5 Pain Management Physicians Discuss Urine Drug Testing
Marc E. Lynch, DO, medical director, Casa Colina Surgery Center (Chino, Calif.): We do use urine drug screening. We randomly test patients. Our experience shows that it can be a useful tool in helping the patients remain compliant. We must remember that these patients we treat have chronic pain, and they want to relieve their pain. Sometimes they feel they must use other medications from other physicians and sometimes illegal substances, not understanding the dangers. The UDS helps remind them of those dangers, as we educate them. The UDS also helps us identify those that divert (sell) their medications.
Ronald DeMeo, MD, MBA, board-certified anesthesiologist and pain-management specialist, Meridian Spine & Interventional Pain Medicine (Coral Gables, Fla.):
Extensively. Most patients get drug tested about every two months. If they're taking opioids, we test it monthly.
Timothy Spencer, DO, Saginaw (Mich.) Valley Neurosurgery: Yes, we implement drug testing. The most important thing is to confirm that the patient is actually taking the narcotic you prescribed for them. If that narcotic is not in their system and they claim to be taking the medication, it leads you to assume that they are selling the medication.
Meeru Sathi-Welsch, MD, Long Island Neuroscience Specialists (East Patchogue, N.Y.): I do urine drug testing on all of my patients, as I have been surprised by many people over the years that I would have never suspected of opioid misuse or illicit drug use. Cocaine and marijuana use has been detected with these tests even in the elderly, who would not be considered to be users of illicit drugs. So, it is very important to gather this information in a practice where opioids are prescribed.
Uzma Parvez, MD, Elite Pain Management (Union, N.J.): Yes, we implement urine testing in our office. It really helps filter out patients who I would consider for prescribing opioids based on the initial office reading and the results from the laboratory. It has helped guide the process of prescribing and maintaining patients on controlled substances.
This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.
Next week's question is: Do you use patient contracts in your practice? What has been your experience with them?
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