Tapentadol is the least common opioid found in admission urine drug-test results at an intensive outpatient opioid-use disorder treatment program in Ohio: A brief report

2021 ◽  
Vol 17 (1) ◽  
pp. 13-17
Author(s):  
Adam Rzetelny, PhD ◽  
Diana Meske, PhD ◽  
Parag Patel, MD, FACOG, FASAM ◽  
Steven Passik, PhD
Keyword(s):  
Treatment Program ◽  
Opioid Use Disorder ◽  
Common Finding ◽  
Prescription Opioid ◽  
Test Results ◽  
Opioid Use ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test ◽  
Dispensing Data

Background: Previous data suggest that tapentadol, an atypical opioid with a putative dual mechanism of action, has relatively low rates of abuse. A better understanding of the rates of abuse among different prescription opioids may help clinicians when considering their potential risks and benefits. The results of urine drug tests (UDTs) may provide a unique opportunity to help answer this question.Method: To investigate different rates of prescription-opioid abuse in this retrospective study, we examined urine drug test results from patients seeking treatment at four facilities of an opioid-use-disorder (OUD) treatment program in Ohio. Urine specimens were collected on admission, one from each patient, in the regular course of care. The opioids reviewed in the present study were tapentadol, hydrocodone, oxycodone, hydromorphone, oxymorphone, and tramadol. Drug dispensing data, including morphine-milligram equivalents (MME) dispensed, were examined to adjust for the relative prevalence of each opioid being examined.Results: Data from 4,162 patients were examined. Tapentadol was the least common finding in UDT results in this cohort and remained so after adjusting for drug availability. The percentage of specimens positive for a given opioid ranged from 0.12 percent (tapentadol) to 7.04 percent (oxycodone). The availability and MME adjustments resulted in a change of rank order, with tapentadol remaining the lowest but tramadol replacing oxycodone as the prescription opioid with the highest rate of abuse.Conclusions: In this sample of UDT results from patients seeking treatment at an OUD program in Ohio, tapentadol was the least frequent finding among the opioids examined, and this remained true when adjusting for dispensing data. Factors potentially contributing to this difference may include pharmacological properties unique to tapentadol. Several important limitations notwithstanding, these findings are consistent with previous real-world evidence and warrant an ongoing line of inquiry. 

scholarly journals Rate of Fentanyl Positivity Among Urine Drug Test Results Positive for Cocaine or Methamphetamine

2019 ◽  
Vol 2 (4) ◽  
pp. e192851 ◽  
Author(s):  
Leah LaRue ◽  
Robert K. Twillman ◽  
Eric Dawson ◽  
Penn Whitley ◽  
Melissa A. Frasco ◽  
...  
Keyword(s):  
Test Results ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

scholarly journals Evaluation of Trends of Near-Real-Time Urine Drug Test Results for Methamphetamine, Cocaine, Heroin, and Fentanyl

2020 ◽  
Vol 3 (1) ◽  
pp. e1918514 ◽  
Author(s):  
Robert K. Twillman ◽  
Eric Dawson ◽  
Leah LaRue ◽  
Maria G. Guevara ◽  
Penn Whitley ◽  
...  
Keyword(s):  
Real Time ◽  
Test Results ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

Reduced urinary opioid levels from pain management patients associated with marijuana use

2019 ◽  
Vol 9 (5) ◽  
pp. 441-447
Author(s):  
Melissa M Goggin ◽  
Breane J Shahriar ◽  
Andy Stead ◽  
Gregory C Janis
Keyword(s):  
Pain Management ◽  
Drug Testing ◽  
Marijuana Use ◽  
Potential Interaction ◽  
Test Results ◽  
Opioid Use ◽  
Target Drug ◽  
Urine Drug ◽  
Urine Drug Test ◽  
Lower Urinary

Aim: Marijuana use has been postulated to modulate opioid use, dependence and withdrawal. Broad target drug testing results provide a unique perspective to identify any potential interaction between marijuana use and opioid use. Materials & methods: Using a dataset of approximately 800,000 urine drug test results collected from pain management patients of a time from of multiple years, creatinine corrected opioid levels were evaluated to determine if the presence of the primary marijuana marker 11-nor-carboxy-tetrahydrocannabinol (THC-COOH) was associated with statistical differences in excreted opioid concentrations. Results & conclusion: For each of the opioids investigated (codeine, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone, fentanyl and buprenorphine), marijuana use was associated with statistically significant lower urinary opiate levels than in samples without indicators of marijuana use.

