Why should I drug test my patients?

There are two primary reasons to test patients. The first is to monitor proper adherence to a prescribed regimen of medication – to make sure the patient is taking what he or she is supposed to be taking. The second is to monitor abstinence – to make sure the patient is not taking anything that he or she is not supposed to be taking.

By regularly testing for both the prescribed medication and its metabolite, the doctor can verify proper and consistent usage of the medicine over time. That is to say that not only did the patient take their medicine prior to the test, but also the patient has been taking the medicine regularly over time.

It is also vitally important that the physician identify usage of illicit substances as quickly as possible as rapid intervention is substantially more effective at keeping a patient in a treatment program. It is also imperative that the physician works to deter usage of any drugs of abuse during treatment. According to its “Principles of Drug Addiction Treatment,” the National Institute on Drug Addiction states:

Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs.

Why not just use “instant” point-of-care drug screen cups?

According to the package insert, the cup method “provides only a preliminary analytical test result. The test is not intended to be used in monitoring the drug levels. A more specific alternate method must be used in order to confirm the test result.” (Emphasis added)

Further, the US Food and Drug Administration (FDA) states, “[if you use a cup,] it is very important to send the urine sample to the laboratory to confirm a positive [instant cup] result because certain foods, food supplements, beverages, or medicines can affect the results of at-home tests. Laboratory tests are the most reliable way to confirm drugs of abuse.” They go on to say, “many things can affect the accuracy of these tests, including (but not limited to): the way you did the test, the way you stored the test or urine, what the person ate or drank before taking the test, and any other prescription or over-the-counter drugs the person may have taken before the test.”

In a 2013 study by forensic toxicologist David K. Lirette Ph.D., MS, MT (ASCP), the point-of-care testing cups presented false results approximately 34% of the time (16.1% false positive, 17.9*% false negative). CLICK HERE for Dr. Lirette’s report.

This finding is backed up by a 2013 report published by the American Society of Addiction Medicine. They found that “an examination of LC/MS/MS results following point-of-care (POC) testing in addiction treatment settings found high rates of clinically false negatives, that is, samples tested by POC were reported negative but LC/MS/MS results were positive.” CLICK HERE for the full report.

Another problem presented by the self-test cups is that they do not take adulteration or contamination into account. By using lab-based testing, a specimen can be checked for pH, specific gravity and other factors to make sure that the sample has not been altered.

What “adulterants” do you check for, and why?

All toxicology tests that are performed at Trilab are adjusted for creatinine. Creatinine is a naturally occurring compound in the body that remains at a fairly constant level. Variations in creatinine levels may indicate changes in hydration of the test subject. These variations are adjusted for in the final Trilab test results report. In an instance where there are drastic changes in creatinine, it is likely that a specimen has been intentionally diluted or manipulated and may be assumed to be invalid.

Additionally, Trilab MRO’s are available to our client’s physicians at any time for consultation, verification or corroboration of their interpretation of the lab results. Sometimes, it is good to have a second opinion.

Will it increase my staff’s workload if we transition to or to work with Trilab?

Absolutely not. At Trilab, we work diligently to simplify our client’s experience

Our account management and “onboarding” team will provide an easy and seamless conversion from any current lab services provider. We furnish all requisition forms, collection cups, bags, and other vital supplies. Depending upon your need, location, volume, and other factors, we can frequently offer courier services, collection services, and other conveniences. We also provide initial training and ongoing support for your staff to make sure that they are familiar with and comfortable with the lab testing process.

At Trilab, we truly PARTNER with our clients. If there is ever a question, issue or uncertainty – whether administrative or technical – we are available to you. Furthermore, when you call our office, a human will answer your call, not an automated phone system. We offer hands-on customer care.

Won’t lab-based testing be too expensive for some of my patients?

No. We work with every patient to make treatment monitoring affordable.

We keep our pricing competitive for all of our testing, even as we continuously expand and improve our list of services and maintain a rigorous quality assurance program. We do everything that we can to simplify a patient’s experience including working diligently to keep treatment monitoring as affordable as possible. We work with most major insurance carriers as well as Medicaid and Medicare. For uninsured patients (or even insured patients unable to afford their copays, deductible or coinsurance), we provide a financial aid program for those who qualify. Depending on the patient’s income level, they may qualify for a waiver of payment or scale payment structure. In addition, we have extended payment plans. We will work directly with your patient to resolve any payment issues.

For additional information, please feel to reach out to us using the contact form below, and one of our representatives will reach out to you at our earliest convenience.

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