CDC Calls for Physicians to Stop Drug Testing for THC
The National Center for Disease Control and Prevention (CDC) published their “Guideline for Prescribing Opioids For Chronic Pain, United States 2016″ on March 18. In it was a statement of discouragement of urine testing for THC, the psychoactive component of marijuana, and a warning against terminating treatment of patients for having positive results on urine drug tests.
Although the CDC’s Guidelines and Factsheet advises physicians involved in opioid therapies to continue using urine testing for “to identify prescribed substances and undisclosed use,” the document itself advises a cautious approach to urine testing from both a reliability and a financial standpoint.
Patients are sometimes removed from pain management because of a positive drug test for THC, and that is a problem recognized by the CDC in the 2016 publication. “Urine drug testing results can be subject to misinterpretation and might sometimes be associated with practices that might harm patients (e.g., stigmatization, inappropriate termination from care).”
This screening process is big business. Per the CDC report: ” Limited information was found on costs of strategies to decrease risks associated with opioid therapy; however, urine drug testing, including screening and confirmatory tests, has been estimated to cost $211-$363 per test.”
Further research is needed to determine the “the cost feasibility and cost-effectiveness of recommended actions, such as use of nonpharmacologic therapy and urine drug testing.”
As a result of expense, lack of reliability and other factors, the CDC recommends reducing the frequency and nature of urine drug tests. Only ask for what you really need to know.
“Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear,” the CDC stated. “For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahyrdocannabinol (THC). In addition, restricting confirmatory testing to situations and substances for which results can reasonably be expected to affect patient management can reduce costs of urine drug testing…”
Dropping patients from treatment programs because of cannabis only makes the situation worse for the patient. “Clinicians should not dismiss patients from care based on a urine drug test result because this could constitute patient abandonment and could have adverse consequences for patient safety, potentially including the patient obtaining opioids from alternative sources and the clinician missing opportunities to facilitate treatment for substance use disorder,” the CDC wrote.
As Pat Anson, Editor of Pain News Networks, said, so-called “”point-of care” (POC) urine drug tests, the kind widely used in doctor’s offices, frequently giving false positive or false negative results for drugs like marijuana, oxycodone and methadone. One study found that 21% of POC tests for marijuana produced a false positive result. The test was also wrong 21% of the time when marijuana is not detected in a urine sample.
Not mentioned in the CDC guidelines is evidence that opioid overdose rates declined by nearly 25 percent in states where medical marijuana was legalized.”
Anson references a letter written by Sen. Elizabeth Warren to the CDC suggesting that the drug agency consider the impact medical and legalized marijuana could have as a solution to the opioid death epidemic.
I am a 51 year old pain management client and have suffered from chronic pain for over 25 years. My current pain management doctor believes in random urine testing for THC among other things. I tested positive once since I’ve been a patient with this doctor, and I was told if this occurs again I will be dismissed with no questions asked. I’ve been a patient there for 10 years. Each time I’m tested I am billed $50. I am on Social Security, and I feel that this is a ridiculous practice.
I started a legal herb I’m in KY called kratom it is LEGAL and when the PM started testing for it with no notification by letter in writing I was discharged from care! This is WRONG!
I am going thru this with my doctor. I get xanax prescribed and last summer they give me 2 24 Tynol 3 prescription. I have quit smoking even though I use it for pain. Don’t want to be on pain pills.
But I am still cleaning up. I would have lost my xanax if my doctor hadn’t been seeing me for over 10 years.
And will not go any other doctor. He is wonderful.
Just wish my state would go medical then I would not need half of the drugs they have to give me..