Document Detail

Witnessed versus unwitnessed random urine tests in the treatment of opioid dependence.
MedLine Citation:
PMID:  23414505     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Clinics licensed to provide pharmacotherapy for opiate dependence disorder are required to perform random urine drug screen (RUDS) tests. The results provide the empirical basis of individual treatment and programmatic effectiveness, and public health policy. Patients consent to witnessed testing but most tests are unwitnessed. The purpose of the present study was to compare treatment effectiveness estimates derived from witnessed versus unwitnessed urine samples.
METHODS: We adopted a policy requiring visually witnessed urine drug screens (WUDS) and studied its impact (a single group, pretest-posttest design) on the RUDS test results in 115 male veterans enrolled in the St. Louis VA Opioid Treatment Program.
RESULTS: The percentage of opioid-positive urine samples increased significantly following implementation of WUDS (25% vs. 41%, χ(2) = 66.5, p < .001).
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Results of this preliminary study suggest that random testing alone does not ensure the integrity of UDS testing. Outcome calculations based on random unwitnessed tests may overestimate the effectiveness of opioid dependence disorder treatment.
Ashok Mallya; Amanda L Purnell; Dragan M Svrakic; Ann M Lovell; Kenneth E Freedland; Britt M Gott; Gregory S Sayuk; Theodore J Cicero; Peter A Brawer; Jodie A Trafton; Jeffrey F Scherrer; Patrick J Lustman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions     Volume:  22     ISSN:  1521-0391     ISO Abbreviation:  Am J Addict     Publication Date:    2013 Mar-Apr
Date Detail:
Created Date:  2013-02-18     Completed Date:  2013-12-16     Revised Date:  2014-03-26    
Medline Journal Info:
Nlm Unique ID:  9208821     Medline TA:  Am J Addict     Country:  England    
Other Details:
Languages:  eng     Pagination:  175-7     Citation Subset:  IM    
Copyright Information:
Copyright © American Academy of Addiction Psychiatry.
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MeSH Terms
Middle Aged
Opiate Substitution Treatment / methods
Opioid-Related Disorders / drug therapy*
Predictive Value of Tests
Substance Abuse Detection / methods*
Treatment Outcome
Urine Specimen Collection / methods*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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