The Use of Urine Drug Testing for Risk Stratification and Efficacious Drug Monitoring in Pain Management Settings

Research Mentor Name

Dr. Khaled Saleh

Research Mentor Email Address

Institution / Department

VA Department of Surgery

Document Type

Research Abstract

Research Type


Level of Research



Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within the continuum of patient care. Second, we explored the use of UDT specifically within the following care settings: acute, acute-on-chronic, and chronic-on-chronic pain presentations.

Results: Current literature is lacking in offering clear instruction on the use of UDT as a tool for opioid abuse risk assessment and monitoring in the setting of pain management. The CDC has published guidelines on prescribing opioids for chronic pain, and the ASAM has also published a consensus statement on appropriate uses for drug testing specifically in clinical medicine. However, there are currently no published guidelines on acute, acute-on-chronic, and chronic-on-chronic pain presentation.

Conclusion: As the United States continues to struggle with opioid drug abuse, the medical community must innovate and implement effective strategies towards reducing opioid abuse. In combination with risk factor identification and physical exam findings, urine drug screening is a tool which may prove beneficial in curtailing opioid abuse.


Community Health and Preventive Medicine | Epidemiology | Health Policy | Medicine and Health | Medicine and Health Sciences | Orthopedics | Other Rehabilitation and Therapy | Pharmacy Administration, Policy and Regulation | Policy Design, Analysis, and Evaluation | Surgery

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