Douglas L. Gourlay, MD, FRCPC, FASAM
The Wasser Pain Management Centre
Mount Sinai Hospital
Yale H. Caplan, PhD, D-ABFT
Director, National Scientific Services
Urine drug testing in clinical practice should be a consensual diagnostic test, which is done with full explanation to
and for the benefit of the patient. It can be used to provide objective documentation showing adherence to the
agreed-upon treatment plan, to aid in the diagnosis and treatment of the disease of addiction or drug misuse, if
present, and to advocate for the patient in family and social issues.
Questions exist regarding which test to order and how to interpret a urine drug test (UDT) result in the clinical
setting. The questions include the purpose of testing, which drugs to test for, the “best” sample to test, how to
collect the sample, which testing methods to use, and the level of understanding of the healthcare professionals
using the resulting data. Healthcare professionals must understand the strengths and limitations of any test,
including the UDT, that may alter patient management.
A healthcare professional should have a relationship of mutual honesty and trust with the patient when using the
UDT in his or her clinical practice. A working relationship with your testing laboratory may be very helpful in
accurately interpreting UDT results.
After completing this educational activity, participants should be better able to:
1. Clarify the purpose of urine drug testing and identify a clear testing strategy.
2. Distinguish between urine drug testing for detection of illicit drug use and for monitoring adherence to a
3. Describe drug-testing methodology, instrumentation, and sensitivity/specificity of results.
4. Highlight strategies to improve:
Interpretation of results.
5. Understand the limitations of urine drug testing.
The goal of this activity is to educate healthcare professionals on proper methods, uses, limitations, and evaluation
of UDT results. This is in order to rationally employ testing in clinical practice to improve patient care, to protect
one’s practice with objective documentation of adherence to the agreed-upon treatment plan, and to advocate for
patients as needed.