POC testing

Buprenorphine Post
MChaplin
Posts: 183

Postby MChaplin » Mon Mar 31, 2014 10:21 pm

just a heads up- we used to use a lab that supplied us with poc cups until we took a closer look and realized that that probably falls into the area of "kickbacks"- if a lab supplies you with "free" cups that have an established value, and you then send all your labwork to them, then you could be considered to have accepted "payment" for referal which is a federal no no. It is unclear where the line is drawn- supplying collection cups (with no POC capacity) , baggies and shipping supplies is apparently ok because the cost of those cups (10cents a piece) is considered neglible. We have gone back and forth on observing collection- it is clearly an added expense, it is intrusive and it too can be beat- there are capsules that can be inserted for women and oinched open to provide a flow of liquid and there are prosthetic penile devices that can also be activated with a quick pinch-bottom line- if someone wants to deceive us, they can and it is naive to think you will "catch" everyone who does- we do not therefore routinely observe but if there are red flags we randomly observe so folks can't prepare- i think a confirmation should be done on all patients several times a year because the poc cups don't measure norbuprenorhine or quantify buprenorphine and it is ridiculously easy to dissove part of a film in a child's urine, keep it close to your body for warmth and then hand it in- or even quickly dip a film in your own urine if you are "skimming" your dose...in those cases the lab results will show ridiculously elevated levels of buprenorphine and little or no norbuprenorphine....but the poc cups look perfect....we have discovered one or more of our "patients" were selling after calling them out on this.

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Mar 31, 2014 10:21 pm

Thanks Guys, I also found some links in some older posts here for www.cliawaived.com (thanks jdpatz) and www.meditests.com (thanks Dr Passer).

Dr. Passer, would you have a link to where you purchase the Transmed UDS? Google can't seem to find them.

Can you give me an idea of the shelf life of these UDS tests? I am just starting and don't have any patients yet, so I don't want to order a bazillion of them and have them expire in a month. Thank you.

Signed - NoDrugs4u
I am new to this, please be gentle with me...

fishdoc
Posts: 111

Postby fishdoc » Mon Mar 31, 2014 10:21 pm

We have been sending all UDS and oral fluids to Millennium Labs. They supply us with free 12 test poc cups which we read first. Then the same cup is sealed and sent to the lab for overnight confirmation. A toxicologist is available to help review results, and I have been amazed at the number of both false positive and false negative results we get with poc testing.

Millennium accepts most insurance and will not bother patients for payment. They do send one bill, but will not persue collection.

Along similar lines the State of Ohio is considering a law requiring all UDS to be observed specimens. I fear this would require 2 employees, one male and one female just to make the observations. Comments?

drpasser
Posts: 1404

Postby drpasser » Mon Mar 31, 2014 10:21 pm

I've tried different ones, am now using the 12 panel test, split cups, from Transmed, $6.47 a piece. I go thru 100 per month. I think the BZO test is fine, but I also have single dip tests for every drug, for confirmation in case pts try and lie about using. I then present them with the two positive results, and they then almost always spill the beans.

DrBallester
Posts: 84

Postby DrBallester » Mon Mar 31, 2014 10:21 pm

I use the Alere IScreen DX

http://www.aleretoxicology.com/products/

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Mon Mar 31, 2014 10:21 pm

Would love some advice on urine drug screen test supplies. Specific brand names that are relatively inexpensive and the most accurate in everyone's experience? Thank you.

Signed - NoDrugs4u
I am new to this, please be gentle with me...

MChaplin
Posts: 183

Postby MChaplin » Mon Mar 31, 2014 10:21 pm

POC cups are only iffy for klonopin as the test is via immunoa**ay- there are some other quirks- lots of false positives for pcp (including effexor )and seroquel can show up as methadone- all in all though, we find the cups extremely helpful due to immediate turnaround- it is worth getting one that has oxycodone and methadone in addition to buprenorphine and opiates.


Return to “Clinical Use of Buprenorphine”

Who is online

Users browsing this forum: No registered users and 3 guests