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Witnessed versus unwitnessed random urine tests in the treatment of opioid dependence.

Authors :
Mallya A
Purnell AL
Svrakic DM
Lovell AM
Freedland KE
Gott BM
Sayuk GS
Cicero TJ
Brawer PA
Trafton JA
Scherrer JF
Lustman PJ
Source :
The American journal on addictions [Am J Addict] 2013 Mar-Apr; Vol. 22 (2), pp. 175-7.
Publication Year :
2013

Abstract

Background and Objectives: Clinics licensed to provide pharmacotherapy for opiate dependence disorder are required to perform random urine drug screen (RUDS) tests. The results provide the empirical basis of individual treatment and programmatic effectiveness, and public health policy. Patients consent to witnessed testing but most tests are unwitnessed. The purpose of the present study was to compare treatment effectiveness estimates derived from witnessed versus unwitnessed urine samples.<br />Methods: We adopted a policy requiring visually witnessed urine drug screens (WUDS) and studied its impact (a single group, pretest-posttest design) on the RUDS test results in 115 male veterans enrolled in the St. Louis VA Opioid Treatment Program.<br />Results: The percentage of opioid-positive urine samples increased significantly following implementation of WUDS (25% vs. 41%, χ(2) = 66.5, p < .001).<br />Conclusions and Scientific Significance: Results of this preliminary study suggest that random testing alone does not ensure the integrity of UDS testing. Outcome calculations based on random unwitnessed tests may overestimate the effectiveness of opioid dependence disorder treatment.<br /> (Copyright © American Academy of Addiction Psychiatry.)

Details

Language :
English
ISSN :
1521-0391
Volume :
22
Issue :
2
Database :
MEDLINE
Journal :
The American journal on addictions
Publication Type :
Academic Journal
Accession number :
23414505
Full Text :
https://doi.org/10.1111/j.1521-0391.2013.00326.x