Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (633 page)

   
Serum
:

   Ethanol

   Confirmation Methods and Limitations

   Confirmation methods are chromatographic and generally require 24–48 hours to provide results.

   Urinary quantitative results of a prescribed medication may be useful under some circumstances (e.g., to assist in differentiating active smoking from passive exposure to nicotine), but in general, qualitative identification of the drug is sufficient.

   Quantitative serum ethanol results are useful in assessing the degree of impairment.

   
PAIN MANAGEMENT

   Purpose

Use of opioids and other medications (nonopioid analgesics, benzodiazepines, antidepressants, anticonvulsants, muscle relaxants) to treat pain of noncancer origin

   Application

Urine drug monitoring to ensure safe and effective therapy. This includes continued effectiveness for pain relief; assessment of the potential for misuse, addiction, or diversion.

Drug testing in this population does not mirror the traditional DOA testing.

The testing requirements are dependent upon

   Patient population

   Specific drug(s) of interest

   Specimen

   Sensitivity