Recommendations for urine drug monitoring as a component of opioid therapy in the treatment of chronic pain

John F. Peppin, Steven D. Passik, Joseph E. Couto, Perry G. Fine, Paul J. Christo, Charles Argoff, Gerald M. Aronoff, Daniel Bennett, Martin D. Cheatle, Kieran A. Slevin, Neil I. Goldfarb

Research output: Contribution to journalReview articlepeer-review

58 Scopus citations


Objective. Several prominent guidelines recommend that patients on long-term opioid therapy have periodic urine drug monitoring (UDM) for appropriate use; however, none address the specific questions of which patients to test, which substances to test for, how often to test, and how to act on the results. Design. In the absence of adequate scientific evidence in the literature, a panel of experts in the field of pain and addiction medicine was convened to develop consensus UDM recommendations. The panel met three times between March 2010 and April 2011, and reviewed several drafts of the recommendations document between meetings. Results. The group was able to achieve consensus on a set of UDM recommendations addressing test selection, test frequency, interpretation of results, and how to handle discrepancies based on specific results. Conclusion. While the participating panel members recognize that there currently is a limited evidence base to support the expert panel's recommendations, primary care providers and pain specialists are largely acting today based on anecdote, intuition, and individual experience. The recommendations are meant to begin to provide a framework for standardizing practices for UDM in the treatment of chronic pain, and to serve as a catalyst to advance research that quantifies the effects of UDM on opioid therapy management and patient outcomes. Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)886-896
Number of pages11
JournalPain Medicine (United States)
Issue number7
StatePublished - Jul 2012


  • Addiction
  • Chronic Pain
  • Drug Toxicology Screens
  • Opioids
  • Pain Management

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


Dive into the research topics of 'Recommendations for urine drug monitoring as a component of opioid therapy in the treatment of chronic pain'. Together they form a unique fingerprint.

Cite this