Urine drug testing in the context of opioid analgesic prescribing for chronic pain: a content analysis of U.S. state laws in 2022.
Urine drug testing in the context of opioid analgesic prescribing for chronic pain: a content analysis of U.S. state laws in 2022.
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慢性疼痛阿片类镇痛处方背景下的尿液药物检测：2022 年美国各州法律的内容分析。
DOI：
10.1093/pm/pnad103
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Stein,BradleyD
中科院分区：
文献类型：
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作者：
Andraka-Christou,Barbara;McAvoy,Elizabeth;Gordon,AdamJ;Ohama,Maggie;Brach,Marilyn;Taylor,ErinA;Vaiana,Mary;Saloner,Brendan;Stein,BradleyD
背景为了应对阿片类药物危机，美国各州已经通过法律，要求在为慢性疼痛开具阿片类镇痛药时进行尿液药物检测（UDT）。我们试图确定国家法律UDT requirements.MethodsWe搜索NATIONAL大学法律的数据库使用UDT，慢性疼痛，阿片类药物相关的条款。我们纳入了2022年春季生效的法律，当阿片类药物用于慢性疼痛时，这些法律要求UDT。我们进行演绎内容分析，编码法律强制UDT频率，类型的临床医生和类型的付款人的法律适用，并在何种情况下UDT是mandatory.ResultsWe发现32个法律在13个州，符合我们的纳入标准。UDT要求因州而异，包括法律适用的临床医生类型，UDT的强制频率（例如，在启动/评估时，至少每年一次，每年一次以上），以及UDT被授权的情况（例如，患者有物质使用障碍;相对较少的州具有与处方阿片类药物作为慢性疼痛治疗相关的UDT授权。在为实证研究制定政策指标时，评估UDT政策如何影响健康结果的研究人员必须考虑UDT要求的复杂性和缺乏统一性。此外，即使各州强制要求UDT，临床医生是否了解使用测试结果的最佳方法也不清楚。
BackgroundIn response to the opioid crisis, U.S. states have passed laws requiring urine drug testing (UDT) when opioid analgesics are prescribed for chronic pain. We sought to identify state law UDT requirements.MethodsWe searched NexisUni legal database using terms related to UDT, chronic pain, and opioids. We included laws effective during spring 2022 that required UDT when opioids were prescribed for chronic pain. We performed deductive content analysis, coding laws for mandated UDT frequency, type of clinician and type of payer to whom the law applied, and circumstances under which UDT was mandated.ResultsWe found 32 laws across 13 states that met our inclusion criteria. UDT requirements varied substantially by state, including with regard to the type of clinician to whom the law applied, the mandated frequency of UDT (eg, at initiation/assessment, at least annually, more than once per year), and the circumstances in which UDT was mandated (eg, patient had substance use disorder; dosage/day threshold).DiscussionRelatively few states have UDT mandates associated with prescribing opioids as chronic pain treatment. When developing policy indicators for empirical studies, researchers evaluating how UDT policy affects health outcomes must consider the complexity and lack of uniformity of UDT requirements. In addition, even if states mandate UDT, it is unclear whether clinicians understand the best way to use the test results.