Appropriate, medically necessary definitive testing for the right substances in oral fluid or urine provides information that can save lives.
Diagnostic drug testing performed using either presumptive or definitive testing methods, or a combination of both, is one of the few objective tools for assessment of medication and substance use available to practitioners that are treating individuals with various conditions.
What is presumptive testing?
Presumptive methodologies utilize immunoassay technology to provide rapid results at the point of care and include products such as dipcards, cups, or tabletop analyzers. While this methodology can provide some information to assist making initial prescribing or treatment decisions, there are limitations with this testing methodology that warrant consideration.
Presumptive immunoassays are often unable to identify specific drugs within many drug classes and may yield false negative or false positive results due to limitations in sensitivity and specificity. Presumptive testing is often inadequate or unavailable for detection of specific substances including high-risk synthetic drugs.
What is definitive testing?
Definitive drug identification methods utilize complex technologies such as gas chromatography/mass spectrometry (GC/MS) or liquid chromatography/tandem mass spectrometry (LC/MS/MS). Such highly specific testing can identify individual drugs, metabolites, and many illicit and synthetic substances and report the results as absent or present.
Definitive testing is widely accepted as medically necessary in numerous clinical scenarios, allows for significantly more sensitive and specific testing in comparison to presumptive methods, and is available for a significantly greater number of compounds than currently available presumptive methods.
What is the role of definitive testing in clinical practice?
To identify substance use and develop risk mitigation strategies, providers rely on medication adherence testing/toxicology testing to identify appropriate prescription use as well as use of non-prescribed substances.
Aegis definitive testing was designed to assist you when answering critical questions concerning patient use of medications:
Are your patients taking the medications you are prescribing?
Are your patients taking non-prescribed or illicit drugs?
Are your patients ingesting drugs or substances that could cause drug interactions or interfere with treatment efficacy?
Open the door to meaningful conversations
Data regarding medication adherence and recent substance use can open the doors to meaningful conversations with patients, improved patient care, prevention of adverse outcomes, and reduction of costs.
Definitive testing for the right substances in oral fluid or urine provides information that can save lives.
“We are seeing more and more individuals entering treatment unaware of substances detected through testing that are in drugs they have used. Unfortunately, some of our approaches to treatment that have been effective in the past are becoming less so now due to the changing drug environment.”
Lauren Grude, Nurse Practitioner
Freeman Recovery
Why access to definitive testing is crucial
How does definitive testing impact patient outcomes and harm reduction?
Data regarding medication adherence and recent substance use can open the doors to meaningful conversations with patients, improved patient care, prevention of adverse outcomes, and reduction of costs.Definitive testing for the right substances in oral fluid or urine provides information that can save lives.
Is your current testing method capable of identifying high-risk synthetic drugs?
Providers are treating medically complex patients at a time when drug overdoses are occurring at a greater rate than any previous point in history, with a growing complexity and increasing rate of change of the drug supply.
Relevant toxicology testing in the clinical setting helps to serve as a thermometer for the illicit drug supply, allowing laboratory professionals to enhance their response both reactively and proactively to the drug epidemic. By observing result trends, laboratories can discontinue infrequently detected substances and add substances that are emerging on the illicit drug market, thus resulting in a more cost-effective and clinically useful test offering.
Why access to definitive testing is crucial
Clinicians and health delivery systems NEED help gaining true insights regarding what their patients are consuming and what impact it may have on them. Synthetic drug supplies are increasing. Accidental poisoning is occurring. The risks are ever-changing.
Presumptive testing is often ineffective or unavailable for high-risk substances, which leaves both providers and patients highly vulnerable.
Results of diagnostic drug testing via definitive testing methods, one of the few objective tools for assessment of prescription and non-prescription substance use, are crucial to sound clinical decision-making and patient care.
Clinicians need the ability to provide effective and safe treatment, including lifesaving intervention. From opioids to fentanyl to xylazine, the drug at the forefront of the drug crisis can change. As the drug supply increasingly includes more complex and potent substances, the issue of polydrug use will persist and, in many cases, lead to overdoses.
Limited access to definitive testing will exacerbate an already devastating public health emergency caused by the explosion of illicitly manufactured drugs flooding into the country and our communities.
“Utilization of definitive testing to assess prescription and non-prescription substance use is medically necessary and supported by evidence-based guidance. Aegis has developed a resource to illustrate potential approaches to testing in various clinical specialties based on guidance from a Medicare Administrative Contractor.”
