Abstract • Accurate detection of unprescribed drug use by addicts in treatment may facilitate their rehabilitation. Many clinics collect urine samples at random, using fixed-interval collection schedules, which are not free from sampling error. Random-interval schedules minimize sampling error and consequently increase detectability of drug use by eliminating safe periods during which drug use cannot be detected. We compared these two methods by observing rates of detected opiate- and quinine-positive samples preceding and following implementation of random-interval schedules. Detected drug use doubled initially. As detection and clinical sanctions became more certain, drug use declined to well below its former level. Programs that use fixed-interval schedules may underdetect drug use by more than 50%. If patients can reliably predict safe periods, the possibility of using drugs without fear of detection may impede their rehabilitation. References 1. Goldstein A, Brown BW Jr: Urine testing schedules in methadone maintenance treatment of heroin addiction . JAMA 214:311-315, 1970.Crossref 2. Kleber HD, Gould LC: Urine testing schedules in methadone maintenance . JAMA 215:2115-2116, 1971.Crossref 3. Goldstein A, Judson B: Three critical issues in the management of methadone programs , in Bourne PG (ed): Addiction: A Comprehensive Treatise . New York, Academic Press Inc, 1974. 4. Gottheil E, Caddy GR, Austin DL: Fallibility of urine drug screens in monitoring methadone programs . JAMA 236:1035-1038, 1976.Crossref 5. Kahn RB, Schramm NT: The urinalysis myth: Pee or people. Read before the North American Congress on Alcohol and Drug Problems, San Francisco, Dec 12-18, 1974. 6. Grevert P, Weinberg A: A controlled study of the clinical effectiveness of urine tests results in a methadone maintenance program, in Proceedings of the Fifth National Conference on Methadone Treatment. New York, National Association for the Prevention of Addiction to Narcotics, 1973, pp 1052-1059. 7. Lundberg GD: Urine drug screening: Chemical McCarthyism . N Engl J Med 287:723-724, 1972.
Archives of General Psychiatry – American Medical Association
Published: Mar 1, 1978
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