Witnessed versus Unwitnessed Random Urine Tests in the Treatment of Opioid Dependence
Article first published online: 15 FEB 2013
Copyright © American Academy of Addiction Psychiatry
The American Journal on Addictions
Volume 22, Issue 2, pages 175–177, March-April 2013
How to Cite
Mallya, A., Purnell, A. L., Svrakic, D. M., Lovell, A. M., Freedland, K. E., Gott, B. M., Sayuk, G. S., Cicero, T. J., Brawer, P. A., Trafton, J. A., Scherrer, J. F. and Lustman, P. J. (2013), Witnessed versus Unwitnessed Random Urine Tests in the Treatment of Opioid Dependence. The American Journal on Addictions, 22: 175–177. doi: 10.1111/j.1521-0391.2013.00326.x
- Issue published online: 15 FEB 2013
- Article first published online: 15 FEB 2013
- Manuscript Accepted: 6 DEC 2011
- Manuscript Revised: 16 SEP 2011
- Manuscript Received: 9 AUG 2011
Background and Objectives
Clinics licensed to provide pharmacotherapy for opiate dependence disorder are required to perform random urine drug screen (RUDS) tests. The results provide the empirical basis of individual treatment and programmatic effectiveness, and public health policy. Patients consent to witnessed testing but most tests are unwitnessed. The purpose of the present study was to compare treatment effectiveness estimates derived from witnessed versus unwitnessed urine samples.
We adopted a policy requiring visually witnessed urine drug screens (WUDS) and studied its impact (a single group, pretest–posttest design) on the RUDS test results in 115 male veterans enrolled in the St. Louis VA Opioid Treatment Program.
The percentage of opioid-positive urine samples increased significantly following implementation of WUDS (25% vs. 41%, χ2 = 66.5, p < .001).
Conclusions and Scientific Significance
Results of this preliminary study suggest that random testing alone does not ensure the integrity of UDS testing. Outcome calculations based on random unwitnessed tests may overestimate the effectiveness of opioid dependence disorder treatment. (Am J Addict 2013;22:175-177)