Magazine article Addiction Professional

Reports Scrutinize Testing Accuracy

Magazine article Addiction Professional

Reports Scrutinize Testing Accuracy

Article excerpt

Addiction treatment organizations could benefit from shedZA ding outdated attitudes about drug testing. For example, JL a. there seems to be a lack of perspective regarding potential test inaccuracies, and there's also the continuing "gotcha" mentality when test results are used as part of a treatment program.

Two articles appeared in the January/February 2015 issue of the Journal of Opioid Management, with one describing results of research on the limits of traditional immunoassay testing, and the other an editorial describing how drug testing can further the goals of states' prescription drug monitoring programs (PDMPs). The articles were supported by Millennium Health and drug testing unit Millennium Laboratories.

Steven D. Passik, PhD, Millennium's vice president of clinical research and advocacy, a co-author of two articles, indicated in an interview with Addiction Professional that proper testing guidelines could move the field toward processes that would improve testings effectiveness while not breaking the bank for treatment facilities.

"When urine drug testing first came into addiction medicine, the field borrowed a method and mindset from vocational testing," says Passik. "Immunoassay was cheap, and there were some inaccuracies."

Study data

The published study, using 2012 and 2013 addiction treatment client data from Millennium Health and Millennium Laboratories databases, makes the case for programs' wider use of confirmatory liquid chromotography tandem mass spectrometry testing. Just under 4,300 tests that underwent confirmatory analysis were included in the study.

A total of 48.5% of the analyzed urine specimens were classified as being in full agreement with reported medications. However, 25.6% detected an unreported prescription medication, and 9.3% included both an unreported prescription drug and an illicit drug. The most commonly detected prescription medications with no evidence of a subject having such a prescription were amphetamines, followed by tramadol.

Exploring the results of prior immunoassay testing, the researchers found that Ecstasy and amphetamines were the drugs most often missed in these tests. Conversely, PCP and Ecstasy were the drugs with the highest percentage of positives generated when no drug was actually present.

Passik says treatment programs often have not grasped the implications of potentially common errors in their on-site testing. No one would accept similar percentages of errors in an area of healthcare such as detecting tumors, he says.

" There is little doubt that there are problems with false positive results on [immunoassay], particularly with implications for courtmandated patients," the journal article states. …

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