Clinical implications of urinary drug screens

Abstract

Urine drug screens are routinely used in the substance abuse treatment setting along with other clinical settings when illicit drug use is suspected. With the importance placed on the results of urine drug screens, clinicians should be aware of the strengths and weaknesses of the tests involved when interpreting the results. Such interpretation is quite complicated and depends on a large number of variables. It is incumbent on the clinician to be aware of what methodology is used by the lab, which cross-reactivities may occur with the methodology used, and what changes occur in the procedure. Clinicians should also consider the clinical presentation of a patient when interpreting positive results to avoid frustration and mistrust in lieu of the desired therapeutic alliance between the patient and clinician. When there is doubt about the results, confirmation may be used in certain cases to help clarify the situation. Since the implications of positive drug screens have an impact on patient treatment, diagnosis, and possibly the status of health care benefits, great care should be taken to avoid misinterpretation of drug screens.