Drug testing is disliked by many people in treatment for opioid use disorder. So why and how does Workit Health use urine drug screens?
Even once they realize they might need treatment for opioid use disorder, there are a lot of reasons why people put off getting that support. Some of these are logistical (like finding a provider and navigating insurance claims), while others are more personal and emotional. Fears and misconceptions are often among these personal barriers, discouraging people from seeking the help they need. Today, I want to talk about one of the personal barriers that crops up a lot: dislike of drug testing or drug screens.
You might not be surprised to hear that many people dislike or fear taking drug screens (most people say “drug tests”). Some people find drug screens invasive, or it can make them feel judged or infantilized. Others just find it inconvenient and annoying. While these feelings are valid, regular drug screens are part of nearly every clinical program that treats opioid use disorder, including Workit Health. I hope this post helps to clarify how and why Workit Health uses drug screens, so anyone who has concerns can feel more confident if they need to complete a drug screen with us.
Workit Health is a harm reduction-based program, so why does it require urine drug screens?
Workit Health is based in harm reduction, which means we encourage positive steps toward recovery, rather than requiring abstinence or punishing people for using substances. Since that is the case, some people are confused about why we require drug screens. There are several reasons to include drug screens in a treatment program for opioid use disorder. Here are some of the reasons that Workit Health requires urine drug screens for our members:
- Your provider needs to know what substances are in your system in order to safely prescribe to you. Whether your clinical treatment for opioid use disorder includes a buprenorphine/naloxone medication like Suboxone or relies on naltrexone, there can be dangerous medication interactions with other substances. While ideally, our members would tell their providers about other drugs they take, not all of them do. Sometimes that’s because of fear. Sometimes it’s because they’re not certain what other substances they’ve used, so they can’t accurately tell their provider. Urine drug screens make sure that your provider knows what other substances are in your system, so they can help you understand possible drug interactions and can adjust your treatment if needed. This is not intended as a “gotcha,” and we are committed to never shaming or judging our members for their use. Instead, it’s a tool that gives your provider important information.
- It’s important to confirm that you’re taking your Suboxone (buprenorphine/naloxone) correctly. At Workit, we use a multi-drug screen that includes a panel for the metabolites of buprenorphine—the compounds that your body processes buprenorphine into. If those compounds aren’t present (or are only present in small amounts) in a member’s urine, it can be a sign that they’re not taking their medication correctly. For example, it’s pretty common for people not to realize at first how important it is to fully dissolve the medication in their mouth, rather than swallowing it. Suboxone (buprenorphine/naloxone) would mean that they’re more likely to feel cravings and uncomfortable withdrawal symptoms. After seeing their screen results, their provider will make sure they know how to take their Suboxone (buprenorphine/naloxone) so they can get the benefits of it.
- Drug screening is legally required in many places for those taking buprenorphine for opioid use disorder. Buprenorphine is a controlled substance, and we have an ethical and legal obligation to make sure that it’s not being diverted. If a member has a negative result for BUP, their provider will follow up and may require additional screening. If a member is not taking their buprenorphine/naloxone, we cannot continue to prescribe it to them.
Workit Health is a virtual program. How does online drug screening work?
Workit innovated at-home drug screening. We mail out screening supplies to our members at no additional cost, and we offer two options for submitting your urine drug screen in the app. For either option, you’ll need:
- a device with a camera and access to the internet
- a permanent marker
- an unopened screen/test (We ship the right kind to our members. If you don’t have one for some reason, send us a chat, and we can help you choose one from a local store.)
- a clean container for your sample
Workit Health’s two screening options are:
- Video drug screening: Video drug screening is available during your clinic’s open screening hours and can be accessed through the mobile and web versions of the Workit Health app. In the app, you’ll enter a private waiting room until a member of the care team is available. Once a member of the care team is free, they’ll admit you to a secure, private video room. You’ll show them your sealed, new drug screen on camera, and then go off-camera to a private space to collect your sample. Then you’ll get back on camera to complete the screening and review your results with them. This is a judgment-free process. The care team member is there to make sure you get the care you need and to help you navigate the process of taking a urine drug screen.
- Automated drug screening: Automated drug screening is available 24/7, only through the mobile app. You’ll log in and enter the automated drug screening tab. You’ll be prompted to prepare your screening materials, label them properly, complete the screening, and clearly photograph the results. Because there will not be a care team member on the line with you, you will take several photos throughout the process (including showing yourself with the screen), and there is a strict time limit. Workit Health staff will later review your screen submission to verify your results, and they’ll be in touch if there are any issues with your photos or with viewing your results.
For either option, your provider may ask you to retake a drug screen that shows unexpected results.
It’s understandable if you don’t like taking drug screens. But I hope this look at how and why Workit Health uses urine drug screens takes some of the worry out of them. Drug screens are just a tool that helps us provide the best care to our members.