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Part 1: Principles of Drug Testing in
Addiction Treatment
Î Providers should present drug testing to patients as a way of providing
motivation and reinforcement for abstinence.
Î Providers should educate patients as to the therapeutic purpose of
drug testing. To the extent possible, persuade patients that drug
testing is therapeutic rather than punitive to avoid an "us versus
them" mentality.
Î If a patient refuses a drug test, the refusal itself should be an area of
focus in the patient's treatment plan.
Assessment
Î Treatment providers should include drug testing at intake to assist in a
patient's initial assessment and treatment planning.
Î Results of a medical and psychosocial assessment should guide
the process of choosing the type of drug test and matrix to use for
assessment purposes.
Î Drug test results should not be used as the sole determinant in
assessment for a substance use disorder (SUD). They should always
be combined with patient history, psychosocial assessment, and a
physical exam.
Î Drug testing may be used to help determine optimal placement in a
level of care.
Î Drug testing can serve as an objective means of verifying a patient's
substance use history.
Î Drug testing can demonstrate a discrepancy between a patient's self-
report of substance use and the substances detected in testing.
Î For a patient presenting with altered mental status, a negative drug
test result may support differentiation between intoxication and/or
presence of an underlying psychiatric and/or medical condition that
should be addressed in treatment planning.
Î Drug testing can be helpful if a provider is required to document a
patient's current substance use.
Monitoring
Î Drug testing should be used to monitor recent substance use in all
addiction treatment settings.
Î Drug testing should be only one of several methods of detecting
substance use or monitoring treatment. Test results should be
interpreted in the context of collateral and self-report and other
indicators.
