Kevin A. Sevarino, MD, PhD | Associate Clinical Professor, Yale University School of Medicine; President-Elect American Academy of Addiction Psychiatry

Physicians, nurses, and healthcare teams who are treating patients with substance use disorder (SUD).

Interprofessional Continuing Education credit, AMA PRA Category 1 Credits™, and Nursing Contact Hours.

• Interpersonal Skills and Communication 
• Medical Knowledge 
• Patient Care

Lab testing in the assessment of substance use disorders may involve many different substrates, though urine drug testing (UDT) dominates clinical practice. This module is meant to provide a short guide to effective use of lab testing in treatment of the patient with a substance use disorder, which to a surprising degree is often misused or misunderstood. The module describes the clinical role of lab testing to guide treatment and not to be punitive. To properly use and interpret UDT, it reviews common false positive and false negatives that might occur in the immunologic-based first step in UDT. To understand confirmatory gas chromatography/mass spectrometry, it goes on to describe the metabolism of common opioids and benzodiazepines, because the detected confirmed moiety often is just a downstream metabolite of several possible parent compounds to which the patient was exposed. The module concludes with a discussion of the difference between UDT for clinical purposes versus forensic ones.

At the conclusion of this activity participants should be able to:

• Discuss clinical issues in performing urine drug testing (UDT).
• Describe the basic types of UDT and when they should be used. 
• Define the metabolism of opioids and benzodiazepines in order to interpret UDT results. 
• Describe other laboratory testing used as part of substance use disorder evaluations

In order to receive maximum credit, learners must: 

1. Review the materials provided in this module.
2. Earn a minimum cumulative score of 80% on the post-test. 
3. Complete an evaluation to assess satisfaction and plans for individual and/or team practice change.
4. Follow instructions at the end of the course regarding how to retrieve a certificate.* 

*Credit will not be awarded unless all components of the program are completed.  Partial credit will not be awarded.