Stimulant Verification?

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prominence

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Does anybody routinely order periodic urine drug testing for patients on stimulants to verify if they are taking the medications (especially for college age students who may be tempted to sell their meds)?

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whopper

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I order tests, but it depends on several factors as to how often.

Guy with a criminal record, showing impulsivity and antisocial traits, I tend to order them more. (In fact patients with a high risk background, I only give them stimulants if they tested (+) for ADHD on psychological testing that is difficult to fake the results such as a TOVA test, they got an EKG, and tried at least one medication for ADHD that is not a stimulant such as Wellbutrin). Guy with ADHD, doing well in school, no criminal record, and seemingly trying to do his best, I tend to order them less.

In Ohio, there's something called OARRS. It allows a doctor to find out every single medication a patient is receiving from every single doctor in the state. If a patient is on more than one medication of possible abuse from multiple doctors, unless they are all different meds being prescribed appropriately, I tell them they can no longer be my patient.

I put all my Suboxone patients on drug screens and OARRS routinely unless they've showed successful treatment and a desire to continue to do well for several months. Then after that, I still do it, but instead of monthly, I may drop it to every few months, possibly even less depending on how well they did and their progress.
 
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