Drug Testing and Other Tools for Patient Monitoring

Abstract

Chapter 12 describes patient monitoring in the setting of addiction or addiction risk, and pain management, to include drug testing. The advantages, disadvantages, and types of available testing for drug use are described, with a discussion of their limitations. Body fluids and tissues for sampling include hair, blood, saliva, sweat, and urine; all yield information regarding drug use within unique limitations and at different levels of convenience. The test methodology imposes a need to know respective sensitivities and specificities, particularly in a forensic setting. Breath testing (alcohol) is not within the scope of this chapter. Recommended frequencies of urine testing are addressed. The utility of other forms of monitoring (self-report, collateral sources, PDMP) is assessed in the final section. Two tables are provided, (1) urine drug detection times, and (2) sources of false positive tests in urine immunoassay studies. Supplemental information sources are cited in a text box.