Don’t order urine drug screens for patients with substance use disorder without a clear clinical rationale.

There is insufficient evidence regarding the utility of urine drug screening and its effect on health outcomes at the individual and community level. Furthermore, results must be interpreted with caution as they have limitations in sensitivity and specificity. Nevertheless, urine drug screens may be considered when confirming substance use at baseline, helping to assess clinical stability before and during the prescription of take-home doses, ensuring medications are being taken, when screening for illicit substances during treatment to evaluate safety and treatment response, and/or if it is in alignment with patient treatment goals.

 

Sources:

British Columbia Centre on Substance Use, BC Ministry of Health, and Ministry of Mental Health and Addictions. Urine Drug Testing in Patients Prescribed Opioid Agonist Treatment— Breakout Resource. Published July 28, 2021.

Kolla B, Callizo G, Schneekloth T. Utility of Urine Drug Testing in Outpatient Addiction Evaluations. J Addict Med. 2019 May 1;13(3):188-92. PMID: 30418336.

McEachern J. et al. Lacking evidence for the association between frequent urine drug screening and health outcomes of persons on opioid agonist therapy. Int J Drug Policy. 2019 Feb; 64:30-33. PMID: 30551003.