Pain Management Drug Testing

Traditionally, urine drug testing has looked for the presence of drugs that should not be there. You are hoping for a completely negative drug test. Because tests for measuring drugs in urine haven’t always been incredibly accurate at the low end of the measurement range, and interferences from other compounds can cause false positives and negatives, back in the early 1990s the Department of Health and Human Services provided cut-off concentrations for abused drugs that gave the best discrimination between samples that actually contain those compounds and those that don’t. What that means today is that if the concentration of the drug in the sample is higher than the cut-off, that sample is positive for the tested drug. If the concentration is less than the cut-off, the test is negative, whether there is actually any drug present or not.

How is pain management drug testing different? When testing urine samples for drugs for pain management, you are looking for the presence of drugs that SHOULD be there. In essence, you’re hoping for a positive drug test. Controlling pain with medication is a massive industry, but to keep prescribing those drugs, the physician needs proof that the patient is actually taking the medication and not diverting it for sale or use by someone else. Thus pain management drug testing looks for the presence of the specific drug and may actually require a quantitative result rather than a simple positive/negative.

In addition, although the assays used for both types of drug testing may be the same (mass spectrometry or immunoassay), traditional urine drug testing often only includes drugs in the major classes of drugs of abuse. Pain management drug testing must also include specific drugs prescribed therapeutically for pain, like methadone and oxycodone. Thus point-of-care (POC) devices for drugs of abuse drug testing may not be adequate for pain management drug testing.

Here is a list of drugs usually included in POC testing panels:

Drugs of Abuse
Amphetamines
Opiates
Cocaine
Benzodiazepines
Tetrahydrocannabinoids
Barbiturates
Phencyclidine

Pain Management Testing

Amphetamines
Opiates
Cocaine
Benzodiazepines
Tetrahydrocannabinoids
Barbiturates
Phencyclidine
Oxycodone
Methadone
Propoxyphene

-Patti Jones

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