Majority of Chronic Pain Patients Improperly Use Prescribed Medications

August 27, 2009

An Ameritox study found that of 938,586 urine toxicology tests administered to chronic pain patients over a three-year period, 11% detected major illicit drugs and 29% had a medication in their system that the patient's doctor was likely unaware of.

A majority of patients suffering from chronic pain who were prescribed opioids are “unlikely to be taking their medicine in a manner consistent with their prescribed regimen,” according to the results of a new study from Ameritox, the self-billed national leader in “medication monitoring solutions, offering specialized laboratory testing and reporting services.”

According to the researchers, among the patients taking chronic opioid therapy who were given urine toxicology tests, “8% of patients had no detectable level of their prescribed medication (typically an opioid or benzodiazepine type drug); 27% had a drug level higher than expected; 15% had a drug level lower than expected; 11% had major illicit drugs such as cocaine or methamphetamines detected in their urine; and 29% had a medication in their system that the doctor was likely unaware of.” In a summary of the findings, the researchers said that “urine toxically testing showed that only 25% of the patients were definitively taking their medications as prescribed, with no evidence of illicit drug use or misuse of prescribed drugs.”

During routine clinic visits from January 2006 to January 2009, the researchers administered 938,586 urine toxicology tests. Using the Ameritox screening process, the researchers first screened first for opiates, benzodiazepines, illicit drugs, and other related medications. The samples that came out positive “were then followed with confirmatory testing using mass spectrometry assays.” In the second phase of tests, using patient demographic data, urine drug test results, urine pH, and specific gravity, the researchers put together a normalized patient result using a proprietary methodology from Ameritox. The “normalized results” were then compared with results from patients who were known to be compliant about medication regimens.

"This large-scale, comprehensive study sheds light on how beneficial pain medication monitoring can be for identifying whether prescribed opioids are appropriately being used by patients and, as a result, whether they are achieving optimal pain management," said Harry L. Leider, MD, MBA, Chief Medical Officer of Ameritox, and one of the study investigators. "Monitoring is a critical tool that physicians can use in combination with clinical expertise, intuition and their knowledge of each patient's history to initiate a conversation about proper use of controlled substances and ultimately improve outcomes for patients with chronic pain."

Results of this study were also published in the August issue of Population Health Management.