150
Views
28
CrossRef citations to date
0
Altmetric
Clinical Features

Urine Toxicology Testing in Chronic Pain Management

, PhD & , PhD
Pages 91-102 | Published online: 13 Mar 2015

References

  • . American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2004;100(6):1573–1581
  • . World Health Organization. Cancer Pain Relief. 2nd ed. Geneva, Switzerland: WHO Office of Publication; 1996
  • . American Pain Society. Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain. 5th ed. Glenview, IL: American Pain Society; 2003
  • . Practice guidelines for cancer pain management. A report by the American Society of Anesthesiologists Task Force on Pain Management, Cancer Pain Section. Anesthesiology. 1996;84(5):1243–1257
  • . AGS Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50( 6 suppl):S205–S224
  • . Chou R, Qaseem A, Snow V, ; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–491
  • . American Pain Society. Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis and Juvenile Chronic Arthritis. Chicago, IL: American Pain Society; 2002
  • . Bhamb B, Brown D, Hariharan J, Anderson J, Balousek S, Fleming MF. Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain. Curr Med Res Opin. 2006;22(9):1859–1865
  • . Upshur CC, Luckmann RS, Savageau JA. Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006;21(6):652–655
  • . Chou R, Fanciullo GJ, Fine PG, ; American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–130
  • . Fishbain DA, Cutler RB, Rosomoff HL, Rosomoff RS. Validity of self-reported drug use in chronic pain patients. Clin J Pain. 1999;15(3):184–191
  • . Preston KL, Silverman K, Schuster CR, Cone EJ. Comparison of self-reported drug use with quantitative and qualitative urinalysis for assessment of drug use in treatment studies. NIDA Res Monogr. 1997;167:130–145
  • . Katz NP, Sherburne S, Beach M, . Behavioral monitoring and urine toxicology testing in patients receiving long-term opioid therapy. Anesth Analg. 2003;97(4):1097–1102
  • . Yang JM. Toxicology and drugs of abuse testing at the point of care. Clin Lab Med. 2001;21(2):363–374
  • . Reisfield GM, Bertholf R, Barkin RL, Webb F, Wilson G. Urine drug test interpretation: what do physicians know? J Opioid Manag. 2007;3(2):80–86
  • . Reisfield GM, Webb FJ, Bertholf RL, Sloan PA, Wilson GR. Family physicians' proficiency in urine drug test interpretation. J Opioid Manag. 2007;3(6):333–337
  • . Hardt J, Jacobsen C, Goldberg J, Nickel R, Buchwald D. Prevalence of chronic pain in a representative sample in the United States. Pain Med. 2008;9(7):803–812
  • . 1999 National Pain Survey: Executive Summary. Ortho-McNeil Pharmaceutical. http://www.chiro.org/LINKS/FULL/1999_National_Pain_Survey.html. Accessed June 2, 2009
  • . SAMHSA. Results from the 2002 National Survey on Drug Use and Health: National Findings, DHHS Publication No. SMA 03-3836. Rockville, MD: Department of Health and Human Services; 2003
  • . Fishbain DA, Cole B, Lewis J, Rosomoff HL, Rosomoff RS. What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Med. 2008;9(4):444–459
  • . Manchikanti L, Manchukonda R, Pampati V, . Does random urine drug testing reduce illicit drug use in chronic pain patients receiving opioids? Pain Physician. 2006;9(2):123–129
  • . Manchikanti L, Fellows B, Damron KS, Pampati V, McManus CD. Prevalence of illicit drug use among individuals with chronic pain in the Commonwealth of Kentucky: an evaluation of patterns and trends. J Ky Med Assoc. 2005;103(2):55–62
  • . Manchikanti L, Manchukonda R, Damron KS, Brandon D, McManus CD, Cash K. Does adherence monitoring reduce controlled substance abuse in chronic pain patients? Pain Physician. 2006;9(1):57–60
