Though drug testing has been an integral part of American substance use disorder care since the early 1970s, the practice was not based on any evidence for improved patient-centered outcomes. During the past half century, profound harm has been done to patients by these laboratory tests, their inaccuracies and misinterpretations, and their negative consequences including discharge from life-saving care. If we are to fulfill a harm reduction approach, we must ask if drug testing is ethically compatible with its principles.
Learning Objectives:
Learners will be able to:
Describe the chronology of drug testing and how it was integrated early on into standard care for substance use disorders.
Explore the impact of drug testing on patients through their direct accounts.
Compare the evidence for patient-centered harms and benefits of drug testing.
Evaluate principles of harm reduction and low-threshold care and their compatibility with routine drug testing as currently recommended and required.
