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More training needed to ensure accuracy of urine drug tests

In a survey of primary care physicians, most reported not using proper techniques when collecting urine samples for drug tests on adolescents and were often unaware of the tests' limitations, according to an article in the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

During the past 25 years, drug testing has become increasingly popular in the U.S., according to background information in the article. In 1995, the Supreme Court ruled that high schools may require student athletes to undergo drug testing. The Office of National Drug Control Policy encourages schools to perform urine drug tests on all students, stating that testing can help recognize students with drug problems while acting as a deterrent for others. Drug tests that are performed incorrectly, however, can result in false accusations or false reassurance.

Sharon Levy, M.D., M.P.H., of Harvard Medical School and Children's Hospital Boston, and colleagues, surveyed primary care physicians about their knowledge of urine drug testing and their typical practices when conducting drug tests. To be included in the survey, physicians had to see 10 or more adolescent patients (aged 12 to 18 years) per week. From April to July 2004, approximately 360 physicians completed the survey, more than 95 percent of whom had ever ordered a drug test.

The researchers said that a properly collected urine sample included being sure that patients provide identification, empty their pockets and use the bathroom without running water; the sample is checked immediately for temperature; blue dye is placed in standing water; and a staff member directly observes the patient or is present inside the bathroom.

Only 23 percent of physicians used an effective method of collecting urine samples, and only ten percent of physicians knew that nitrous oxide, ecstasy and oxycodone were not detectable by standard urine tests. Almost one-third did not know that alcohol u
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Contact: Aaron Patnode
617-355-5337
JAMA and Archives Journals
6-Feb-2006


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