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Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens
Authors:Karen E. Moeller  Julie C. Kissack  Rabia S. Atayee  Kelly C. Lee
Affiliation:1. University of Kansas School of Pharmacy, Lawrence, KS;2. Harding University College of Pharmacy, Searcy, AR;3. UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA
Abstract:Urine drug testing is frequently used in clinical, employment, educational, and legal settings and misinterpretation of test results can result in significant adverse consequences for the individual who is being tested. Advances in drug testing technology combined with a rise in the number of novel misused substances present challenges to clinicians to appropriately interpret urine drug test results. Authors searched PubMed and Google Scholar to identify published literature written in English between 1946 and 2016, using urine drug test, screen, false-positive, false-negative, abuse, and individual drugs of abuse as key words. Cited references were also used to identify the relevant literature. In this report, we review technical information related to detection methods of urine drug tests that are commonly used and provide an overview of false-positive/false-negative data for commonly misused substances in the following categories: cannabinoids, central nervous system (CNS) depressants, CNS stimulants, hallucinogens, designer drugs, and herbal drugs of abuse. We also present brief discussions of alcohol and tricyclic antidepressants as related to urine drug tests, for completeness. The goal of this review was to provide a useful tool for clinicians when interpreting urine drug test results and making appropriate clinical decisions on the basis of the information presented.
Keywords:6-MAM  6-monoacetylmorphine  CNS  central nervous system  DMAA  dimethylamylamine  EtG  ethyglucuronide  ELISA  enzyme-linked immunosorbent assay  FDA  Food and Drug Administration  GC-MS  gas chromatography/mass spectrometry  LC-MS/MS  liquid chromatography/tandem mass spectrometry  MDPV  methylendioxyprovalerone  NSAID  nonsteroidal anti-inflammatory drug  POCT  point-of-care testing  PCP  phencyclidine  PPI  proton pump inhibitor  TCA  tricyclic antidepressant  THC  tetrahydrocannabinol  THCV  UDT  urine drug test
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