The Curbsiders Addiction Medicine Podcast S2 Ep7: #18 Urine Drug Testing with Dr. Timothy Wiegand
Aug 17, 2023
Toxicologist Dr. Timothy Wiegand discusses interpreting urine drug tests (UDT), false positives, and counseling patients prior to ordering the test. Topics include detection windows, interpreting opiates and opioids in UDT, resources for interpretation, discussing results with patients, buprenorphine testing, specimen validity testing, and saliva testing.
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Screening vs Confirmatory Testing
- Urine drug screens use antibody technology for initial rapid screening but can yield false positives due to cross-reactivity.
- Confirmatory testing with chromatography and mass spectroscopy accurately identifies substances and quantifies levels.
Communicate Openly with Patients
- Discuss urine drug testing openly with patients to build trust and support harm reduction.
- Use test results to guide conversations on exposure risks, especially with fentanyl contamination.
Variable Detection Windows
- Detection windows vary by drug, usage frequency, and individual factors; fentanyl and THC can remain detectable for weeks.
- Saliva and hair tests offer shorter or longer detection windows respectively but differ in utility and interpretation.