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Urine testing a frontline defense against comp-based opioid abuse

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Urine drug testing is one of the few tools that allow payers and physicians to monitor compliance and aberrant behavior among injured workers on opioids, speakers said during a webinar by pharmacy benefit manager myMatrixx, the marketing name of Matrix Healthcare Services Inc.

When done correctly, the tests are a valuable part of any comprehensive risk reduction strategy, which can help ensure that only legitimate patients have access to opioids and can identify patients who have become addicted, said Phil Walls, chief clinical and compliance officer for the Tampa, Florida-based PBM.

When urine drug tests are ordered and inconsistent results aren’t addressed, it increases costs for payers without providing a return on investment, Mr. Walls said Thursday.

It’s also important that results be interpreted correctly, as false positives and negatives can have serious consequences in a workplace setting, he added.

“Urine drug testing is helpful — it’s not perfect, but its one of the few tools we have to uncover aberrant behavior, addiction and diversion,” Dr. Steven Stanos, who specializes in occupational medicine and pain management at the Swedish Medical Center in Seattle, said during the webinar.

Mr. Walls said payers should consider asking prescribers how often injured workers will be tested, if they’ll agree to discuss results with a toxicologist before making conclusions about aberrant results, and what their policy is regarding patients who refuse testing, among other questions.

Negotiating contracts with companies that perform the tests is another good idea for payers, Mr. Walls said, noting that a rate of $300 to $400 should include testing for a panel of drugs commonly used in workers comp, the ability to test for additional drugs at no charge, screenings and confirmation tests, and an interpretation of the results.

Comprehensive risk reduction strategies can also include a baseline risk screening, prescription drug monitoring programs and psychiatric assessments to determine if someone has a higher risk of drug abuse, speakers said.