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Evaluating the Utility of Drug Testing in an Outpatient Addiction Program

Vakili, Shervin PhD* †; Currie, Shawn PhD† ‡; el-Guebaly, Nady MD* §

Addictive Disorders & Their Treatment: March 2009 - Volume 8 - Issue 1 - p 22-32
doi: 10.1097/ADT.0b013e318166efc4
Original Articles
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Objectives This study evaluated the impact of different frequencies of urine drug screening in an outpatient treatment program in terms of reducing the use of drugs or alcohol, supporting the patient's treatment goals, deterring the use of drugs or alcohol, and gathering more reliable information than self-reports.

Methods This study involved 229 patients who were in treatment at the Calgary Health Region's Addiction Centre. Patients' weekly self-reports of drug/alcohol use were compared with their urine screens. Half the participants had all their urines tested, whereas the other half only had half their urine samples tested on a random biweekly schedule. All participants provided their opinions on the importance of drug testing compared with other possible motivating factors in assisting them in their recovery process.

Results Adults were more likely to believe that urine testing is an important factor in their treatment than adolescents. Adolescents reported a lower likelihood to honestly report use during their treatment and were less likely to have any intrinsic motivation to stop using drugs or alcohol. Reducing the number of drug screens tested from weekly to a random biweekly schedule did not impact the deterrence value of the screens and had no impact on the amount of use during treatment. More frequent testing modestly increased the detection of unreported drug use in the patients.

Conclusions Urine drug screens may play an especially important role in the treatment of adolescents. Clinical programs can balance cost effectiveness with clinical benefits to treatment by collecting frequent (eg, weekly) urine drug screens, but only testing a randomly selected half.

*Calgary Health Region Addiction Centre

Faculty of Medicine, Department of Psychiatry

Information and Evaluation Unit, Mental Health, Calgary Health Region

§Addiction Division, University of Calgary, Calgary, Alberta, Canada

Research for this article supported in part by the Calgary Laboratory Services grant ID 17891.

Reprints: Shervin Vakili, PhD, Addiction Centre, 1403 29th Street NW, Calgary, AB, T2N-2T9, Canada (e-mail: shervin.vakili@calgaryhealthregion.ca).

© 2009 Lippincott Williams & Wilkins, Inc.