  • . Manchikanti L, Pampati V, Damron KS, Fellows B, Barnhill RC, Beyer CD. Prevalence of opioid abuse in interventional pain medicine practice settings: a randomized clinical evaluation. Pain Physician. 2001;4(4):358–365
  • . Manchikanti L, Pampati V, Damron KS, Beyer CD, Barnhill RC, Fellows B. Prevalence of prescription drug abuse and dependency in patients with chronic pain in western Kentucky. J Ky Med Assoc. 2003;101(11):511–517
  • . Turk DC, Swanson KS, Gatchel RJ. Predicting opioid misuse by chronic pain patients: a systematic review and literature synthesis. Clin J Pain. 2008;24(6):497–508
  • . Hammett-Stabler CA, Pesce AJ, Cannon DJ. Urine drug screening in the medical setting. Clin Chim Acta. 2002;315(1-2):125–135
  • . Bush DM. The U.S. Mandatory Guidelines for Federal Workplace Drug Testing Programs: current status and future considerations. Forensic Sci Int. 2008;174(2-3):111–119
  • . Vandevenne M, Vandenbussche H, Verstraete A. Detection time of drugs of abuse in urine. Acta Clin Belg. 2000;55(6):323–333
  • . Reisfield GM, Salazar E, Bertholf RL. Rational use and interpretation of urine drug testing in chronic opioid therapy. Ann Clin Lab Sci. 2007;37(4):301–314
  • . Crouch DJ, Hersch RK, Cook RF, Frank JF, Walsh JM. A field evaluation of five on-site drug-testing devices. J Anal Toxicol. 2002;26(7):493–449
  • . Cone EJ, Dickerson S, Paul BD, Mitchell JM. Forensic drug testing for opiates. IV. Analytical sensitivity, specificity, and accuracy of commercial urine opiate immunoassays. J Anal Toxicol. 1992;16(2):72–78
  • . Smith ML, Hughes RO, Levine B, Dickerson S, Darwin WD, Cone EJ. Forensic drug testing for opiates. VI. Urine testing for hydromorphone, hydrocodone, oxymorphone, and oxycodone with commercial opiate immunoassays and gas chromatography-mass spectrometry. J Anal Toxicol. 1995;19(1):18–26
  • . Caplan YH. Specimen validity testing. In: Karch SB, ed. Drug Abuse Handbook. Boca Raton, FL: CRC Press; 2007:842–856
  • . Cook JD, Caplan YH, LoDico CP, Bush DM. The characterization of human urine for specimen validity determination in workplace drug testing: a review. J Anal Toxicol. 2000;24(7):579–588
  • . Cody JT, Valtier S, Kuhlman J. Analysis of morphine and codeine in samples adulterated with Stealth. J Anal Toxicol. 2001;25(7):572–575
  • . Wu AH, Bristol B, Sexton K, Cassella-McLane G, Holtman V, Hill DW. Adulteration of urine by “Urine Luck.” Clin Chem. 1999;45(7): 1051–1057
  • . US Department of Transportation. Urine Specimen Collection Guidelines. US Department of Transportation; 2008
  • . US Nuclear Regulatory Commission. Checking the acceptability of the urine specimen. US Nuclear Regulatory Commission; 2008
  • . Cook JD, Strauss KA, Caplan YH, Lodico CP, Bush DM. Urine pH: the effects of time and temperature after collection. J Anal Toxicol. 2007;31(8):486–496
  • . Fraser AD, Zamecnik J. Impact of lowering the screening and confirmation cutoff values for urine drug testing based on dilution indicators. Ther Drug Monit. 2003;25(6):723–727
  • . Department of Health and Human Services. Mandatory guidelines for federal workplace drug testing programs; notice. Federal Registry. 2008;73:71858–71907
  • . Luzzi VI, Saunders AN, Koenig JW, . Analytic performance of immunoassays for drugs of abuse below established cutoff values. Clin Chem. 2004;50(4):717–722
  • . Smith ML, Shimomura ET, Summers J, . Detection times and analytical performance of commercial urine opiate immunoassays following heroin administration. J Anal Toxicol. 2000;24(7):522–529
  • . McDonough PC, Levine B, Vorce S, Jufer RA, Fowler D. The detection of hydromorphone in urine specimens with high morphine concentrations. J Forensic Sci. 2008;53(3):752–754
