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The purpose of drug testing is to identify aberrant behavior, undisclosed drug use and/or abuse, and verify compliance with treatment. When used with an appropriate level of understanding, urine drug testing can improve the prescriber’s ability to safely and appropriately manage opioid therapy. Urine drug testing is an important part of the baseline risk assessment which prescribers should perform on all candidates for chronic opioid therapy. (Interagency Guideline on Opioid Dosing for Chronic Non-cancer Pain (CNCP),Washington State Agency Medical Directors’ site at www.agencymeddirectors.wa.gov)
Patients and their physicians together need to reach agreement on the goals of treatment and develop a treatment plan based on the patient’s particular problems and needs. During the stabilization phase, patients receiving maintenance treatment should be seen on at least a weekly basis. Once a stable buprenorphine dose is reached and toxicologic samples are free of illicit opioids, the physician may determine that less frequent visits (biweekly or longer, up to 30 days) are acceptable. During opioid addiction treatment with buprenorphine, toxicology tests for relevant illicit drugs should be administered at least monthly. (Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction TIP 40 http://buprenorphine.samhsa.gov/Bup_Guidelines.pdf)
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