In my office, the patient testing results on the point of care drug cassette are all negative. Can I discard the rest of the urine?
No! You should submit it for more inclusive testing. The point of care tests only examine the urine for a limited number of tests. Drugs such as fentanyl, SOMA, buprenorphine and some others used and abused by pain patients cannot be found using these devices. Tests for these drugs are performed by specialized laboratories such as Millennium. In addition the cutoffs of point of care devices are higher than those obtained by the more sensitive LC-MS/MS tests. Thus patients with lower but confirmable concentrations will not be diagnosed. Finally, point of care devices can be deceived by adulterants, yielding false negative results. Often times these agents will not deceive the mass spectrometer. Thus the point of care testing is only the first step of the process to define the patient’s drug status. Further testing is recommended.
