OTP 9: Toxicology Testing for Continued Drug Use

Toxicology specimens are obtained:

1. with respect for individual privacy;
2. in a safe treatment atmosphere;
3. randomly; and
4. in a manner that minimizes the possibility of falsification.

After the individual's initial admission test, the timing and frequency of toxicology testing is clinically appropriate for each individual, and the opioid treatment program conducts:

1. at least eight random drug tests per service recipient, per year;
2. at least one initial and two subsequent tests for individuals in interim maintenance treatment; and
3. tests, as appropriate, during medically supervised and other types of withdrawal.

Toxicology testing practices include, and are not limited to:

1. informing individuals about how specimens are collected and of their responsibility to provide a specimen when asked;
2. discussing positive toxicology results with the individual;
3. providing counseling, medical review, and other interventions if the person continues to test positive for illegal substance use;
4. methods to minimize falsification during the drug testing sample collection;
5. a process for reviewing false-positive and false-negative results; and
6. documenting results in the case record along with the person’s response.

Following the receipt of toxicology test results, the organization:

1. evaluates negative reports for opioid treatment medication and related metabolites;
2. reviews dosage when positive toxicology reports for drugs are received;
3. investigates the possibility of false positive results when individuals deny drug use;
4. rapidly responds if the individual is found to be in danger of relapse; and
5. uses the results to determine the need for additional interventions.