Lab Testing in Assessment of Substance Use Disorders-Presentation

Video Transcription

Video Summary

The video is a presentation by Kevin Sevarino on lab testing in the assessment of substance use disorders. Sevarino discusses the clinical uses of lab testing, focusing primarily on urine drug testing. He explains the purpose and practicalities of conducting drug testing, including the choice of matrix (urine being the most widely used), advantages and disadvantages of urine testing, and the debate on whether testing should be observed or unobserved. Sevarino also talks about other matrix options like breath, blood, oral fluids, sweat, and hair/nails, highlighting their advantages and disadvantages. <br /><br />He then delves into the types and interpretation of urine drug testing, including presumptive tests that are less specific and definitive tests that use gas chromatography mass spec or liquid chromatography dual mass spec for accurate identification of specific drugs. Sevarino emphasizes the importance of understanding the metabolism of opioids and benzodiazepines to interpret urine drug test results correctly. He also briefly touches on forensic issues and other lab testing used in substance use disorder evaluations, such as biomarkers for chronic alcohol use, testing for infections, and detecting comorbidities. <br /><br />The presentation includes a case vignette where the audience is asked to interpret a positive urine drug screen for opioids and buprenorphine in a patient on buprenorphine/naloxone. Sevarino explains that the expected result should be positive for buprenorphine only, and suggests asking the patient about what happened and further exploring the situation before considering confirmatory testing or adjusting the treatment plan.<br /><br />No credits were provided in the video.

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Keywords

lab testing

substance use disorders

urine drug testing

matrix options

advantages and disadvantages

presumptive tests

definitive tests

interpretation of urine drug testing