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Demystifying Urine Drug Testing: Using Case Studies and Reviewing Guidelines for Controlled Substance Monitoring

Expires October 25, 2020


Video length: 53 minutes



Pain is one of the most common reasons people seek care, and it affects more Americans than diabetes, heart disease, and cancer—combined. Treatment is subjective as pharmacological interventions use opioids and other controlled substances, and treatment options involve empirical adjustments based upon observed clinical outcomes, including the presence of adverse drug reactions. Addiction and diversion of medications are also growing problems and key concerns for clinicians. Therefore, urine drug testing has been recommended by multiple clinical practice guidelines for use in the management of patients. This program will discuss the limitations of each type of urine test, discuss metabolic pathways of opioids, present urine drug-testing case studies to facilitate understanding and interpretation of test results, and provide the latest laboratory medicine practice guidelines on testing for controlled substances.



Upon completion of this activity, participants should be able to:

  • Discuss the clinical utility and limitations of urine screening assays and definitive tests for drugs of abuse and opioids.
  • Identify the challenges of correctly interpreting urine drug-testing results and define the metabolic profiles of common classes of pain-management medications.
  • Assess the role of adulterant/specimen validity testing and the use of alternative specimen types.
  • Discuss the AACC/AAPM-endorsed Laboratory Medicine Practice Guidelines (LMPG) on using clinical laboratory tests to monitor drug therapy in pain-management patients.


Intended Audience

This session is intended for clinical pathologists, clinicians, residents, fellows, and laboratorians.



Image of Paul Jannetto, Ph.D. Associate Professor of Laboratory Medicine and Pathology, Division of Clinical Biochemistry, Mayo Clinic, Rochester, MinnesotaPaul Jannetto, Ph.D.
Associate Professor of Laboratory Medicine and Pathology
Division of Clinical Biochemistry
Mayo Clinic, Rochester, Minnesota




Level of instruction




The following types of credit are offered for our Virtual Lecture programs:

State of California
State of Florida

To obtain credit:

  1. Watch the video.
  2. Complete the posttest and evaluation that launches immediately following the video.
  3. Generate and print your certificate.



Mayo Medical Laboratories is approved as a provider of continuing education programs in the Clinical Laboratory Sciences by the ASCLS P.A.C.E. ®program. This program has been approved for a maximum of 1 P.A.C.E® contact hour.

State of California

Mayo Medical Laboratories is approved as a Continuing Education Accrediting Agency for Clinical Laboratory Sciences for State of California. This program has been approved for 1 contact hour.

State of Florida

Mayo Medical Laboratories is approved as a Continuing Education Accrediting Agency for the clinical laboratory sciences for the State of Florida. Florida Board of Clinical Laboratory Personnel has designated this program for Clinical Chemistry/UA/Toxicology credit. This program has been approved for 1 contact hour.

National Physician Payment Transparency Program

Mayo Medical Laboratories is not an applicable manufacturer or applicable group purchasing organization (GPO). (GPOs, per the Centers for Medicare & Medicaid Services, and this program do not trigger any reporting requirements pursuant to Open Payments [Sunshine Act] legislation.)

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This post was developed by our Education and Technical Publications Team.