  • . Cone EJ, Caplan YH, Moser F, Robert T, Black D. Evidence that morphine is metabolized to hydromorphone but not to oxymorphone. J Anal Toxicol. 2008;32(4):319–323
  • . Cone EJ, Heit HA, Caplan YH, Gourlay D. Evidence of morphine metabolism to hydromorphone in pain patients chronically treated with morphine. J Anal Toxicol. 2006;30(1):1–5
  • . Kirchheiner J, Schmidt H, Tzvetkov M. Pharmacokinetics of codeine and its metabolite morphine in ultra-rapid metabolizers due to CYP2D6 duplication. Pharmacogenomics J. 2007;7(4):257–265
  • . Cone EJ, Jufer R, Darwin WD, Needleman SB. Forensic drug testing for opiates. VII. Urinary excretion profile of intranasal (snorted) heroin. J Anal Toxicol. 1996;20(6):379–392
  • . Inturrisi CE, Max MB, Foley KM, Schultz M, Shin SU, Houde RW. The pharmacokinetics of heroin in patients with chronic pain. N Engl J Med. 1984;310(19):1213–1217
  • . OxyContin⊙ [package insert]. Stamford, CT: Purdue Pharma LP; 2007
  • . Sloan PA, Barkin RL. Oxymorphone and oxymorphone extended release: a pharmacotherapeutic review. J Opioid Manag. 2008;4(3):131–144
  • . Manchikanti L. National drug control policy and prescription drug abuse: facts and fallacies. Pain Physician. 2007;10(3):399–424
  • . Hydrocodone [package insert]. Corona, CA: Watson Laboratories; 2004
  • . Oyler JM, Cone EJ, Joseph RE Jr, Huestis MA. Identification of hydrocodone in human urine following controlled codeine administration. J Anal Toxicol. 2000;24(7):530–535
  • . Yue QY, Alm C, Svensson JO, Saäe J. Quantification of the O- and N-demethylated and the glucuronidated metabolites of codeine relative to the debrisoquine metabolic ratio in urine in ultrarapid, rapid, and poor debrisoquine hydroxylators. Ther Drug Monit. 1997;19(5):539–542
  • . Hamid R, Deren S, Beardsley M, Tortu S. Agreement between urinalysis and self-reported drug use. Subst Use Misuse. 1999;34(11):1585–1592
  • . Katz N, Fanciullo GJ. Role of urine toxicology testing in the management of chronic opioid therapy. Clin J Pain. 2002;18( 4 suppl):S76–S82
  • . Cone EJ, Fant RV, Rohay JM, . Oxycodone involvement in drug abuse deaths. II. Evidence for toxic multiple drug-drug interactions. J Anal Toxicol. 2004;28(7):616–624
  • . Cone EJ, Fant RV, Rohay JM, . Oxycodone involvement in drug abuse deaths: a DAWN-based classification scheme applied to an oxycodone postmortem database containing over 1000 cases. J Anal Toxicol. 2003;27(2):57–67
  • . Denton JS, Donoghue ER, McReynolds J, Kalelkar MB. An epidemic of illicit fentanyl deaths in Cook County, Illinois: September 2005 through April 2007. J Forensic Sci. 2008;53(2):452–454
  • . Hull MJ, Juhascik M, Mazur F, Flomenbaum MA, Behonick GS. Fatalities associated with fentanyl and co-administered cocaine or opiates. J Forensic Sci. 2007;52(6):1383–1388
  • . Shields LB, Hunsaker Iii JC, Corey TS, Ward MK, Stewart D. Methadone toxicity fatalities: a review of medical examiner cases in a large metropolitan area. J Forensic Sci. 2007;52(6):1389–1395
  • . Wolf BC, Lavezzi WA, Sullivan LM, Flannagan LM. Methadone-related deaths in Palm Beach County. J Forensic Sci. 2004;49(2):375–378
  • . Manchikanti L, Damron KS, McManus CD, Barnhill RC. Patterns of illicit drug use and opioid abuse in patients with chronic pain at initial evaluation: a prospective, observational study. Pain Physician. 2004;7(4):431–I37
  • . Parsons HA, Delgado-Guay MO, El Osta B, . Alcoholism screening in patients with advanced cancer: impact on symptom burden and opioid use. J Palliat Med. 2008;11(7):964–968
  • . Kadian⊙ [package insert]. Piscataway, NJ: Alpharma, 2007
