Opioid cheating is a billion-dollar industry

If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a less critical issue. Unfortunately, one major reason for our inability to control this issue might be in the testing. Most patients in the throes of addiction or recovery require regular urine testing as part of their treatment (which is much more common than blood, hair or saliva) and that has unfortunately led to widespread cheating. The cheating industry is equally or if not more lucrative than the opioid market. Once a patient submits a sample for testing, each sample undergoes specimen validity testing. For most samples, this involves pH testing, specific gravity, and creatinine levels. One could easily circumvent the specific gravity and creatinine test by creatine loading — a supplement found very commonly in nutrition stores. Unfortunately, most physicians who do testing and bill for services (CPT 80305-7) in their office or send it to a commercial lab stop testing at this stage (pH, specific gravity and creatinine). However, the cheating industry is much more technologically and reagent savvy. There are eight possible identified sources of subversion in addition to the pH and specific gravity. We have already mentioned creatine loading. Another method is to add small amoun...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Medications Nephrology Source Type: blogs