Trauma-informed Drug Screens for Veterans with Co-occurring Disorders: A Case Series

Controversies with routine urine drug screening

“…• Evaluate the process in collaboration with the patient, including changes for next time. 8 GLAPE supports that UDS is not a one-size-fits-all procedure but an individualized tool to best meet patient needs when applied with their input. Nurses are well-positioned to evaluate and enhance the UDS process to include a trauma-informed approach because of their relational role in developing, implementing, and evaluating collaborative care plans.…”

“…In community-based mental health and substance use programs, patients may be required to provide urine samples for UDS on a regular schedule or a random basis as outlined in the policies, procedures, and guidelines of the program 8…”

“…In community-based mental health and substance use programs, patients may be required to provide urine samples for UDS on a regular schedule or a random basis as outlined in the policies, procedures, and guidelines of the program. 8 Potential harms of UDS include possible exposure of patients and lab staff to SARS-CoV-2 in a community setting, violation of patient trust, and retraumatization of patients while observing urination. [8][9][10] Questioning the practice Increasing evidence suggests UDSs are not an innocuous intervention.…”

“…8 Potential harms of UDS include possible exposure of patients and lab staff to SARS-CoV-2 in a community setting, violation of patient trust, and retraumatization of patients while observing urination. [8][9][10] Questioning the practice Increasing evidence suggests UDSs are not an innocuous intervention. Known harms include retraumatization, violation of trust, and the per-ception that clinicians do not respect patients' privacy.…”

“…Known harms include retraumatization, violation of trust, and the per-ception that clinicians do not respect patients' privacy. 8 A UDS requires the patient to provide a sample, often witnessed. 1 Collection procedures are bound by the underlying assumptions of dishonesty about substance use, medication nonadherence, and patient unreliability or ignorance.…”