According to American Pain Society Guidelines

Who Should I Test

A patient:

  1. Already taking a controlled substance

  2. Resistant to full assessment and evaluation

  3. Requests a specific medication

  4. Displays aberrant behavior

When Should I Test

Test when:

  1. Treatment initiation with a controlled substance

  2. Change in treatment

  3. To support the decision to refer

  4. Periodic testing is recommended for all patients on chronic opioid therapy

Why Urine Test In Pain Management

“Urine drug testing (UDT) must be done routinely as part of an overall best practice program in order to prescribe chronic opioid therapy. This program may include risk stratification; baseline and periodic UDT; behavioral monitoring, and prescription monitoring programs as the best available tools to monitor chronic opioid compliance.”
— PPJ-Pain Physician Journal
“Clinically the benefits of UDT are multiple. These include reducing the risk for toxicity in patients vulnerable to adverse drug effects, avoidance of medico-legal problems, detecting patient non-compliance, reducing the risk of therapeutic failure, and avoiding or detecting drug-drug interaction. Additionally, UDT enhances the physician’s ability to use drugs effectively and minimizes treatment costs.”
“Primary care practitioners often provide medical management for patients taking opioids for chronic pain. Long-term pain treatment with opioids requires monitoring for continuing effectiveness for pain relief and the potential for misuse, addiction and diversion.”
— SAMSHA - Substance Abuse and Mental Health Services Administration