The Implications of Urine Drug Testing in Pain Management

被引:1
作者
Vadivelu, Nalini [1 ]
Chen, Isabel L. [1 ]
Kodumudi, Vijay [1 ]
Ortigosa, Esperanza [2 ]
Teresa Gudin, Maria [2 ]
机构
[1] Yale Univ, Dept Anesthesiol, New Haven, CT 06520 USA
[2] Hosp Univ Getafe, Dept Anesthesiol, Madrid, Spain
关键词
Pain management; urine testing; opioids;
D O I
10.2174/157488610791698361
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
In the treatment of pain management, physicians employ a variety of drugs, ranging from low-impact to highly potent, and to maximize patient health, urine toxicology analyses can significantly improve the delivery of pain treatment. Drugs such as opioids that are used for pain management are peculiar in that they provide effective pain relief and have a high risk of addiction. The use of illicit drugs in the general population has been on the rise; however, self-reporting and close monitoring of patient behavior are insufficient means to detect drug abuse and confirm compliance. Therefore, in order to create more effective drug treatment plans, physicians must understand and account for the implications of patient drug use history. Urine toxicology analysis is an important tool for pain physicians because it is more sensitive than most alternative blood tests, more efficient and cost-effective. Urine testing in addition to improving patient pain management also has forensic and legal implications. There are however limitations to urine toxicology methods as they can produce false-positive and false-negative results and are prone to human error and sample contamination There is also a need for more specific and rapid urine drug testing. Healthcare professionals should therefore be familiar with the limitations of various urine drug testing methods, and possess skills necessary to properly interpret these results. This review suggests that the overall benefits incurred by both the patient's short-term and long-term health support the routine integration of urine toxicology analysis in routine clinical care. In addition to improving health care and patient health, it has a strong potential to improve patient-physician relationships and protects the interest of involved healthcare practitioners.
引用
收藏
页码:267 / 270
页数:4
相关论文
共 30 条
[1]   Opioids and the treatment of chronic pain in a primary care sample [J].
Adams, NJ ;
Plane, MB ;
Fleming, MF ;
Mundt, MP ;
Saunders, LA ;
Stauffacher, EA .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2001, 22 (03) :791-796
[2]   Concordance between verbal report and urine screen of recent marijuana use in adolescents [J].
Akinci, IH ;
Tarter, RE ;
Kirisci, L .
ADDICTIVE BEHAVIORS, 2001, 26 (04) :613-619
[3]   SCREENING FOR DRUGS OF ABUSE .1. OPIATES, AMPHETAMINES AND COCAINE [J].
BRAITHWAITE, RA ;
JARVIE, DR ;
MINTY, PSB ;
SIMPSON, D ;
WIDDOP, B .
ANNALS OF CLINICAL BIOCHEMISTRY, 1995, 32 :123-153
[4]   Urine drug screening in adolescents [J].
Casavant, MJ .
PEDIATRIC CLINICS OF NORTH AMERICA, 2002, 49 (02) :317-+
[5]   Chronic pain, substance abuse and addiction [J].
Compton, P ;
Athanasos, P .
NURSING CLINICS OF NORTH AMERICA, 2003, 38 (03) :525-+
[6]   The characterization of human urine for specimen validity determination in workplace drug testing: A review [J].
Cook, JD ;
Caplan, YH ;
LoDico, CP ;
Bush, DM .
JOURNAL OF ANALYTICAL TOXICOLOGY, 2000, 24 (07) :579-588
[7]  
Crouch DJ, 1998, J FORENSIC SCI, V43, P35
[8]   Chronic opioid therapy for nonmalignant pain in patients with a history of substance abuse: Report of 20 cases [J].
Dunbar, SA ;
Katz, NP .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1996, 11 (03) :163-171
[9]   Validity of self-reported drug use in chronic pain patients [J].
Fishbain, DA ;
Cutler, RB ;
Rosomoff, HL ;
Rosomoff, RS .
CLINICAL JOURNAL OF PAIN, 1999, 15 (03) :184-191
[10]   The opioid contract in the management of chronic pain [J].
Fishman, SM ;
Bandman, TB ;
Edwards, A ;
Borsook, D .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1999, 18 (01) :27-37