Presented at the 2012 AAPM Annual Meeting « Back

Clinical Ramifications Of Random Drug Screening Versus Scheduled

Eva C Dickinson, MD, PhD, evaevamd@yahoo.com, Compassionate Pain Management, Seaford, Delaware, United States

Introduction: The current recommendation is to do such screens initially and then subsequently on a random basis on all such patients. Studies have shown that profiling patients based on risk factors for drug addiction will miss up to 45% of patients who are non-compliant with a narcotic regimen. Prescription deaths and diversion has increased steadily over the past 5 years to epidemic proportions. We compared the risk of death and medication compliance in a control group of patients. Materials and Methods: A retrospective crossover study was performed on 2000 patients who attended a comprehensive pain management clinic in three seperate locations. The first group was tested initially and then randomly therafter and the second randomized group were tested every time they received a prescription for narcotics. If the patients tested positive for any illegal substances except for THC narcotic medications were withheld until they produced clean urine. After 8 months the groups were then crossed over to the opposite group. IRB approval was not needed as we have obtained an non-significant risk waiver. Statistical analysis using standard software was utilized for analysis of the data. Results: We found a significant decrease in death by 45% (p< 0.001) and increased compliance by 38% (p<0.001) in patients who were tested every single time. We found that the patients who were crossed over to the randomized screening group after 6 months had the same decrease in compliance after 8 weeks of screening. References: 1) Braithwaite RA, Jarvie DR, Minty PS, Simpson Ann Clinical Biochem 2)Gourley, D, Heit, HA Pharma 3)Heit, HA, Gourley, D Academy of Pain Practice

Funding: None