Substance and Non Substance Related Addiction Disorders: Diagnosis and Treatment

Urine Drug Screening (UDS) in the Management of Substance Use Disorders

Author(s): Teri Gabel

Pp: 10-20 (11)

DOI: 10.2174/9781681083438117010005

* (Excluding Mailing and Handling)

Abstract

Urine drug screens can add accountability to a patient’s recovery plan. An upfront discussion of the role of the urine drug screen in treatment is important for a solid provider client therapeutic relationship. Substance use disorders are relapsing and remitting disorders. The goal of treatment is to extend the duration of sobriety until it is life-long, a lifestyle. The role of the urine drug screen in a treatment program should be therapeutic not penalizing. Understanding what a drug screen can and can not do in providing information is important. Using a consistent screen and appropriately certified laboratory is a must. This chapter covers the types of drug screens, the substances identified in a standard urine dug screen and provides guidance on when other substances may need to be requested during screening. Some substances such as “bath salts” are not identified in current urine drug screens. In clinical situations it will be important to confirm any positive results found on a urine drug screen. Common agents and medications that cause false positive or negative results are identified in the chapter. Proper process for obtaining and handling the urine sample including proper chain of custody are presented.


Keywords: Adulteration, Bath salts, Chain of custody, False negative, False positive.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1739835000 and j.to_date >= 1739835000 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 9894) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1739835000 and j.to_date >= 1739835000 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 9894) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1739835000 and j.to_date >= 1739835000 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 9894)
      640μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1945 and `b`.`banner_from_date` <= 1739835000 and `b`.`banner_to_date` >= 1739835000 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.18msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1945
      • 3: 1739835000
      • 4: 1739835000
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='9cfd6f55ad34c6b9d0693a1a25cdf8a6'
      300μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    5Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        qCYQSCbyYARjUcPKMWSGFiUhEV1bga8F5EqFch5n
        uc_cart_id
        9cfd6f55ad34c6b9d0693a1a25cdf8a6
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/9894" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/9894
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6Im9LQW1CZFVkTm1lY1NQK1c0S0xIRFE9PSIsInZhbHVlIjoiTk1Pc2lLRERDYklkaU9ybFkxTXRFbVA1WXdvSDVyL1YvVDJIRFFmM1c5ST0iLCJtYWMiOiI3MTZiNTg5ZjNlODBiN2FlNjQ3Yzc5MTU5MTIxNzU0MTI2NTg3Nzk3M2Y0MDEyMTAwOWY3ZjA5NDVhMzI3OGM3IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6Im9LQW1CZFVkTm1lY1NQK1c0S0xIRFE9PSIsInZhbHVlIjoiTk1Pc2lLRERDYklkaU9ybFkxTXRFbVA1WXdvSDVyL1YvVDJIRFFmM1c5ST0iLCJtYWMiOiI3MTZiNTg5ZjNlODBi" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 17 Feb 2025 23:30:00 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlFvYVlmci9Qb202MDh4c2liTFhWOUE9PSIsInZhbHVlIjoiRGYwQURMdWF3cGduZER6SlJJbnRNMURHc25XdzdBVjBMU0Uycllvb0pDdXRiWlN2K2tUQTl5alRuTWVGQk0xbjdJWEpncmZGTDhRSzJwMnF6T3ZXdlJaMVNkOGNKSURiN1hXVUlWUTQ5d2RpT0ZZaitYT0JNWndzNHZ2RDFWOTMiLCJtYWMiOiIzNTY3NjlkN2Q3ZDhjNTU2NGY0NDNhMzg1MzhlNTliYWFhNGY3MzAxNTEyNzk5ZDMzYWY2YzgzYTkyZWRjZmFjIiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 11:30:00 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlFvYVlmci9Qb202MDh4c2liTFhWOUE9PSIsInZhbHVlIjoiRGYwQURMdWF3cGduZER6SlJJbnRNMURHc25XdzdBVjBMU0Uycllvb0pDdXRiWlN2K2tUQTl5alRuTWVGQk0xbjdJWEpnc" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlEyYVFzY2FDYWV0bWloS1Q4VmpIL3c9PSIsInZhbHVlIjoiZ1hwUHl5WHhTZzhUM3IwT0dLeU9QV2RkajVGVVp4bXhwaEdlRVNwZUpRbFhCaFlCa1JhQlEwcDM4Ny9LS2NTZzlyN0lZSkFqNERRY1lDTlJGZ3Fwa0Fic1FnclpIZjFkaDVvZGNqZ01HRWErdkVXNlFHZWQvMm9tSm9hSFA2VjMiLCJtYWMiOiIyYjJiYjY4ZTUxOTZlYzA5OGYyYmVmMWI1Y2U4ZWQ5ZGIzNmUyNjZkMzU2Yzc3M2E1MjQyOWE3NDcwM2M2MjNhIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IlEyYVFzY2FDYWV0bWloS1Q4VmpIL3c9PSIsInZhbHVlIjoiZ1hwUHl5WHhTZzhUM3IwT0dLeU9QV2RkajVGVVp4bXhwaEdlRVNwZUpRbFhCaFlCa1JhQlEwcDM" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlFvYVlmci9Qb202MDh4c2liTFhWOUE9PSIsInZhbHVlIjoiRGYwQURMdWF3cGduZER6SlJJbnRNMURHc25XdzdBVjBMU0Uycllvb0pDdXRiWlN2K2tUQTl5alRuTWVGQk0xbjdJWEpncmZGTDhRSzJwMnF6T3ZXdlJaMVNkOGNKSURiN1hXVUlWUTQ5d2RpT0ZZaitYT0JNWndzNHZ2RDFWOTMiLCJtYWMiOiIzNTY3NjlkN2Q3ZDhjNTU2NGY0NDNhMzg1MzhlNTliYWFhNGY3MzAxNTEyNzk5ZDMzYWY2YzgzYTkyZWRjZmFjIiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 11:30:00 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlFvYVlmci9Qb202MDh4c2liTFhWOUE9PSIsInZhbHVlIjoiRGYwQURMdWF3cGduZER6SlJJbnRNMURHc25XdzdBVjBMU0Uycllvb0pDdXRiWlN2K2tUQTl5alRuTWVGQk0xbjdJWEpnc" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlEyYVFzY2FDYWV0bWloS1Q4VmpIL3c9PSIsInZhbHVlIjoiZ1hwUHl5WHhTZzhUM3IwT0dLeU9QV2RkajVGVVp4bXhwaEdlRVNwZUpRbFhCaFlCa1JhQlEwcDM4Ny9LS2NTZzlyN0lZSkFqNERRY1lDTlJGZ3Fwa0Fic1FnclpIZjFkaDVvZGNqZ01HRWErdkVXNlFHZWQvMm9tSm9hSFA2VjMiLCJtYWMiOiIyYjJiYjY4ZTUxOTZlYzA5OGYyYmVmMWI1Y2U4ZWQ5ZGIzNmUyNjZkMzU2Yzc3M2E1MjQyOWE3NDcwM2M2MjNhIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IlEyYVFzY2FDYWV0bWloS1Q4VmpIL3c9PSIsInZhbHVlIjoiZ1hwUHl5WHhTZzhUM3IwT0dLeU9QV2RkajVGVVp4bXhwaEdlRVNwZUpRbFhCaFlCa1JhQlEwcDM" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "qCYQSCbyYARjUcPKMWSGFiUhEV1bga8F5EqFch5n" "uc_cart_id" => "9cfd6f55ad34c6b9d0693a1a25cdf8a6" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/9894" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:30:00GET/chapter/9894112197