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Int J Drug Policy. 2019 Feb;64:30-33. doi: 10.1016/j.drugpo.2018.08.006. Epub 2018 Dec 12.

Lacking evidence for the association between frequent urine drug screening and health outcomes of persons on opioid agonist therapy.

Author information

1
British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
2
Oregon Health & Science University (OHSU)-Portland State University (PSU) School of Public Health, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; OHSU MD-PhD Program, School of Medicine, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
3
Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
4
British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
5
School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
6
British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland. Electronic address: jklimas@cfenet.ubc.ca.

Abstract

BACKGROUND:

Opioid agonist therapy (OAT) is a first-line treatment for opioid use disorder (OUD); however, the efficacy and role of urine drug screening (UDS) in OAT has received little research attention. Prior evidence suggests that UDS frequency reflects philosophy and practice context rather than differences in patient characteristics or clinical need. Therefore, we reviewed the literature on the effect of and recommendations for the frequency of UDS on health outcomes for persons with OUD who receive OAT.

METHODS:

We searched Medline and EMBASE for articles published from 1995-2017. Search results underwent double, independent review with discrepancies resolved through discussion with a third reviewer, when necessary. Additional articles were identified through snowball searching, hand searching (Google Scholar), and expert consultation. The Cochrane tool was used to assess risk of bias.

RESULTS:

Of the 60 potentially eligible articles reviewed, only one three-arm randomized open-label trial, comparing weekly and monthly UDS testing with take-home OAT doses, met our inclusion criteria.

CONCLUSIONS:

Our review identified an urgent gap in research evidence underpinning an area of clinical importance and that is routinely reported by patients as an area of concern.

KEYWORDS:

hospitalization; office-based opioid treatment; opioid agonist treatment; substance-related disorders; urinalysis; urine drug screening

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