ASAM Drug Testing Pocket Guide

Drug Testing Pocket Guide

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11 Knowledge and Proficiency Î Providers responsible for ordering tests should be familiar with the limitations of presumptive and definitive testing. Î Providers responsible for ordering tests should be familiar with the potential for cross-reactivity in drug testing. Î Providers responsible for ordering tests should consider the possible impact of tampering on test results. Providers should note that tampering is more likely in settings where consequences for substance use are severe, such as discharge from treatment. Î Providers responsible for ordering tests should understand the potential benefits and limitations of alternative matrices to urine (e.g., oral fluid, hair, etc.). Î Providers responsible for ordering tests should be aware of the costs of different test methods. Î If the provider responsible for making clinical decisions based on test results does not have training in toxicology, he or she should collaborate with a medical toxicologist, a toxicologist from the testing laboratory, or an individual with MRO certification, as needed. Language and Attitude Î Providers should communicate with patients about drug testing using non-stigmatizing language. For example, results should be discussed as "positive" or "negative" as opposed to "clean" or "dirty." Î Providers should exhibit a consistent and positive attitude toward drug testing. Ambivalent attitudes toward drug testing among staff can be a barrier to its effective use. Test Facilities and Devices Point of Care Tests (POCTs) Î Staff training and demonstrated proficiency is particularly important for organizations that use point of care tests. Î Providers performing POCTs should be evaluated for their proficiency. POCTs should be performed only by providers who demonstrate adequate proficiency with the drug test in question. Facilities using POCTs should periodically evaluate the accuracy of their system in comparison to a qualified laboratory. • Users of POCT devices need to be educated about the tests. ▶ They need to understand the statistical and analytical sensitivity of the device. ▶ They need to understand the spectrum of analytes (drugs and metabolites) detected by the device. ▶ They need to understand any known interferences from drugs or metabolites that could affect interpretation of results. ▶ They need to understand the nomenclature of the device.

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