Pain Patients Who Adhere to Opioid Prescriptions Less Likely to Test Positive for Illicit Drugs

In an analysis of 600,000 urine drug tests (UDT), patients who had been prescribed opioids to treat pain were found to be less likely to test positive for illicit drugs, according to a new study co-authored by researchers from Millennium Health and Kevin Zacharoff, MD, FACIP, FACPE, FAAP, of Stony Brook University.

Findings were published in the Journal of Opioid Management.

Researchers analyzed specimens collected from patients who had been prescribed opioid pain medications between January 2015 and September 2021. They found that illicit drug (cocaine, heroin, fentanyl, and methamphetamine) positivity for the total study population was less than 5%.

The researchers noted that 24% of the population studied were found to be inconsistent in adhering to their opioid prescriptions, according to UDT test results. Patients who were taking their prescribed opioid were 47% less likely to test positive for heroin and 35% less likely to test positive for methamphetamine compared to patients who were inconsistent in their prescription adherence. There were no statistically significant differences in fentanyl positivity rates between patients who were adhering to their opioid prescriptions and those who weren’t.

“Clinically, the results of this study may be encouraging to clinicians who are prescribing opioids and monitoring patients via definitive UDT, as we showed that monitored patients in a pain setting had low positivity rates for illicit drugs, with the lowest rates in those taking their prescribed opioid,” Maria Guevara, PharmD, CPE, Millennium Health director of clinical affairs, education and training, said in a news release.

In their published findings, the researchers noted that if a patient tests negative for their prescribed opioid, “a conversation about medication therapy and additional substance use may be warranted.” Further, with patients who fail to adhere to prescriptions being more likely to test positive for nonprescribed or illicit substances, clinicians may want to consider expanded drug testing and other risk mitigation strategies, the researchers said.

References

Millennium Health publication in Journal of Opioid Management provides encouraging data on drug use trends in patients treated in pain management practices prescribed opioids. News release. Millennium Health. Sept. 7, 2022. Accessed Sept. 12, 2022.

Guevara MG, LaRue L, Zacharoff KL, et al. Definitive urine drug test findings in patients prescribed opioids for pain from a large national database. J Opioid Manag. Vol 18, No 4. 2022. DOI: 10.5055/jom.2022.0723