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July 24, 2013

More doctors require patients to take drug tests for pain pills

Daily Briefing

Physicians prescribing pain medications are increasingly asking their patients to take urine drug tests and sign written agreements that they will not misuse prescribed painkillers, the Wall Street Journal's Timothy Martin reports.

The trend is propelled by a growing concern among physicians that they will be held liable for deaths or accidents stemming from drug overdoses, Martin writes. Federal data indicate that the number of overdose deaths from painkillers now surpass those from heroin and cocaine combined.

The American Society of Interventional Pain Physicians last year adopted guidelines requiring its 4,000 members to implement urine tests to determine if patients are already misusing drugs or are likely to do so. In addition, three other pain physician groups—including the American Pain Society—have endorsed drug testing for high-risk patients, while at least 10 states, including Kentucky and Washington, have recommended some level of testing.

Overall, the number of drug tests administered in the United States increased by 28% between 2006 and 2011, according to consulting firm Venture Planning Group. Experts predict that the drug-test market will further expand by more than 21% by 2016.

Do drug tests weaken doctor-patient relationships?

Critics of the trend say that drug testing interferes with the doctor-patient relationship, but some physicians—such as Anand Thakur—say it is all they can do to weed out addicts who know how to work the system. "Unfortunately, we're in a trust-and-verify situation with prescription opioids," Thakur told the Journal.

Some patient groups—such as the American Chronic Pain Association (ACPA)—hope that aggressive screening now will eventually create an environment in which patients with overall clean records can largely avoid scrutiny. Penney Cowan, ACPA's executive director of education, said that the environment could be "like airline pre-check, where the airport identifies people they think they can trust" (Martin, Journal, 7/19).

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