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An increasing number of doctors who treat chronic pain are requiring their patients who take opioids to submit to urine drug tests. The doctors are trying to avoid being held responsible if patients die from painkiller overdoses, The Wall Street Journal reports.

The tests can tell doctors whether patients are taking pain medications as directed, the article notes. Physicians are also asking pain patients to sign agreements stating they will not sell their medications, and will obtain prescriptions only from that doctor.

Dr. William Piechal, a pain doctor in Fayetteville, Arkansas, says when he initiated urine drug tests last year, he was shocked to find some failed tests came from patients he had been treating for more than a decade. The tests showed some patients were taking opioids he had not prescribed, or were taking illegal drugs. “This is where chronic pain treatment is headed,” he said.

The American Society of Interventional Pain Physicians endorses urine tests for all patients, and several other groups, including the American Pain Society, have endorsed drug testing for high-risk patients. At least 10 states recommend some level of urine drug testing for pain patients.

Some critics say drug testing and written agreements violate patient rights. Edward Michna, an anesthesiologist at Brigham and Women’s Hospital in Boston, who has studied urine testing in pain patients, says it is not known whether these tests decrease abuse or diversion.

Many health insurance plans cover much of the cost of the drug tests, which can run between $30 and $3,000, depending on how many drugs are screened. Some insurers do not cover any of the costs.


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