The Levy et al article1 on adolescent physicians' knowledge of the practices of screening for drug abuse is timely. We have long felt that practicing physicians' knowledge of drug testing has not recognized the technical and ethical issues involved.2 In our experience, clinical testing for drug abuse does not follow the policies and procedures outlined for federal workplace testing. In fact, most hospital laboratories do not have established policies for validation of specimens and many do not have the ability to perform confirmatory testing, which in federal testing requires gas chromatography/mass spectroscopy. We disagree with the blanket statement of Levy et al that urine drug screenings do not detect oxycodone and ecstasy (3,4-methylenedioxymethamphetamine). The ability to detect these substances depends on the cross-reactivity of the particular immunoassay used. The technology for immunoassays is continually evolving and many of the currently used assays do, in fact, detect these substances. