8
Part 2: Process of Drug Testing in
Addiction Treatment
Î An appropriate response to positive presumptive test results may
include speaking with the laboratory for assistance in interpreting the
test results.
Î Because presumptive tests may use cutoff values, a negative
presumptive test result should not be over-interpreted. It does not rule
out substance use or SUD, as the latter is a clinical diagnosis.
Î It is appropriate to consider ordering a definitive test if presumptive
test results are negative, but the patient exhibits signs of relapse.
Definitive Test Results
Î In the event of a positive definitive test result, consider intensifying
treatment or adding adjunctive treatments.
Î An appropriate response to positive definitive test results may include
speaking with the laboratory for assistance in interpretation.
Î Providers should use caution when using drug test results to
interpret a patient's amount or frequency of substance use. Individual
metabolism and variability in absorption should be considered.
Î Providers should not over-interpret a negative definitive test result.
It does not rule out substance use or SUD, as the latter is a clinical
diagnosis.
Test Scheduling
Note: See Part 5 for testing frequency in specific settings
Test Frequency
Î For people in addiction treatment, frequency of testing should be
dictated by patient acuity and level of care.
Î Providers should look to tests' detection capabilities and windows of
detection (see pages 29–35) to determine the frequency of testing.
Î Providers should understand that increasing the frequency of testing
increases the likelihood of detection of substance use, but there is
insufficient evidence that increasing the frequency of drug testing has
an effect on substance use itself.
Î Drug testing should be scheduled more frequently at the beginning of
treatment and decreased as recovery progresses.
Î During the initial phase of treatment, drug testing should be done
at least weekly. When possible, testing should occur on a random
schedule.
