all results are considered presumptive until confirmatory testing is performed. Immunoassays for opioids may not detect commonly prescribed semisynthetic and synthetic opioids such as methadone and fentanyl; similarly, immunoassays for benzodiazepines may not detect alprazolam or clonazepam. Immunoassays can cross-react with other medications and give false-positive results, which have important implications for a patient's pain treatment plan. False-negative results can cause missed opportunities to detect misuse. Urine samples can be adulterated with other substances to mask positive results on urine drug testing. Family physicians must be familiar with these substances, the methods to detect them, and their effects on urine drug testing. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/30600984/Urine_Drug_Tests:_Ordering_and_Interpreting_Results_ DB - PRIME DP - Unbound Medicine ER -