Drug testing is now a widely accepted practice in the workplace. It is a fact that alcohol and drug abuse generate considerate health and safety hazards that can negatively threaten their safety and clients (where applicable), affect employee morale and decrease productivity.
Pain management centers are not exempted from doing routine urine drug test not only for their employees but for their patients as well. A pain management center is involved in the practice of dispensing prescription drugs that can be addictive if abused; so it is the responsibility of such facility to ensure that their patients are not misusing their prescription drugs. Since access to potentially addictive drugs is open to the center’s staff, it is just right to include them in pre-employment screening for illicit drug use.
According to Landmark Recovery, an intervention is an act of disrupting the destructive habits of a person suffering from addiction. This is often the first step or catalyst of a drug abuser's entry into a rehabilitation or pain management program.
A routine urine drug testing is a very useful tool in Pain Management Centers as it provides objective information to assist healthcare providers in their therapeutic and diagnostic decisions.
The result of a urine test will confirm if a patient is in compliance or adherence with his recommended and approved drug dosage. Instant urine test kits that make use of the immunoassay method of testing are recommended as a first step. Through this quick drug test, a healthcare provider can diagnose drug misuse, abuse or relapse. Finding unprescribed or illicit drugs, or finding no presence of the prescribed drug in the urine is another issue that needs further discussion with the patient. In cases like this, the next step is a confirmation test from a reputable laboratory.
A urine drug test done in a laboratory is suggested to have a screening panel for:
• Amphetamines/Methamphetamine
• Cocaine
• Marijuana
• Methadone
• Opioids
• Benzodiazepines
Urine is the preferred biologic specimen for establishing the absence or presence of most drugs. This is based on the increased window of detection of 1 to 3 days for majority of drugs and their metabolites. See table below:
• Windows of Detection in Urine Drug Testing
| Drugs | Retention Time (Approximate) |
|---|---|
| Barbiturates | Secorbarbital(shortacting):24hours
Phenobarbital (long acting):2-3 weeks |
| Amphetamines | 48 hours |
| Benzodiazepines | 3 days Therapeutic
dose:4-6 weeks Extended dosage: 1 or more years |
| Cocaine Metabolite | 2-4 days |
| Methadone | 3 days |
| Ethanol | 2-4 hours |
| Propoxyphene | 6-48 hours |
| Opiates | 2 days |
| Phencyclidine | Moderate smoker (4 times/week): 5 days
Heavy smoker (smoking daily): 10 days Retention time for chronic smokers may be 20-28 days
|
Source: http://www.constructionrisk.com/2011/02/rapid-result-drug-testing/
To avoid possible complications in testing patients, it is best for a pain management center to have a uniform policy in drug testing. The purpose of the drug test should be carefully explained to patients to allay their concerns. It has been observed in the past that requesting for a urine sample for drug testing has been misconstrued as mistrusting the patient which consequently damaged patient-healthcare provider relationship.
Aside from pre employment drug testing for employees, random drug testing is highly recommended. This move will deter employees from using or abusing drugs that are available to them as healthcare providers. Statistics from Substance Abuse and Mental Health Services Administration (SAMSHA) for the Healthcare Industry in 2012 is shown below.
| Industry | Current Illicit Drug Use % | Current Alcohol Use % | Past Year Substance Use |
|---|---|---|---|
| Healthcare and Social Services
|
5.5 | 4.4 | 5.7 |
Of course there are protocols in these centers but it is best to be safe than sorry in this issue. Other available drug tests for employees are:
• Saliva test - This test is cost-efficient, non-invasive and can be done on the spot. Unlike urine test, saliva test, is impossible to adulterate. This is the best drug test for determining current illicit drug abuse.
• Hair test -This is the most reliable method to determine long term drug use. It is the best option for pre-employment drug testing together with a basic background screening test.
Drug and alcohol drug testing is in compliance with state and Federal laws.
Call us now for inquiries.
www.prescriberesponsibly.com/articles/urine-drug-testing
http://webapps.dol.gov/elaws/asp/drugfree/drugs/dt.asp
http://www.samhsa.gov/data/sites/default/files/report_1959/ShortReport-1959.html
CLIA-Waived Instant Urine Test Kits for Pain Management Center
