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Hospital and Internal Medicine Podcast

Urine Drug Testing - Misinterpretation is Very Common

Hospital and Internal Medicine Podcast

Gil Porat, M.D., FACP, CPT

Health & Fitness:medicine, Medicine, Fitness, Science, Health & Fitness

4.8587 Ratings

🗓️ 28 May 2017

⏱️ 21 minutes

🧾️ Download transcript

Summary

You know all those people on social media wanting mandatory drug testing for welfare recipients? Perhaps, reasonable in theory, if the test wasn't frequently producing false-positives and false-negatives. Making accurate clinical decisions is always challenging, but particularly with urine drug testing. The consequences of misinterpretation can be awful.

Transcript

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0:00.0

You see these cases in the news and read about them all the time, and they're really scary stuff of people that have spent long prison sentences after now being proven to be falsely accused.

0:13.2

Even some people who have been put to death that later evidence shows that they were innocent.

0:20.2

And I think it's just the most horrendous nightmare a person

0:23.6

can live. It's been going on throughout history, right? I mean, you've got the Inquisitions and the

0:29.3

Salem witch trials and even modern day false accusations. So if anybody ever tries to tell you that

0:36.2

a clear conscience laughs at a false accusation,

0:40.0

ask them how they would feel if they were falsely accused of child abuse or date rape

0:45.3

or didn't get a job because of a false positive urine test.

0:49.9

And I see it all the time in hospitals that a urine drug test changes how a clinician or a nurse

0:57.4

feels about a patient when those results come back.

1:00.6

Or a wrong diagnosis associated with urine drug test stigmatizes a patient and can result

1:07.4

in chart law that follows them for a very long time.

1:10.5

You know, I was recently at a restaurant a couple years ago where a buddy of mine thought

1:15.6

that the wasabi was guacamole and he got quite a surprise when he ate it.

1:20.6

So people get the wrong impression of things all the time,

1:24.6

but when medical people interpret urine drug test wrong it can end up

1:30.5

actually in character assassination and at a very minimum it often kills the

1:36.2

trust between patients and clinicians if the patient is falsely accused of taking a

1:42.5

drug that they didn't take.

1:45.4

So let me start off by saying there are a lot of ways to do drug testing, and usually what

1:51.4

we're talking about is drug testing of abuse, although obviously we could sometimes test

1:55.7

for drugs like phenytoin and all kinds of levels that we're looking for for therapeutic

...

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