Med-Sci: Course and White Paper Show Renewed Emphasis on Clinical Drug Testing

A key to improved treatment of patients with drug addiction lies in knowing more about those patients, so ASAM has developed a white paper and offered a four-hour, two-part course, “Clinical Drug Testing in Medical Care” during its Med-Sci Conference.  

“The white paper was needed because drug testing is becoming the MRI of addiction treatment. ASAM developed the white paper because there were no standards or national guidelines that could be applied in a general or specific way for interpretation,” said Louis E. Baxter, Sr., MD, FASAM, ABAM Diplomate, one of the authors of the white paper and an organizer and speaker at the course. “This is our special tool for diagnosing substance use disorders. It helps assess effectiveness of treatment plans, and it serves as a deterrent for individuals struggling with recovery.”

“Clinical Drug Testing in Medical Care” differs from past ASAM courses about drug testing, which were designed for medical review officers and geared toward testing required in the transportation industry.

“This new course is designed to give the clinician practical clinical advice and information on how to apply clinical drug testing in their practices,” said Michael Sprintz, DO, ABAM Diplomate, also an organizer and speaker at the course. “We discussed the way drug testing is performed on urine, oral fluid, hair, and blood. We will talk about the differences between a screening test and a confirmation.

“We also went into a lot more depth on which patients we should be testing, how to test those patients, and specialty-specific issues. Another important difference is that the final section of the course provides the nuts and bolts of how to start doing clinical dug testing in your own practice, including information about billing and compliance, and how to get reimbursed.”

ASAM has not offered a course about clinical drug testing since 2006, and a lot has changed since then. Pain management has grown, leading to the epidemic of prescription drug abuse, said Dr. Baxter, Executive Medical Director of the Professional Assistance Program of New Jersey.

“Now, more urine drug testing is required,” he said. “Primary care physicians are needing to use urine testing, and we want to make sure they have state-of-the-art information and guidance. There are various modalities. Breath testing is most appropriate for certain issues. We also use swabs, hair, and patches. With all of these modalities, it is important to know which one to select.”

Speakers at the course discussed the science of drug testing, clinical drug testing basics, how to discuss test results with patients, and how to apply drug testing in practice as well as test interpretation, said Dr. Sprintz, Founder and Chief Medical Officer of the Sprintz Center for Pain and Dependency, The Woodlands, Texas.

The sessions reviewed the results of ASAM’s Millennium drug testing survey to gauge the physician knowledge base, he said.

“We found that most physicians are not regularly testing their patients for prescription drug abuse and illicit drug abuse,” Dr. Sprintz said. “We are not able to get people help if we don’t know that they have a problem. That is a big reason why we thought that now is an important time to start a clinical drug testing course.

“We need to teach physicians not just how to do drug testing, but how to know which patients to test, how to do it smartly to make it clinically relevant, and testing in a way that minimizes the predictability for patients. To quote Howard Heit, MD, clinical drug testing is something we do for our patients, not to our patients.”

An online live-captured version of the session will be available through ASAM's e-Live Learning Center in about a month.