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New Evidence Points to a "Profits Over Efficacy" Approach to Drug Testing
Date:2/15/2012

SACRAMENTO, California, February 15, 2012 /PRNewswire/ --

It has become common for people with chronic pain who use opioid pain medication to be required to submit to random drug screens as a condition of treatment.  The rationale for the use of this billable procedure is to prevent and reduce opioid associated morbidity and mortality.  However, there remains insufficient evidence as to the efficacy of drug testing people with chronic pain.      

A new article entitled "Profit-Driven Drug Testing" published today in the Journal of Pain & Palliative Care Pharmacotherapy suggests that drug testing may have also been motivated by money.

"The paper takes a retrospective look at drug testing and presents Medicare data which shows a meteoric climb in drug screens," explains report author Mark Collen, a patient advocate.  "I was very surprised when I saw the numbers, which shows that between 2000 and 2009 the number of all Medicare laboratory services increased by about 48%, while the number of drug tests conducted in physicians' offices increased over 3,000,000%."  

The article provides evidence which suggests doctors made as much as $200 per screen and that Medicare identified and closed the drug testing profit center.  In addition, the paper looks at clinical laboratories whose primary business is to provide toxicology screens for people on opioid therapy and their alleged kickbacks to physicians.

Mark Collen is one of a few in the literature to question the use of drug screens for people with chronic pain.  In 2009, Collen wrote an article published in The Journal of Law, Medicine & Ethics entitled "Opioid Contracts and Random Drug Testing for People with Chronic Pain - Think Twice."  A second article followed in 2011 entitled "The Fourth Amendment and Random Drug Testing of People with Chronic Pain" published in the Journal of Pain & Palliative Care Pharmacotherapy.  While interviewing a physician for a possible third article, Mr. Collen was told that doctors would likely conduct fewer drug screens as a result of Medicare having changed their reimbursement rules.  

"He explained to me that physicians were charging Medicare around $225 per test but now could only bill them at $20, and that doctors would have less incentive to drug test their pain patients," says Collen.

Collen began to search for evidence to support or refute these claims and the results are published in the Commentary article. "The lesson remains the same," Collen says, "profit-driven healthcare will always be inferior to evidence-based medicine."  

According to the Institute of Medicine, chronic pain affects 116 million American adults and costs the US economy approximately $600 billion per year. Mark Collen is a patient advocate and founder of PainExhibit.com.  His focus is on improving pain care and reducing the healthcare costs associated with chronic pain.

The Journal of Pain & Palliative Care Pharmacotherapy is published by Informa Healthcare.  


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SOURCE Journal of Pain & Palliative Care Pharmacotherapy
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