Health Science Center, University of Tennessee College of Medicine, 1100 E. 3rd Street, Chattanooga, TN 37403, USA.
Am Fam Physician. 2010 Mar 1;81(5):635-40.
Urine drug screening can enhance workplace safety, monitor medication compliance, and detect drug abuse. Ordering and interpreting these tests requires an understanding of testing modalities, detection times for specific drugs, and common explanations for false-positive and false-negative results. Employment screening, federal regulations, unusual patient behavior, and risk patterns may prompt urine drug screening. Compliance testing may be necessary for patients taking controlled substances. Standard immunoassay testing is fast, inexpensive, and the preferred initial test for urine drug screening. This method reliably detects morphine, codeine, and heroin; however, it often does not detect other opioids such as hydrocodone, oxycodone, methadone, fentanyl, buprenorphine, and tramadol. Unexpected positive test results should be confirmed with gas chromatography/mass spectrometry or high-performance liquid chromatography. A positive test result reflects use of the drug within the previous one to three days, although marijuana can be detected in the system for a longer period of time. Careful attention to urine collection methods can identify some attempts by patients to produce false-negative test results.
尿液药物筛查可以增强工作场所安全性、监测药物依从性和检测药物滥用。进行这些测试需要了解测试方式、特定药物的检测时间以及假阳性和假阴性结果的常见解释。雇佣筛选、联邦法规、异常患者行为和风险模式可能会促使进行尿液药物筛查。服用受控物质的患者可能需要进行合规性测试。标准免疫测定测试快速、廉价，是尿液药物筛查的首选初始测试。这种方法可靠地检测到吗啡、可待因和海洛因；然而，它通常不能检测到其他阿片类药物，如氢可酮、羟考酮、美沙酮、芬太尼、丁丙诺啡和曲马多。异常的阳性测试结果应使用气相色谱/质谱法或高效液相色谱法进行确认。阳性测试结果反映了在过去一到三天内使用了药物，尽管大麻可能在体内停留更长时间。仔细注意尿液采集方法可以识别一些患者试图产生假阴性测试结果的行为。
