In summary, pain management clinicians have become a significant driver and utilizer for laboratory toxicology testing. Screening and confirming opiates, and other drugs, in the urine of patients being prescribed analgesics has become very common. The abuse of prescription medications (specifically opiates), is a serious and growing problem. The laboratory can play a vital role in assessing the compliance of patients and in assisting clinicians in their management of PM patients. Because many physicians who practice PM are not trained in toxicology or even PM (and are often only primary care physicians learning PM as they go), they often need help interpreting laboratory results. The laboratorian can provide a key service to clinicians in primary care, PM, and addiction medicine if they are able to:
- Explain their screening assay's performance and cross reactivities
- Help make sense of results given the prescription of the patient
- Identify adulterated samples
- Answer routine questions about what services and which drugs the laboratory can detect and not detect.
The laboratorian should take an active role supporting their PM clinicians. When a knowledgeable toxicology technologist is found, clinicians will quickly look to such a person as a vital reference and resource. Such recognition helps to elevate one's scope of practice, self-esteem and the practice of laboratory medicine.