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  • 1.  Direct Observed Urine Drug Screen Collection

    Posted 7 days ago

    Does anyone do direct-observed collections for urine drug screens (for pts with SUD; NOT for employment/occupational health) in their clinics? I searched the archives but can't find any discussions <5 yrs old.

    We had a provider request that our MAs occasionally do direct observation when there's suspicion that a patient is providing an illegitimate specimen (ie: previous confirmatory UDS has shown the urine is not human urine; urines are testing negative for meds the pt states they are actually taking, etc), but I have concerns about patient privacy, staff training, operationalizing the request, etc. Would love any guidance from others who have dealt with this issue.  



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    Ashley Martin, MPH, RN, BSN
    Manager of Nursing Services
    Lower Lights Christian Health Center
    Columbus, OH
    ashley.martin@llchc.org
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  • 2.  RE: Direct Observed Urine Drug Screen Collection

    Posted 6 days ago

    Hi Ashley!

    We recently navigated this very question.  Our Risk Manger was strongly against this practice in our setting.  They shared that there are rules and practices that drug treatment programs or specialty labs follow that we did not want to navigate.  However, I am not able to quote his exact concerns.  

    We let our staff know that if the patient needed to be observed, we could send them to a specialty lab. 

    I agree with you that this poses concerns.  For me this includes thinking about privacy, dignity, staff safety, and liability. 

    Hope that is helpful!

    Angela




  • 3.  RE: Direct Observed Urine Drug Screen Collection

    Posted 6 days ago
    Our clinics sadly do not.  We have patients who are on pain contracts and on opioids who have negative urine toxicity screens, a waste of money and pharmaceuticals as it would appear pt is selling their pain meds.  We are now ordering blood draws to screen for toxins, they can be ordered alongside a BMP or CBC and the patient is none the wiser.  Until the results come in.



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