The opioid crisis has put significant strain on the healthcare system and resources, including the clinical laboratory which has seen significant increases in requests for urine drug screening. Setting up and selecting tests for urine drug screening can be challenging even for experienced laboratories. Many labs rely on a screen and confirm approach, combining immunoassay screens with definitive mass spectrometry analysis. However, selection of appropriate tests and cutoffs depends on the patient population and type of service. In addition, interpretation of this testing can be very challenging as laboratory staff and clinicians require knowledge of drug metabolism, drug windows of detection and analytical detection and performance. In this presentation, Dr. Boyd will give an overview of options for opioid testing including immunoassay and MS testing, and the interpretive challenges of each. She will also show how her lab has changed their urine drug screen workflow to address the challenges of the opioid epidemic.

Learning Objectives:

1. Discuss the impact of the opioid crisis on the clinical laboratory

2. Discuss important factors in setting up a urine drug screening program

3. Compare available techniques for urine drug screening for opioids and challenges in interpretation