Few benefits, likely harms: against universal random urine drug screening in pain management.

Abstract

There are three reasons why we oppose universal mandatory random urine drug screening (RUDS) in chronic pain management [1]. First, there is extremely weak evidence supporting its efficacy. Second, whatever purpose is meant to be accomplished via such screening can already be accommodated via the informed consent process. Third, such screening carries a significant likelihood of stigmatizing already disadvantaged populations. As to the first rationale, there is very little evidence demonstrating that opioid agreements improve treatment efficacy or reduce prescription drug misuse [2]. Indeed, a general Cochrane review of physician–patient contracts noted insufficient evidence upon which to “base a recommendation …