  • . OPANA ER⊙ [package insert]. Chadds Ford, PA: Endo Pharmaceuticals, Inc.; 2008
  • . Duragesic⊙ [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2008
  • . Dilaudid-HP⊙ [package insert]. Chicago, IL: Abbott Laboratories; 2008
  • . DeRienz RT, Holler JM, Manos ME, Jemionek J, Past MR. Evaluation of four immunoassay screening kits for the detection of benzodiazepines in urine. J Anal Toxicol. 2008;32(6):433–437
  • . Elian AA. ELISA detection of clonazepam and 7-aminoclonazepam in whole blood and urine. Forensic Sci Int. 2003;134(1):54–56
  • . Joseph R, Dickerson S, Willis R, Frankenfield D, Cone EJ, Smith DR. Interference by nonsteroidal anti-inflammatory drugs in EMIT and TDx assays for drugs of abuse. J Anal Toxicol. 1995;19(1):13–17
  • . Stout PR, Klette KL, Horn CK. Evaluation of ephedrine, pseudoephedrine and phenylpropanolamine concentrations in human urine samples and a comparison of the specificity of DRI amphetamines and Abuscreen online (KIMS) amphetamines screening immunoassays. J Forensic Sci. 2004;49(1):160–164
  • . Roberge RJ, Luellen JR, Reed S. False-positive amphetamine screen following a trazodone overdose. J Toxicol Clin Toxicol. 2001;39(2):181–182
  • . Maurer HH, Kraemer T. Toxicological detection of selegiline and its metabolites in urine using fluorescence polarization immunoassay (FPIA) and gas chromatography-mass spectrometry (GC-MS) and differentiation by enantioselective GC-MS of the intake of selegiline from abuse of methamphetamine or amphetamine. Arch Toxicol. 1992;66(9):675–678
  • . Weintraub D, Linder MW. Amphetamine positive toxicology screen secondary to bupropion. Depress Anxiety. 2000;12(1):53–54
  • . Nagai T, Matsushima K, Nagai T, . Interpretation and enantiomer analysis of methamphetamine abusers' urine and illegally brewed methamphetamine crystals. J Anal Toxicol. 2000;24(2):140–145
  • . Al-Dirbashi O, Wada M, Kuroda N, Inuduka S, Nakashima K. Enantiomer-specific high-performance liquid chromatography with fluorescence detection of methamphetamines in abusers' hair and urine. Biomed Chromatogr. 1999;13(8):543–547
  • . Cone EJ, Johnson RE, Darwin WD, . Passive inhalation of marijuana smoke: urinalysis and room air levels of delta-9-tetrahydrocannabinol. J Anal Toxicol. 1987;11(3):89–96
  • . Niedbala S, Kardos K, Salamone S, Fritch D, Bronsqeest M, Cone EJ. Passive cannabis smoke exposure and oral fluid testing. J Anal Toxicol. 2004;28(7):546–552
  • . SUSTIVA⊙ [package insert]. Princeton, NJ: Bristol-Myers Squibb; 2002
  • . PROTONIX⊙ [package insert]. Philadelphia, PA: Wyeth Pharmaceuticals; 2008
  • . Fortner N, Fogerson R, Lindman D, Iversen T, Armbruster D. Marijuana-positive urine test results from consumption of hemp seeds in food products. J Anal Toxicol. 1997;21(6):476–481
  • . Struempler RE, Nelson G, Urry FM. A positive cannabinoids workplace drug test following the ingestion of commercially available hemp seed oil. J Anal Toxicol. 1997;21(4):283–285
  • . Bosy TZ, Cole KA. Consumption and quantitation of delta9-tetrahydrocannabinol in commercially available hemp seed oil products. J Anal Toxicol. 2000;24(7):562–566
  • . Gustafson RA, Levine B, Stout PR, . Urinary cannabinoid detection times after controlled oral administration of delta9-tetrahydrocannabinol to humans. Clin Chem. 2003;49(7):1114–1124
  • . Bergström J, Helander A, Jones AW. Ethyl glucuronide concentrations in two successive urinary voids from drinking drivers: relationship to creatinine content and blood and urine ethanol concentrations. Forensic Sci Int. 2003;133(1–2):86–94
  • . Wurst FM, Skipper GE, Weinmann W. Ethyl glucuronide—the direct ethanol metabolite on the threshold from science to routine use. Addiction. 2003;98( suppl 2):51–61
