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Part 1: Principles of Drug Testing in
Addiction Treatment
Clinical Value of Drug Testing
Principles of Biological Detection of Substance Use
Î Providers should understand that drug tests are designed to measure
whether a substance has been used within a particular window of time.
Drug Testing and Self-Reported Substance Use
Î Drug testing should be used in combination with a patient's self-
reported information about substance use.
Î Drug testing is an important supplement to self-report because
patients may be unaware of the composition of the substances(s) they
have used.
Î Drug testing is particularly appropriate for patients facing negative
consequences if substance use is detected, who are therefore less
likely to provide accurate self-reported substance use information.
Î Discrepancy between self-report and drug tests results can be a point
of engagement for the provider.
Drug Testing and Patient Outcomes
Î Because evidence suggests that drug testing assists with monitoring
adherence and abstinence in treatment and can improve patient
outcomes, drug testing should be used widely in addiction treatment
settings.
Drug Testing and Evidence-Based Therapy
Î Contingency management is the most extensively researched
behavioral therapy used in conjunction with drug testing. When
utilizing contingency management therapy to encourage abstinence,
providers should consider incorporating drug testing.
Clinical Use of Drug Testing
Therapeutic Tool
Î Drug testing is recommended as a therapeutic tool as part of
evidence-based addiction treatment.
Î Providers should utilize drug testing to explore denial, motivation, and
actual substance use behaviors with patients.
Î If drug testing results contradict self-reports of use, therapeutic
discussions should take place.
