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About one in nine patients who are prescribed opioids for chronic pain test positive for illicit drug use, according to a study released Thursday.
Baltimore-based pain medication monitoring firm Ameritox Ltd.' conducted an observational study of more than 450,000 urine samples submitted for testing between January 2013 and July 2015.
The data was released during the American Pain Society's 35th Annual Scientific Meeting in Austin, Texas.
Patients' urine samples were tested for cocaine; heroin; marijuana; 3,4 methylenedioxy-methamphetamine, which is better known as MDMA; and phencyclidine, which is better known as PCP.
The study found that 10.4% of the samples tested positive for at least one illicit substance.
Of the total, 12.2% tested positive for marijuana; 2.0%, cocaine; 1.3%, heroin; and 125 samples, PCP and MDMA.
Workers compensation was the primary payer for 22,525 of the 450,081 patients included in the study.
The urine tests paid for by workers comp showed use of illicit substances 8.4% of the time, according to the study. Meanwhile, illicit substance detection was the highest among Medicaid patients, at 16.4%, and the lowest among Medicare patients, at 8.1%.
When paid for by commercial insurance and the patients themselves, illicit substances were detected 8.4% and 12.5% of the time, respectively, according to the research.
The use of illicit drugs varied depending on the opioid that was prescribed. It was highest for patients on hydrocodone and codeine, 10.9% and 10.7%, respectively, and the lowest for patients on oxymorphone, at 8.2%.
“Understanding factors associated with the likelihood of positive urine testing for illicit substances may better inform strategies for using urine drug testing in the clinical management of patients on prescribed opioid therapy,” Ameritox said in the study.