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Why Test: Protecting Your Patients, the Public, and Your Practice

Bill H. McCarberg, MD, a family healthcare physician, moderates Drug Testing in Pain Management.  Dr. McCarberg joins panel members in a discussion about why urine drug testing (UDT) can help protect your patients, the public, and your practice.  Doctors Humam Akbik, Michael Clark, and Howard Heit lend their expertise to the dialogue led by Dr. McCarberg.

Protecting Patients:  A Reason to Use Urine Drug Testing
Urine drug testing is an important clinical tool that can help you fulfill a fundamental tenant of medical care—serve the best interests of your patients and strive to improve their health.

Primary care physicians (PCP) and family healthcare practitioners are in a unique position to have opportunities to care for the same patients over an extended period of time.  Both the PCP and the patient can benefit from such a long-term relationship. 

  •  It may be easier for the patient to approach the physician about a difficult problem and vice versa.
  • An established relationship between a physician and patient can help reduce apprehension and ease difficult conversations about opioid therapy and UDT. 

Clinical Attitude:  How You Approach UDT Is Important
UDT should not be considered adversarial by either the physician or patient.

Rather, UDT is performed for the patient and not to the patient.  Regardless of whether the UDT results are normal or abnormal, it can benefit the patient.

  • Normal UDT results support the patient’s efforts to remain compliant with the opioid treatment plan as prescribed.
  • Abnormal UDT results allow you to act within that golden moment by (1) talking with the patient about their UDT results, (2) offering treatment options, and (3) using the opportunity to educate.

Remember, the purpose of UDT in the clinical setting is not to penalize the patient.  Rather, UDT results can be used to educate and improve communication with the patient.  This reflects a patient-centered approach to medical care.

Protecting the Public: Identify Treatable Medical Problems
Opioid misuse and abuse are public health concerns.  Pain medicine physicians realize that in most practices, there will be patients who misuse or abuse drugs.

Dr. Howard Heit, a member of this video panel, stated that “on average, about 10% of the population has a disease of addiction, excluding nicotine (about 20%) in this country [United States].”

If UDT is not performed, the PCP is less likely to identify misuse, abuse, or addiction.  This amounts to a missed opportunity to address a treatable medical problem.

Protecting Your Practice: UDT Results Document Patients’ Charts
Prescribing opioid medications to your patients with chronic pain impacts your practice.  The Federal and State agencies are alert to the growing problem of prescription drug misuse, abuse, diversion, addiction, and overdose deaths.

Including urine drug testing is a doable extra step that provides an objective medicolegal record for inclusion in the patient’s chart.  Furthermore, UDT testing demonstrates vigilance in safeguarding patient health and therapy compliance.

First published on: January 30, 2013