7
Responding to Test Results
Î Providers should attach a meaningful therapeutic response to test
results, both positive and negative, and deliver it to patients as quickly
as possible.
Î Providers should not take a confrontational approach to discussing
positive test results with patients.
Î Providers should be aware that immediate abstinence may not be a
realistic goal for patients early in treatment.
Î When making patient care decisions, providers should consider all
relevant factors surrounding a case rather than make a decision based
solely on the results of a drug test. Considering all relevant factors
is particularly important when using drug test results to help make
irreversible patient care decisions.
Unclear Test Results
Î Providers should contact the testing laboratory if they have any
questions about interpreting a test result or to request information
about the laboratory procedures that were used.
Î Providers may consult with a medical toxicologist or a certified
Medical Review Officer (MRO) for assistance in interpreting drug test
results.
Î If the provider suspects the test results are inaccurate, he or she
should consider repeating the test, changing the test method,
changing/adding to the test panel, adding specimen validity testing, or
using a different matrix.
Î If tampering is suspected, samples should not be discarded. Rather,
further testing should be performed to help identify whether and how
tampering occurred.
• Providers should consider samples that have been tampered with to be
presumptive positive.
Presumptive Test Results
Î Positive presumptive test results should be viewed as 'presumptive
positive' results until confirmed by an independent chemical technique
such as Gas Chromatography–Mass Spectrometry (GC-MS) or Liquid
Chromatography–Mass Spectrometry (LC-MS).
Î An appropriate response to positive presumptive test results includes
speaking with the patient.
• Providers should seek definitive testing if the patient denies substance use.
• Providers should review all medications, herbal products, foods, and other
potential causes of positive results with the patient.
