Evidence map›Paper›PMID 39723346›Full record

ArticleAddictive behaviors reports2025

Do we need urine drug screens in opioid addiction treatment: An observational study on self-report versus urine drug screens.

Alannah McEvoy, Myanca Rodrigues, Brittany B Dennis, Jacqueline Hudson, David C Marsh, Andrew Worster, Lehana Thabane, Zainab Samaan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Addictive behaviors reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alannah McEvoyDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7, Canada.
Myanca RodriguesDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St. W, Hamilton, ON L8S 4L8, Canada.
Brittany B DennisDepartment of Medicine, Division of Social Medicine, University of British Columbia, Vancouver, BC V5Z1M9, Canada.
Jacqueline HudsonDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7, Canada.
David C MarshNOSM University, 935 Ramsey Lake Rd., Sudbury, ON P3E 2C6, Canada.
Andrew WorsterDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St. W, Hamilton, ON L8S 4L8, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St. W, Hamilton, ON L8S 4L8, Canada.
Zainab SamaanDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The substance use crisis continues to progress. Medication for Opioid Use Disorder (MOUD) are prescribed to reduce opioid use and related harms; however, many individuals continue to use substances while on treatment. The objective of this study was to describe the temporal and demographic trends of the agreement between self-reported and urine tested substances. Methods: The current study is a retrospective secondary analysis of three phases of a prospective cohort study (Pilot 2011, Genetics of opioid addiction (GENOA) 2013-2017, and Pharmacogenetics of opioid substitution treatment (POST)) 2018-2022) spanning 2011-2022. We compared the self-reported substance use data for opioids, benzodiazepines, amphetamine/methamphetamine (AMP/MET), and cocaine with urine drug results. We compared the positive predictive value (PPV), false omission rate (FOR), sensitivity, and specificity between (i) different drugs; (ii) by sex, and (iii) age group at enrollment in each phase of the study using self-reported substance use at baseline and retrospective electronic health record data on urine drug screenings collected over the same time period. Results: Overall, the average PPV and FOR for any drug across all phases was 80.7 % and 37.9 %, respectively. Sensitivity and specificity were highest for cocaine and lowest for benzodiazepines. We found no specific trend by sex. Lastly, we found a higher sensitivity for opioids and AMP/MET in those under 25 years of age compared to other age groups. PPV increased over time for benzodiazepines, AMP/MET and cocaine and FOR was higher during the pilot and POST phases than the GENOA phase. Conclusion: Our study highlights the unique challenges associated with ascertaining substance use behaviour for individuals receiving MOUD, indicating many patients will accurately report substance use while others do not. It is therefore important to consider the context of the patient, and the type of the co-substance used to select patient-centred testing as indicated. Therefore, the answer to the question of do we need urine drug screen is yes in some cases.

Indexed as

Medication assisted treatmentOpioid use disorderSensitivitySpecificityUrine drug screens

Identifiers

PMID39723346
PMCPMC11667632

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.