Study: More frequent drug testing associated with less drug misuse
Drug testing in shorter intervals than federal guidelines recommend could drive down drug misuse among some patients, according to researchers who analyzed urinary drug testing results from 49,601 people who were being treated for chronic pain.
The findings, published in the Journal of Opioid Management by researchers affiliated with Quest Diagnostics and New York-Presbyterian Hospital, suggest that clinicians should consider drug testing their patients at least quarterly, if not weekly, to prevent drug misuse and substance addiction. For the study, drug misuse was defined as “the absence of a prescribed substance or the presence of a non-prescribed substance” in patients with at least three sets of urinary drug test results.
Declines in drug misuse were most significant for those tested at the shortest intervals. Rates of misuse dropped 19 percent for patients tested weekly, 15 percent for those tested monthly, 12 percent for those tested twice per month, and 9 percent for those tested quarterly. Declines in drug misuse were strongest for opioids compared to other drugs. Use of heroin declined 32 percent, and use of nonprescribed fentanyl dropped by 10 percent.
Drug misuse increased by 1 percent in patients who were tested only annually, and the rate showed no meaningful change in patients tested semi-annually. The federal Centers for Disease Control and Prevention recommends that clinicians prescribing opioids for chronic pain should consider “at least annual urine drug testing.”
The possible reasons increased drug testing could drive down drug misuse are complex, researchers reported: “For some patients, the increased accountability for their actions, or fear of possible legal ramifications, may play a large role. Physicians may threaten to stop prescribing particular medications to patients when inappropriate/nonprescribed positive tests occur. It is also possible physicians stop prescribing drugs to patients who are not testing positive for them, leading to less noncompliance.”
Whatever the reason, efforts to drive down drug misuse are important. Overdose deaths in the United States are increasing at an alarming rate. Between 2014 and 2017, these deaths spiked nearly 50 percent from 47,055 to 70,237 — and in 2019, death by drug overdose represented one in every 39 deaths.
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