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Author: Admin | 2025-04-28
To note which opioids are included on an institution’s standard screening, as certain opioids may require an additional order or GC-MS.SummaryWhile urine drug screening using immunoassay is convenient, the test is associated with multiple limitations. An understanding of these limitations is necessary to identify false-positive and false-negative results. Additionally, a thorough medication history should be obtained to anticipate false-positive results. In addition to medications, certain body washes, foods, and supplements have been associated with false-positives, which may be difficult to identify. Positive results on urine immunoassay screening should be considered presumptive, and confirmatory testing with GC-MS should be considered to confirm the findings.ReferencesIllicit drug use. Centers for Disease Control and Prevention (CDC). Updated March 1, 2021. Accessed April 8, 2021. https://www.cdc.gov/nchs/fastats/drug-use-illicit.htmMoeller KE, Kissack JC, Atayee RS, Lee KC. Clinical interpretation of urine drug tests: what clinicians need to know about urine drug screens. Mayo Clin Proc. 2017;92(5):774-796. doi: 10.1016/j.mayocp.2016.12.007Drug-free workplace guidelines and resources. Substance Abuse and Mental Health Services Administration (SAMHSA). Updated March 15, 2021. Accessed April 8, 2021. https://www.samhsa.gov/workplace/resourcesAnalytes and their cutoffs. Substance Abuse and Mental Health Services Administration (SAMHSA). Analytes. November 25, 2008. Accessed April 8, 2021. https://www.samhsa.gov/sites/default/files/workplace/2010GuidelinesAnalytesCutoffs.pdfMandatory guidelines for federal workplace drug testing programs. Substance Abuse and Mental Health Services Administration (SAMHSA). January 23, 2017. Accessed April 8, 2021. https://www.federalregister.gov/documents/2017/01/23/2017-00979/mandatory-guidelines-for-federal-workplace-drug-testing-programsNelson ZJ, Stellpflug SJ, Engebretsen KM. What can a urine drug screening immunoassay really tell us? J Pharm Pract. 2016; 29(5):516-26. doi: 10.1177/0897190015579611Grunbaum AM, Rainey PM. Laboratory principles. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Goldfrank’s Toxicologic Emergencies. 11th ed. McGraw-Hill; 2019: chap 7. Accessed April 8, 2021. https://accesspharmacy.mhmedical.com/content.aspx?sectionid=210267566&bookid=2569#216818178Saitman A, Park HD, Fitzgerald RL. False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol. 2014;38(7):387-369. doi: 10.1093/jat/bku075Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010;67(16):1344-1350. doi: 10.2146/ajhp090477Standridge JB, Adams SM, Zotos. Urine drug screening: a valuable office procedure. Am Fam Physician. 2010;81(5):635-640.Cupp M. PL Detail-Document, urine drug testing. Pharmacist’s Letter/Prescriber’s Letter. March 2014.Prepared by:Amanda Gerberich, PharmD, BCPSClinical Assistant Professor, Drug Information SpecialistUniversity of Illinois at Chicago College of PharmacyMay 2021The information presented is current as April 5, 2021. This information is intended as an educational piece and should not be used as the sole source for clinical decision making.
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