  • . Beck O, Stephanson N, Böttcher M, Dahmen N, Fehr C, Helander A. Biomarkers to disclose recent intake of alcohol: potential of 5-hydroxytryptophol glucuronide testing using new direct UPLC-tandem MS and ELISA methods. Alcohol Alcohol. 2007;42(4):321–325
  • . Böttcher M, Beck O, Helander A. Evaluation of a new immunoassay for urinary ethyl glucuronide testing. Alcohol Alcohol. 2008;43(1):46–48
  • . U.S. Department of Health and Human Services, Center for Substance Abuse Treatment. The Role of Biomarkers in the Treatment of Alcohol Use Disorders; 2006
  • . Ferrari A, Coccia CP, Bertolini A, Sternieri E. Methadone—metabolism, pharmacokinetics and interactions. Pharmacol Res. 2004;50(6): 551–559
  • . The use of opioids for the treatment of chronic pain. A consensus statement from the American Academy of Pain Medicine and the American Pain Society. Clin J Pain. 1997;13(1):6–8
  • . Hariharan J, Lamb GC, Neuner JM. Long-term opioid contract use for chronic pain management in primary care practice. A five year experience. J Gen Intern Med. 2007;22(4):485–490
  • . Edlund MJ, Steffick D, Hudson T, Harris KM, Sullivan M. Risk factors for clinically recognized opioid abuse and dependence among veterans using opioids for chronic non-cancer pain. Pain. 2007;129(3):355–362
  • . Chou R, Fanciullo GJ, Fine PG, Miaskowski C, Passik SD, Portenoy RK. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):131–146
  • . Wasan AD, Butler SF, Budman SH, Benoit C, Fernandez K, Jamison RN. Psychiatric history and psychologic adjustment as risk factors for aberrant drug-related behavior among patients with chronic pain. Clin J Pain. 2007;23(4):307–315
  • . Webster LR, Webster RM. Predicting aberrant behaviors in opioid treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005;6(6):432–142
  • . Butler SF, Budman SH, Fernandez KC, . Development and validation of the Current Opioid Misuse Measure. Pain. 2007;130(1-2):144–156
  • . Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R). J Pain. 2008;9(4):360–372
  • . Gourlay DL, Heit HA, Almahrezi A. Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med. 2005;6(2):107–112
  • . Passik SD, Weinreb HJ. Managing chronic nonmalignant pain: overcoming obstacles to the use of opioids. Adv Ther. 2000;17(2):70–83
  • . American Academy of Pain Medicine, American Pain Society, American Society of Addiction Medicine. Definitions Related to the Use of Opioids for the Treatment of Pain. A consensus document from the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. Glenview, IL: 2001
  • . Weaver MF, Jarvis MA, Schnoll SH. Role of the primary care physician in problems of substance abuse. Arch Intern Med. 1999;159(9):913–924
  • . Prater CD, Miller KE, Zylstra RG. Outpatient detoxification of the addicted or alcoholic patient. Am Fam Physician. 1999;60(4): 1175–1183
  • . Polcin DL. Rethinking confrontation in alcohol and drug treatment: consideration of the clinical context. Subst Use Misuse. 2003;38(2): 165–184
  • . Heit HA. The truth about pain management: the difference between a pain patient and an addicted patient. Eur J Pain. 2001;5( suppl A):27–29
  • . Weaver M, Schnoll S. Abuse liability in opioid therapy for pain treatment in patients with an addiction history. Clin J Pain. 2002;18( 4 suppl):S61–S69
  • . The use of opioids for the treatment of chronic pain. A consensus statement from the American Academy of Pain Medicine and the American Pain Society. Clin J Pain. 1997;13(1):6–8
  • . Smith HS. Opioid metabolism. Mayo Clin Proc. 2009;84(7):613–624

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.