@article{ref1,
title="Opioid and cocaine use among primary care patients on buprenorphine-self-report and urine drug tests",
journal="Drug and alcohol dependence",
year="2018",
author="Bagley, Sarah M. and Cheng, Debbie M. and Winter, Michael and Alford, Daniel P. and LaBelle, Colleen and Walley, Alexander Y. and Samet, Jeffrey H.",
volume="192",
number="",
pages="245-249",
abstract="BACKGROUND: Urine drug tests (UDTs) are recommended to monitor patients treated for opioid use disorder in primary care. The aims are to (1) estimate the frequency of self-report and UDT results of opioid and cocaine use and (2) evaluate the association between treatment time with non-disclosure of opioid or cocaine use and having a positive UDT. <br><br>METHODS: We conducted a retrospective review of patients enrolled in a primary care-based buprenorphine program between January 2011-April 2013. We describe three clinical visits types: no disclosure of opioid/cocaine use and positive UDT; disclosure of opioid or cocaine use and a negative or positive UDT; and no disclosure of opioid or cocaine use and a negative UDT. We fit generalized estimating equations logistic regression models to evaluate whether treatment time is associated with non-disclosure of opioids or cocaine use and a positive UDT. <br><br>RESULTS: Among all UDT results (n = 1755) from 130 patients, 10% were positive for illicit opioids and 4% for cocaine. Among UDTs with illicit opioid or cocaine positive results, in 57% and 76% of these scenarios, the patient did not disclose. The odds of non-disclosure and having a positive UDT was higher in the first 180 days for opioids and 90 days for cocaine. <br><br>CONCLUSION: Among primary care patients treated with buprenorphine, a small but substantial percentage of UDTs were cocaine or opioid positive. As treatment time increased, non-disclosure was less common but persisted even after six months. Among primary care patients treated with buprenorphine, UDTs contribute information to optimize clinical care.<br><br>Copyright © 2018 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2018.08.010",
url="http://dx.doi.org/10.1016/j.drugalcdep.2018.08.010"
}