Adjusting Drug Testing Protocols

COVID-19 - Adjusting drug testing protocols 

Adjusting Drug Testing Protocols 

While urine drug testing is generally an important part of buprenorphine treatment, during a public health emergency, urine drug testing should not be a required part of treatment. This section provides guidance to addiction treatment providers and programs (regarding making adjustments to drug testing protocols to address the COVID-19 pandemic. The goal is to balance the utility of having the data from a urine drug test against the risk of COVID-19 virus exposure to patients, laboratory staff, and clinic staff/providers.

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Updated: 3/29/20

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In areas or settings where community spread of COVID-19 virus is occurring, it may be appropriate to provide continued access to on-going medications for addiction treatment without attending their treatment facility or having drug testing done. Urine drug testing is only one piece of information in the comprehensive treatment of opioid use disorder. Other information obtained from patients can be used to adequately inform treatment strategies such as self-reported use of substances, timing of refill requests, checking of the state prescription monitoring program, and other indications of improvements (housing, employment, relationship status). Requiring patients to present to a health care facility to provide urine samples for urine drug testing may be more harmful than beneficial. Patients may unnecessarily increase their risks of exposure to the COVID-19 virus through their travel to or presence in health care facilities. Providers and programs should carefully weigh the risks and benefits of urine drug testing, both for the patient and for community public health and particularly for patients who are stable.

Collecting specimens for drug testing outside the treatment facility: For patients for whom it is deemed necessary to have drug testing done as required for ongoing medication treatment, it may be appropriate to have this testing done outside of the normal protocols. Any alternative testing protocol should minimize contact between staff and patients and minimize the strain on local laboratory services. A recent study examined different body fluid samples taken from patients with COVID-19 for presence of coronavirus RNA. All 72 urine samples tested negative. However, the CDC still does recommends taking precautions with collecting any bodily fluid samples because they do not yet have a complete picture of how transmission occurs. Strong consideration should be given to the availability of personal protective equipment (PPE) and the need to ration these scarce resources.

Drug testing from home: The COVID-19 pandemic and related social distancing practices may go on for many months. Treatment providers should explore options for drug testing at a distance such as using oral fluid-based tests and/or home breathalyzer tests monitored via telehealth.