#7: Inconsistent Results on Drug Tests

 An inconsistent drug test on a patient’s toxicology report is nothing to be taken lightly. At the minimum an inconsistent report could mean dismissal from the practice and at the worst could mean jail time or even send a patient with SUD (Substance Use Disorder) into suicidal tendencies. After doing our monthly analysis of reports we send out, that have inconsistencies, we have discovered that an extremely high percentage of these reports are a result of one or two things. The clinic is either not reporting the prescribed medication the patient is on, or secondly the clinic reports the wrong medication. A common example is Subutex is reported as prescribed and the patient had been switched to Suboxone. I recently had a discussion with a Suboxone clinic where a patient who was prescribed Suboxone had zero Naloxone on her drug test. This patient’s treatment was court ordered and if she failed her drug test she would lose the right to see her children and would be returned to jail. Although this top notch clinic reported the drug she was prescribed correctly, one can see quickly how important making sure the prescribed drugs written down are correct. If the provider changes a patient to a different medication, the new prescribed medication must be written down.

Although convenient, sending a large list of medications a patient is currently prescribed or was prescribed in the past, is not appropriate. The data entry people at the lab are not healthcare providers. Picking correctly prescribed medications out of a list can quickly become a legal issue. They should only enter what the clinic tells them the patient is prescribed. There are times when they do not recognize the names of different drugs and they can easily miss a medication a patient is on which would then be reported as inconsistent. Just as importantly, the lists we get at times are old and the current meds are either not listed or difficult to interpret. We are unconcerned with medications not on our requisition list such as statins, diabetic medication, heart meds, etc. Prescribed Opioids, Amphetamines, Relaxants, Benzodiazepines, Tri-Cyclic Anti-Depressants, SSRI’s, Anti-Convulsants, Barbiturates, Antihistamines, and Antipsychotics are the only drugs we need listed.

Okay enough already. For those of you who needed scolding, consider yourself scolded. Time for something interesting regarding a question asked about CBD oil. Yes, if used in large does, legal high quality CBD/Hemp oil can produce a false positive for THC (marijuana’s psychoactive and euphoric ingredient) on a drug screen, however that same patient would be negative on a drug confirmation test for THC. Now you know!

As you prepare for your great weekend I share with you some words of wisdom from the great speaker Joe Charbonneau. You can’t teach what you don’t know. You can’t lead where you don’t go. You can’t be what you are not. You can’t give what you ain’t got!!

Thank you all for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners
04/15/2019