Does random urine drug testing reduce illicit drug use in chronic pain patients receiving opioids?

Prescription drug abuse and illicit drug use are common in patients with chronic pain. Adherence monitoring with screening tests, urine drug testing, and prescription monitoring programs, are common practice. Random drug testing for appropriate use of opioids and use of illicit drugs is often used in pain management practices to prevent the use of illicit drugs and improve compliance with therapy. These researchers studied the prevalence of illicit drug use in patients receiving opioids for chronic pain and compared the results of illicit drug use with the results from a previous study.

A total of 500 consecutive patients on opioids were studied by random drug testing (rapid drug screen). Results were considered positive if one or more of the monitored illicit drugs including cocaine, marijuana (THC), methamphetamine or amphetamines were present. The investigators report that illicit drug use was evident in 80 patients (16%) with marijuana in 11%, cocaine in 5%, and methamphetamine and/or amphetamines in 2%. When compared with their previous data, overall illicit drug use was significantly less. Elderly patients exhibited no signs of illicit drug use. This study suggests that illicit drug use can be significantly reduced with adherence monitoring combined with random urine drug testing. Manchikanti L, Manchukonda R, Pampati V, Damron KS, Brandon DE, Cash KA, McManus CD. Adapted from Pain Physician. 2006 Apr;9(2):123-9.

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