#6: Define the Word “drug”

 Would you be able to define “drug” if someone asked you to? We are in the business of drug testing yet many would not be able to accurately define the word “drug.” A medicine or other substance which has a physiological effect/change in the body when inhaled, injected, smoked, consumed, absorbed via a patch or dissolved under the tongue is how Wikipedia defines it. Webster’s definition is similar, just shorter. In both definitions the words “other substance” stand out. The drug that kills the most people in the United States is an “other substance”. Over 40 million people use tobacco. There is more information regarding the dangers of this drug than any other drug out there. Tobacco claims more lives than any other drug, yet I would bet if you were asked, “What is the most abused drug in your clinic?”, the first thing that would come to your mind would not be tobacco. If someone wants to quit smoking, but is unable to, they are addicted. I attended a seminar back in the 90’s where a PhD was speaking to a room full of physicians. He asked us to name any disease and then he showed how smoking affected every disease mentioned, from obvious lung cancer to rheumatoid arthritis, bladder cancer, cataracts, diabetes, sexual dysfunction, and multiple others. It was an enlightening two hours. We test for Cotinine (Nicotine metabolite) for some clinics that offer smoking cessation for their patients.

The purpose of the lead paragraph was to stimulate you to consider how you classify the people being drug tested in your clinic. It is so easy to get caught up in the popular thought process that people going to pain clinics are all drug addicts. All they want are the drugs. Is that your thought process about your friend who smokes two or three packs of cigarettes a day. (By the way there are 20 cigarettes in a pack) Maybe you smoke? Do you look at the patients you test the same way you look at your smoking friend? My point is urine drug testing is just part of a treatment plan. It should never be done to be punitive. It should not be done to “catch a patient”. It definitely should not be done to shame a patient. I will admit it is so easy to become bitter and hardened and even cynical doing this job. The person who smokes did not come out of the womb saying I am going to start using a drug which causes all sort of diseases and will eventually kill me. I would bet most wish they never picked up a cigarette. The patients in substance abuse treatment or the pain patients you test most likely feel the same way about the drugs they test positive for. Urinary drug testing is an important tool that a clinician can use to document adherence to a treatment plan, diagnose abuse or addiction, uncover diversion and determine appropriate treatment protocols. If I have changed your attitude towards some of your patients in a positive direction my mission with this blog has been a success.

Have an awesome weekend. Get some exercise. Help someone do something. Love on your family. Live your life to the fullest. As always we very much thank you all for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners
03/22/2019