Nearly two out of three patients who take a urine drug test are misusing their prescription medications, according to a new study by one of the nation’s largest drug labs. The misuse includes failing to take a prescribed drug or taking it in combination with another medication that may be harmful.
Quest Diagnostics analyzed nearly 76,000 urine screens from across the United States, testing them for up to 26 commonly prescribed and abused drugs, including pain medications, amphetamines, cocaine and marijuana.
“Our findings demonstrate that a large number of patients are using drugs, potentially in dangerous combinations, without physician oversight,” states the Quest Diagnostics study “Laboratory Insights into the New Drug Epidemic.”
Sixty three percent of the test results were found to be “inconsistent” with what the doctor prescribed. In 60% of the inconsistent cases, the screen detected drugs other than what the doctor ordered. In the other 40%, no drug was detected. Such a high level of noncompliance, according to the report, suggests “that some patients cannot afford their medications… while others divert drugs, including potentially selling them to others.”
The researchers found that 21% of men and 15% of women tested positive for an illegal substance.
Younger patients (ages 18-24), Medicaid patients and lower income patients (who make under $29K) were more likely to have inconsistent results. The findings suggest that less affluent Americans are more likely to limit or forgo taking prescribed medications for financial reasons.
“These results are sobering, and suggest that changes in prescribing medications — and educating patients in appropriate prescription drug use — are urgently needed,” said Keith Heinzerling, MD, Assistant Professor with the UCLA Department of Family Medicine and UCLA Center for Behavioral and Addiction Medicine. “The study provides a unique perspective on the problem of prescription drug misuse by comparing what the doctor indicates is the patient’s prescribed medication to what is actually in the patient’s urine test.”
Inconsistent results declined slightly to 55% if a patient had a repeat drug screen a month later.
“This finding supports medical recommendations to perform routine urine testing for prescription drug monitoring,” the researchers concluded. That claim is somewhat self-serving, because Quest Diagnostics – which paid for the study – would obviously benefit from any increase in drug testing.
It’s also not the first time a drug test laboratory funded a study that promoted further screening. Research presented at the American Academy of Pain Medicine’s annual meeting in February was paid for by Ameritox, one of the nation’s largest drug labs. A panel of experts recommended drug testing of chronic pain patients at least four times a year if a doctor believes they are at risk of misusing painkillers. Regular drug screening was recommended even though the panel admitted “there currently is a limited evidence base to support the expert panel’s recommendations.”
A recent report by a patient advocate claimed that profits, not patient care, were a driving force behind the soaring number of drug tests given to people with chronic pain.