Urine Drug Testing Workshop to Focus on Physician-Patient Partnership

A two-part, four-hour workshop on Sunday will help participants increase their knowledge and confidence about using patient-centered urine drug tests in clinical practice.

Part one of “Urine Drug Testing ‘for’ your Patient not ‘to’ your Patient,” will be devoted to knowledge- and confidence-building, so urine drug testing can be applied appropriately to prevent, detect, and treat substance use disorders. Presenters will cover the basic science of urine drug testing by reviewing different methodologies, such as qualitative and quantitative urine drug testing; how to set up urine drug testing protocols in the clinical setting; and how to select a testing laboratory.

Part one will be from 8 to 9:30 am and part two from 10 to 11:30 am. Both sessions will be in Governor’s Ballroom C, Fourth Floor.

D3-Heit

Howard Heit, MD, FACP, FASAM

“The emphasis throughout the workshop will be on using urine drug tests for your patient’s benefit rather than as a punishment or as a trap for catching patients,” said workshop organizer Howard Heit, MD, FACP, FASAM, Assistant Clinical Professor at Georgetown University. Washington, DC. “Urine drug tests are a vastly underused, misunderstood, and misinterpreted modality.”

He will be a presenter at both sessions along with Michael Sprintz, DO, Founder and Chief Medical Officer at the Sprintz Center for Pain and Dependency, the Woodlands, Texas, and Gary M. Reisfield, MD, Assistant Professor at the University of Florida College of Medicine, Orange Park.

It’s vital that physicians become educated about how to approach patients, said Dr. Heit, who is a board-certified gastroenterologist and hepatologist.

“A patient could say, ‘What if I don’t want to do a urine drug test? Do you think I have addiction? Is that why you’re doing a urine drug test?’ How do you approach this patient in a patient-centered fashion? In urine drug testing, you must know the questions that you want to ask. Doing a urine drug test is for the benefit of the patient to help improve clinical care and your communication with the patient,” Dr. Heit said.

He cautioned that physicians need to understand the sophistication levels and limitations of urine drug tests, and that interpreting the results beyond their scientific capability could result in poor patient care and medical-legal problems.

“With any diagnostic test, you need to document why you ordered the test, the results, and what you are going to do with the test results,” he said.

Part two of the workshop will focus on clinical applications and skill-building. Through the use of role-play and case studies, presenters will demonstrate how to approach common clinical challenges. This session will highlight constructive communication with patients—communication that maintains therapeutic relationships without sacrificing treatment goals. Presenters also will use case studies to review the basic and applied science of urine drug tests and emphasize the appropriate tests to use, correct test interpretation, and next steps.

For example, presenters will describe how to respond in a nonpunitive but therapeutic way to an unexpected urine drug test result, including how to use the results to aid in a diagnosis and treatment plan to encourage positive behavior.

“You can’t do addiction medicine and pain medicine unless there is honesty on both sides,” Dr. Heit said. “Patients have a responsibility to give me the information that I need and the information that is in their past histories as best they can.

“I have a responsibility to my patients to give informed consent for what I’m doing and to provide them with the best medical care that I possibly can. It’s a bidirectional relationship. If it’s not bidirectional, you will not get the optimal results no matter what you do.”

ASAM’s Drug Testing White Paper is available online. During the ASAM board meeting on Wednesday, the Board voted to approve a subsequent “Statement of Consensus on the Proper Utilization of Urine Testing in Identifying and Treating Substance Use Disorders.” This final report will be published online next month and distributed through ASAM’s weekly electronic newsletter, ASAM Weekly. Click here to subscribe to ASAM Weekly.