Opioid Drug Screenings May Dissuade People from Treatment

Patient sitting on an examination tableDrug screenings designed to monitor patients for prescription opioid abuse may reduce the number of people who return for treatment, according to a study published in Pain Physician.

Understanding Opioid Addiction

Abuse of opioids, particularly prescription opioids, has risen to epidemic levels. According to the U.S. Centers for Disease Control and Prevention (CDC), opioid-related overdose deaths have risen 200% since 2000.

Prescription opioids are the leading cause of overdose death, killing more than 16,000 people in 2013. In that same year, more than 2 million Americans were addicted to opioid pain relievers, according to the National Institute on Drug Abuse. Doctors write 259 million prescriptions for opioids each year.

The CDC recently published a number of guidelines for reducing opioid addiction and overdose rates. The recommendations included a suggestion that doctors administer urine screenings to monitor drug use.

How Urine Screenings Can Affect Patients

To test how such protocols might impact patients, researchers from the University of Houston and the University of Texas Medical Branch gathered electronic medical records on 723 patients who sought care between April 2009 and January 2012. The patients visited clinics for symptoms of chronic pain a total of 4,448 times.

Those who underwent urine screenings for drug use were less likely to show up for subsequent appointments. Of those who tested positive for illicit drugs, 34.57% did not come to a subsequent appointment.

Even among those who tested negative, urine screenings were a deterrent to future care, elevating the no-show rate to 21.74%. Those who did not undergo urine screenings had no-show rates of 10.24%.

The team of researchers replicated their findings with eight different subsamples. Overall, they found each additional urine drug screening increased the medical care dropout rate by 100.3%.

The authors caution that their study included a non-random sample, and was retrospective in nature. They hope to conduct future research in which patients are randomly assigned to either the urine screening or non-urine screening group. They are also interested in learning whether patients seek medical care elsewhere when they undergo urine screenings, or if they altogether avoid medical care.

References:

  1. America’s addiction to opioids: Heroin and prescription drug abuse. (2014, May 14). Retrieved from https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse
  2. Draft CDC guidelines for prescribing opioids for chronic pain. (2016, January 28). Retrieved from http://www.cdc.gov/drugoverdose/prescribing/guideline.html
  3. Krishnamurthy, P., PhD, Ranganathan, G., MD, Williams, C., MD, & Doulatram, G., MD. (n.d.). Impact of urine drug screening on no shows and dropouts among chronic pain patients: A propensity-matched cohort study. Pain Physician, 19(2), 89-100.
  4. Rudd, R., MSPH, Aleshire, N., JD, Zibbell, J., PhD, & Gladden, R. M., PhD. (2016, January 1). Increases in in drug and opioid overdose deaths–United States, 2000-2014. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm

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  • shayne

    shayne

    February 10th, 2016 at 11:23 AM

    So I understand that this might discourage some people but come on! They can’t continue to abuse and receive treatment all at the same time! Shouldn’t a person receiving treatment actually be looking to make some changes and with that now comes having to be accountable to others? And part of that would be being willing to prove that they are no longer using or abusing. I don’t see what the problem should be if they are serious about kicking the habit.

  • Rolf

    Rolf

    February 11th, 2016 at 3:33 PM

    But are the providers just supposed to take their word for the fact that they are no longer abusing?

    I know that the goal is to trust them but there are some and you know that this is true who are experts on manipulating others and this could easily be done in a medical facility as well.

  • jade

    jade

    February 12th, 2016 at 7:52 AM

    My instinct says that they will avoid it because they are embarrassed if they have relapsed.

  • Jess MC

    Jess MC

    February 12th, 2016 at 1:07 PM

    When someone is really ready to kick their habit then they are going to do it. I am not saying that it is going to be easy because fighting any addiction rarely is easy, but they are going to have that mindset of anything that they need to do is what they are going to do to overcome this obstacle. If they are ready then being screened with blood or urine or breath tests is not going to stop them. They will be proud of their progress.

  • Lil

    Lil

    February 14th, 2016 at 4:22 PM

    Just because some of the numbers say that this will deter them I still believe that for any system there has to be some checks and balances. The drug testing should serve as that check and balance in these facilities that treat addiction.

  • Harris

    Harris

    February 15th, 2016 at 10:26 AM

    Do you think that there would be the same dissuasion with blood testing?

  • Kyra

    Kyra

    February 16th, 2016 at 10:37 AM

    Please tell me that I am not the only person who is getting pretty fed up with the pandering that we seem to do for every one these days. I think that this could be a large part of what is going wrong in our society, that we look to make things easy when in reality this is not life. There are going to be times for all of us when we have to be held accountable for our actions and I think that this is true no matter which demographic that you fall into. We have got to stop with all of the letting people do what they feel like is best fro them in that one moment and do more of what is best for them long term.

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