WASHINGTON – AACC has issued a new guideline detailing how healthcare providers can use laboratory tests to manage treatment of pain and prevent prescription drug overdoses. Especially relevant in light of the worsening opioid epidemic, the guideline emphasizes increased collaboration between clinicians and laboratory experts as well as the use of more precise drug tests as key to identifying pain patients who are abusing their opioid prescriptions.
The opioid crisis shows no sign of slowing, with deaths from these drugs pushing U.S. life expectancy down for a second year in a row. In many scenarios, though, opioids are still the most efficacious treatment for severe pain, which leaves clinicians in the difficult position of deciding which patients can safely start or continue opioid therapy. Urine drug tests provide information that is critical to this decision by detecting drugs and their metabolites, but a thorough understanding of the appropriate use of these tests often lies outside the realm of clinicians’ expertise.
AACC’s guideline gives clinicians and laboratories evidence-based recommendations for using urine drug tests to ensure that patients receive effective pain treatment without fueling the upsurge in addiction. One of the guideline’s major recommendations is that laboratory experts should partner with clinicians and contribute their specialized knowledge to pain management cases, particularly when aberrant drug test results need to be interpreted. The guideline also emphasizes that targeted, definitive drug tests, such as those based on mass spectrometry technology, should be used as frontline drug screens whenever possible. Mass spectrometry-based tests overcome the limitations of the current frontline screening method, the immunoassay, which is useful but can produce a high rate of incorrect results and sometimes only reveals what general drug class is present in a patient’s urine rather than the specific drug.
Other important recommendations from the guideline include best practices for dealing with adulterated specimens; when and how often patients should undergo drug screening based on their risk for addiction; and what drugs should be included in routine testing regimens versus only in high risk patients or special cases.
“From start to finish, the laboratory drug testing process involves many types of healthcare professionals, from laboratory medicine experts to clinicians, nurses, and pharmacists—all of whom have different areas of expertise and varying levels of familiarity with the tests,” said AACC CEO Janet B. Kreizman. “AACC’s guideline aims to give all healthcare providers a solid foundation in urine drug testing best practices, and especially urges healthcare teams to involve laboratory experts in pain management cases. Laboratory tests are crucial to reducing opioid overdoses, and interdisciplinary collaboration will ensure these tests are used for maximal patient benefit.”
Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.aacc.org.