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Using urine drug testing to support healthy boundaries in clinical care

Howard A. Heit, MD, FACP, FASAM, Douglas L. Gourlay, MD, MSc, FRCPC, FASAM

Abstract


Risk management is first and foremost about protecting patients. This article will examine risk management in general, and urine drug testing (UDT) in particular, as core constituents in an effective, comprehensive risk management strategy. The article will explore UDT as a tool to help practitioners and patients make better choices in the clinical management of chronic pain. How one makes these difficult clinical decisions based on UDT results as well common barriers encountered in conducting patient-centered UDT will also be examined.

Keywords


urine drug testing, risk management, patient-centered

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References


Gourlay DL, Heit HA: Pain and addiction: Managing risk through comprehensive care. J Addict Dis. 2008; 27(3): 23-30.

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.

Gourlay D, Heit H, Caplan YH: Urine Drug Testing in Clinical Practice: The Art and Science of Patient Care. 5th ed. Baltimore, MD: Johns Hopkins University School of Medicine 2012.

Heit HA, Gourlay DL: Urine drug testing in pain medicine. J Pain Symptom Manage. 2004; 27(3): 260-267.

Gourlay D, Heit HA: The art and science of urine drug testing. Clin J Pain. 2010; 26(4): 358.

Nafziger AN, Bertino JS Jr: Utility and application of urine drug testing in chronic pain management with opioids. Clin J Pain. 2009; 25(1): 73-79.

Federation of State Medical Boards: Model Policy on the Use of Opioid Analgesics in the Treatment of Chronic Pain. July 2013: 1-29. Available at http://www.pcsso.org/sites/default/files/FSMB%20Pain%20Policy%20(July%202013).pdf. Accessed October 27, 2014.

Gourlay DL, Heit HA: Universal precautions revisited: Managing the inherited pain patient. Pain Med. 2009; 10(Suppl 2): S115-S123.

Savage SR: Long-term opioid therapy: Assessment of consequences and risks. J Pain Symptom Manage. 1996; 11(5): 274-286.

Gourlay D, Heit H: Universal precautions: A matter of mutual trust and responsibility. Pain Med. 2006; 7(2): 210-211; author reply 212.




DOI: https://doi.org/10.5055/jom.2015.0247

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