Association Between Urine Drug Test Results and Treatment Outcome in High-Risk Chronic Pain Patients on Opioids

2010 ◽  
Vol 4 (3) ◽  
pp. 167-173 ◽  
Author(s):  
Kelly S. Barth ◽  
William C. Becker ◽  
Nancy L. Wiedemer ◽  
Shahrzad Mavandadi ◽  
David W. Oslin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Treatment Outcome ◽  
High Risk ◽  
Test Results ◽  
Drug Test ◽  
Chronic Pain Patients ◽  
Urine Drug ◽  
Urine Drug Test ◽  
Pain Patients

Fentanyl analog positivity among near-real-time urine drug test results in patients seeking health care

2020 ◽  
Vol 217 ◽  
pp. 108264
Author(s):  
Joseph D. Stanton ◽  
Penn Whitley ◽  
Leah LaRue ◽  
William L. Bundy ◽  
Eric Dawson ◽  
...  
Keyword(s):  
Health Care ◽  
Real Time ◽  
Test Results ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

Interpreting Urine Drug Test Results in the Context of Chronic Opioid Analgesic Therapy and Poppy Seed Consumption

Pain Medicine ◽  
2021 ◽  
Author(s):  
Jamie Lewis ◽  
Karlee De Monnin ◽  
Jonathan Smith ◽  
Evan Lewis ◽  
Marian Wilson
Keyword(s):  
Opioid Analgesic ◽  
Test Results ◽  
Poppy Seed ◽  
Drug Test ◽  
Analgesic Therapy ◽  
Urine Drug ◽  
Urine Drug Test

scholarly journals Trends in Urine Drug Monitoring Among Persons Receiving Long-Term Opioids and Persons with Opioid Use Disorder in the United States

2021 ◽  
pp. E249-E256
Keyword(s):  
Chronic Pain ◽  
Drug Monitoring ◽  
Opioid Analgesics ◽  
The United States ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Administrative Claims ◽  
Opioid Use ◽  
Urine Drug ◽  
Prescription Opioid Analgesics

BACKGROUND: Practice guidelines recommend urine drug monitoring (UDM) at least annually in the setting of chronic opioid therapy as an objective assessment of substance use. However, empirical evidence on who gets tested and how often testing occurs is lacking. OBJECTIVES: This study investigates 10-year UDM trends in the United States based on 2 factors: (1) the duration of prescription opioid treatment, and (2) having an opioid use disorder (OUD) diagnosis and medications for opioid use disorder (MOUD) prescriptions. STUDY DESIGN: Observational cross-sectional study. SETTING: Research was conducted using administrative claims data from Optum’s deidentified Clinformatics Data Mart Database for the period 2007 to 2016. The dataset contained information on the plan enrollment and health care claims from 50 states and the District of Columbia. METHODS: To examine trends in UDM based on the duration of prescription opioid treatment, persons receiving prescription opioid analgesics were categorized into 4 groups based on the number of days covered: (a) less than 90 days, (b) 90 to 179 days, (c) 180 to 269 days, and (d) at least 270 days. To examine trends based on an OUD diagnosis and MOUD prescriptions, persons diagnosed with OUD were identified and categorized based on the presence of MOUD prescriptions as follows: (a) OUD with buprenorphine (BPN) and naltrexone (NTX) in the same year; (b) OUD with BPN only; (c) OUD with NTX only; (d) OUD with chronic prescription opioid analgesics (≥ 90 days); (e) OUD without prescription opioid analgesics, BPN, or NTX; and (f) chronic prescription opioid analgesics (≥ 90 days) without an OUD diagnosis. For analysis, the percent receiving UDM was estimated per group per year. Then the data were restricted to those receiving at least one UDM to estimate the average number of UDM per person. RESULTS: Data included an average of 364,485 persons per year receiving prescription opioid analgesics for chronic use, and 10,277 per year receiving an OUD diagnosis. Among those receiving prescription opioid analgesics, less than 50% received UDM. For those receiving at least one UDM, one additional UDM was performed per person as the duration of opioids increased by 90 days. Among persons with OUD, the percent receiving UDM was the highest for those receiving both BPN and NTX (87%), followed by those receiving BPN only (80%), chronic opioids (79%), NTX only (72%), and those not receiving any MOUD/opioids (54%). LIMITATIONS: Methadone dispensing for OUD treatments was not captured in administrative claims data. CONCLUSIONS: Although recommended for patients with chronic pain, UDM is provided less than half of the time for these patients. However, once patients received at least one UDM, they would continue to receive it on a fairly regular basis. Compared with those with chronic pain, persons diagnosed with OUD are more likely to receive UDM at a more frequent interval. KEY WORDS: Urine drug monitoring, urine drug testing, urine drug screening, chronic pain, opioid use disorder, prescription opioid analgesic, buprenorphine, naltrexone, medications for opioid use disorder

scholarly journals Clinician Response to Aberrant Urine Drug Test Results of Patients Prescribed Opioid Therapy for Chronic Pain

2019 ◽  
Vol 35 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Morasco ◽  
Erin E. Krebs ◽  
Melissa H. Adams ◽  
Stephanie Hyde ◽  
Janet Zamudio ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Opioid Therapy ◽  
Test Results ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test
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