Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (634 page)

   Specificity

   Requirement for quantitative results

The objectives of periodic urine drug tests are

   To detect drug use

   Verify adherence to prescribed medications

   Identify use of undisclosed drugs

   To discourage drug misuse

   Decrease potential of abuse

   Decrease potential for diversion

   Screening Methods and Limitations

   May be point of care (POC) or laboratory immunoassay tests or high-resolution mass spectrometric techniques. Results obtained will depend upon screening method. Variables include sensitivity and specificity.

   IA tests with low cross-reactivity to a class of compounds have a high probability of false-negative results, and therefore, consideration should be given to confirm these drugs regardless of screening result, for example, opioids and benzodiazepines.

   A typical urine drug testing panel for pain management includes

   Opiates—morphine, codeine, 6-acetylmorphine