Interpretation of urine drug testing in pain patients

Background. Traditionally, urine drug screens have only been concerned with positive or negative results. Those results provide physicians treating patients for pain with chronic opioid therapy with information about medication compliance, use of nonprescribed medications, and use of illicit drugs. However, the analysis of urine for drugs offers additional information that, when compiled and accurately interpreted, may also be of great value to these doctors. Purpose: The aim of this article was to discuss the interpretation of urine drug tests and their application to pain physician practices. Method. We utilized a selection of recent articles on urine drug screening applicable to the pain patient population. Results and Conclusions. The article provides pertinent information about interpretation of urine drug testing, which is separated into six categories: which drugs and metabolites to test for; which analytical cutoffs to use; pain medication metabolism; identification of alcohol use; determination of patient compliance; and which patient groups to consider for more frequent testing.