The Role of Urine Drug Testing for Patients on Opioid Therapy

Joseph Pergolizzi, Macro Pappagallo, Joseph Stauffer, Christopher Gharibo, Neil Fortner, Mathew N. De Jesus, Michael J. Brennan, Charlotte Richmond, Desmond Hussey

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Opioid analgesics must be prescribed with discernment and their appropriate use should be periodically assessed. Urine drug testing, although not designed specifically for this role, is a widely available and familiar method for monitoring opioid use in chronic pain patients. Urine drug testing can help track patient compliance and expose possible drug misuse and abuse. We sought to evaluate current attitudes and practices regarding the use of urine drug testing among chronic pain patients taking opioids. To the best of our knowledge, this is one of the first such attempts in the literature to examine and document the practice patterns of urine drug testing in this context. A total of 99 attendees at the American Congress of Pain Medicine were surveyed in 2008 about their urine testing practices for patients on opioid therapy. Surprisingly, more urine testing was motivated by a desire to detect undisclosed substances than to evaluate appropriate opioid use. Some respondents never urine-tested their opioid patients, and about two-thirds of respondents had no formal training in urine testing of patients on opioid therapy. The literature does not thoroughly address the role of urine drug testing in this patient population. Most respondents did random rather than scheduled testing; few had any urine testing protocol. The study found motivations for urine testing and testing practices varied widely, and urine testing, despite its clinical utility, is not used consistently.

Original languageEnglish (US)
Pages (from-to)497-507
Number of pages11
JournalPain Practice
Issue number6
StatePublished - 2010
Externally publishedYes


  • Analgesics
  • Narcotics
  • Opioid
  • Opioid analgesics
  • Opioid misuse
  • Opioid therapy
  • Opioids
  • Pain
  • Pain clinics
  • Urine drug testing

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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