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Part 2: Process of Drug Testing in
Addiction Treatment
Î Federal cutoff threshold concentrations used for occupational testing
are not appropriate for clinical use.
Î Definitive testing techniques should be used whenever a provider
wants to detect specific substances not identified by presumptive
methods, quantify levels of the substance present, and refine the
accuracy of the results.
Î Definitive testing should be used when the results inform clinical
decisions with major clinical or non-clinical implications for the
patient (e.g., treatment transition, changes in medication therapies,
changes in legal status).
• If a patient disputes the findings of a presumptive test, a definitive test should be
done.
Î When ordering a definitive test, providers should advise the testing
laboratory if the presence of any particular substance or group of
substances is suspected or expected.
Î Because not all laboratories automatically perform a definitive test
on positive presumptive results (the common term for this is "reflex"
testing), providers should be aware that laboratories may require a
specific order for definitive testing.
Cost
Î Providers should always consider cost both to patients and insurers
when utilizing drug testing.