Literature DB >> 17237667

Urine toxicology screening among chronic pain patients on opioid therapy: frequency and predictability of abnormal findings.

Edward Michna1, Robert N Jamison, Loc-Duyen Pham, Edgar L Ross, David Janfaza, Srdjan S Nedeljkovic, Sanjeet Narang, Diane Palombi, Ajay D Wasan.   

Abstract

OBJECTIVE: To examine the incidence of abnormal urine toxicology screening among chronic pain patients prescribed opioids for their pain and to relate these results to patient descriptors and type, number, and dose of prescribed opioids.
METHODS: A retrospective analysis of data from 470 patients who had urine screening at a pain management program in an urban teaching hospital was performed. Urine samples were analyzed using gas chromatography-mass spectrometry. Patients were categorized as having urine screens that were "normal" (expected findings based on their prescribed drugs) or abnormal. Abnormal findings were those of (1) absence of a prescribed opioid, (2) presence of an additional nonprescribed controlled substance, (3) detection of an illicit substance, and (4) an adulterated urine sample.
RESULTS: Forty-five percent of the patients were found to have abnormal urine screens. Twenty percent were categorized as having an illicit substance in their urine. Illicit substances and additional drugs were found more frequently in younger patients than in older patients (P<0.001). No other variables were found to predict abnormal urine screen results. DISCUSSION: These results confirm past findings that random urine toxicology screens among patients prescribed opioids for pain reveal a high incidence of abnormal findings. Common patient descriptors, and number, type, and dose of prescribed opioids were found to be poor predictors of abnormal results.

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Year:  2007        PMID: 17237667     DOI: 10.1097/AJP.0b013e31802b4f95

Source DB:  PubMed          Journal:  Clin J Pain        ISSN: 0749-8047            Impact factor:   3.442


  46 in total

1.  Substance misuse treatment for high-risk chronic pain patients on opioid therapy: a randomized trial.

Authors:  Robert N Jamison; Edgar L Ross; Edward Michna; Li Q Chen; Caroline Holcomb; Ajay D Wasan
Journal:  Pain       Date:  2010-03-23       Impact factor: 6.961

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3.  Toxicologic testing for opiates: understanding false-positive and false-negative test results.

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Review 4.  Strategies to prevent opioid misuse, abuse, and diversion that may also reduce the associated costs.

Authors:  Kathryn L Hahn
Journal:  Am Health Drug Benefits       Date:  2011-03

5.  Validation of a brief Opioid Compliance Checklist for patients with chronic pain.

Authors:  Robert N Jamison; Marc O Martel; Robert R Edwards; Jing Qian; Kerry Anne Sheehan; Edgar L Ross
Journal:  J Pain       Date:  2014-08-01       Impact factor: 5.820

6.  Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.

Authors:  Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski
Journal:  J Pain       Date:  2009-02       Impact factor: 5.820

7.  Catastrophic thinking and increased risk for prescription opioid misuse in patients with chronic pain.

Authors:  M O Martel; A D Wasan; R N Jamison; R R Edwards
Journal:  Drug Alcohol Depend       Date:  2013-04-22       Impact factor: 4.492

8.  Gender differences in risk factors for aberrant prescription opioid use.

Authors:  Robert N Jamison; Stephen F Butler; Simon H Budman; Robert R Edwards; Ajay D Wasan
Journal:  J Pain       Date:  2009-11-27       Impact factor: 5.820

9.  Development and validation of the Current Opioid Misuse Measure.

Authors:  Stephen F Butler; Simon H Budman; Kathrine C Fernandez; Brian Houle; Christine Benoit; Nathaniel Katz; Robert N Jamison
Journal:  Pain       Date:  2007-05-09       Impact factor: 6.961

10.  Challenges in using opioids to treat pain in persons with substance use disorders.

Authors:  Seddon R Savage; Kenneth L Kirsh; Steven D Passik
Journal:  Addict Sci Clin Pract       Date:  2008-06
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