Module 12: Lab Testing in Assessment of Substance Use Disorders

Note: Following this module’s development, we were given approval to change the term “Medication Assisted Treatment (MAT)” to “Medications for Addiction Treatment (MAT)” or “Medications for Opioid Use Disorder (MOUD). ” We support this change and have begun to implement throughout our educational trainings, resources and website as we move forward.

Presenter: Kevin A. Sevarino, MD, PhD | Associate Clinical Professor, Yale University School of Medicine; President-Elect American Academy of Addiction Psychiatry

Cost:  No Fee

Target Audience:  Physicians, nurses, and healthcare teams who are treating patients with substance use disorder (SUD).

Core Competencies as a result of participating in this activity:   
Interpersonal Skills and Communication 
Medical Knowledge 
Patient Care

Module Description: Lab testing in the assessment of substance use disorders may involve many different substrates, though urine drug testing (UDT) dominates clinical practice.   This module is meant to provide a short guide to effective use of lab testing in treatment of the patient with a substance use disorder, which to a surprising degree is often misused or misunderstood.  The module describes the clinical role of lab testing to guide treatment and not to be punitive.  To properly use and interpret UDT, it reviews common false positive and false negatives that might occur in the immunologic-based first step in UDT.  To understand confirmatory gas chromatography/mass spectrometry, it goes on to describe the metabolism of common opioids and benzodiazepines, because the detected confirmed moiety often is just a downstream metabolite of several possible parent compounds to which the patient was exposed.  The module concludes with a discussion of the difference between UDT for clinical purposes versus forensic ones.

Educational Objectives 
At the conclusion of this activity participants should be able to:

  • Discuss clinical issues in performing urine drug testing (UDT).
  • Describe the basic types of UDT and when they should be used. 
  • Define the metabolism of opioids and benzodiazepines in order to interpret UDT results. 
  • Describe other laboratory testing used as part of substance use disorder evaluations

Method of participating in the learning process

In order to receive maximum credit, learners must: 

1. Review the materials provided in this module.
2. Earn a minimum cumulative score of 80% on the post-test. 
3. Complete an evaluation to assess satisfaction and plans for individual and/or team practice change.
4. Follow instructions at the end of the course regarding how to retrieve a certificate.* 

*Credit will not be awarded unless all components of the program are completed.  Partial credit will not be awarded.

Accreditation and Certification of this activity

imageJoint Accreditation Statement

In support of improving patient care, American Academy of Addiction Psychiatry is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

In 2019, AAAP also added accreditation from The American Academy of PAs (AAPA), American Psychological Association (APA) and Association for Social Work Boards (ASWB).

Release Date: July 26, 2019                               Date of Expiration: July 26, 2022

imageInterprofessional Continuing Education (IPCE) Designation Statement 

This activity was planned by and for the healthcare team, and learners will receive 1 Interprofessional Continuing Education credit for learning and change.

Physician Designation Statement 

American Academy of Addiction Psychiatry designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Nursing Designation Statement

American Academy of Addiction Psychiatry is an approved provider of nursing continuing education through AAAP's Joint Accreditation provider #4008192. This program is approved for up to 1 Nursing Contact Hour.

Disclosures:

AAAP's interprofessional continuing education program aims to provide educational information that is balanced, independent, objective and free of bias and based on evidence. During the planning process, anyone that is involved in the content is required to disclose to AAAP and our learners any real or potential conflict of interest related to the educational activity. The following individuals have no relevant financial relationships with an ACCME defined commercial interest to disclose: Thomas Penders, MD, Michael Goedde, MD, Nitigna Desai, MD, Karen Oliver, PhD, John Renner, Jr, MD, Kevin Sevarino, MD, PhD, Kathryn Cates-Wessel, Miriam Giles, Carol Johnson, Jennifer Lundstrom, and Justina Pereira.  PCSS Clinical Expert Committee members and content reviewers David Fiellin, MD, Michelle Lofwall, MD, Larissa Mooney, MD, and Colleen LaBelle, MSN, RN-BC, CARN, have nothing relevant to the content of this module to disclose. Content Developer Kevin A. Sevarino, MD, PhD, has nothing to disclose. 

Faculty have been advised that any recommendations involving clinical medicine must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in the presentation must conform to the generally accepted standards of experimental design, data collection, and analysis. Learners are advised that this activity may contain references to unlabeled uses of US FDA-approved products or to products not approved by the FDA for use in the United States. In these instances, participants will be made aware of such usage and discussions regarding either non–FDA-approved or investigational use of products/devices.

ADA Accommodation Statement 

AAAP encourage persons with disabilities to participate in our programs and activities. If you anticipate needing any type of accommodation or have questions about this activity, please email pcss@aaap.org.

Privacy and Confidentiality Policy 

AAAP values your privacy and confidentiality of the information you choose to share with us. Personal information collected from evaluations will not be shared with third parties. 

Disclaimer: The views, opinions, and content expressed herein do not necessarily reflect the views or policies of AAAP, CSAT, SAMHSA, or HHS. No official support of or endorsement by AAAP, CSAT, SAMHSA, or HHS for these opinions or for particular instruments, software, or resources is intended or should be inferred.

Support for the Program: 

Funding for this initiative was made possible (in part) by grant no. 5U79TI026556 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Key:

Complete
Failed
Available
Locked
Online Module Pre Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass Please answer the following pre-test questions to the best of your ability. These will serve only as a brief assessment of prior knowledge before accessing the training. A passing score is not required in order to advance in the course.
Presentation Recording
Open to view video.
Open to view video. You must access this entire recorded module to attest that you have viewed the presentation in its entirety. Note: by viewing the full presentation it will unlock and allow you to proceed to the post-test.
Online Module Post Test
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass Please answer the following questions to the best of your ability. NOTE: In order to receive your certificate, you must earn a score of 4 out of 5 on this post-test. Upon passing the post-test, you will be directed to complete an evaluation.
Evaluation
Upon completion of this modules post test, please complete the evaluation survey to end this course and obtain your certificate. Note: Upon completion of this evaluation, you will receive a verification code noted on the last page of the survey. Please enter that verification code in the component below to claim your certificate.
Verification Code
Enter code to continue.
Enter code to continue. Enter the verification code provided at the end of the evaluation to access your certificate for this course.
I am an MD or DO and would like a CME Credit Certificate
1.00 (one) credit  |  Certificate available
1.00 (one) credit  |  Certificate available Certificate for AMA PRA Category 1 Credit(s)™
I am not an MD or DO and would like a CME Credit Certificate
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1.00 (one) credit  |  Certificate available Certificate for AMA PRA Category 1 Credit(s)™
I am an RN or NP and would like a Nursing Contact Hour Certificate
1.00 (one) Nursing credit  |  Certificate available
1.00 (one) Nursing credit  |  Certificate available Certificate for Nursing Contact Hour(s)
I would like an Interprofessional Continuing Education Credit Certificate
1.00 (one) IPCE credit  |  Certificate available
1.00 (one) IPCE credit  |  Certificate available Certificate for Interprofessional Continuing Education (IPCE) credit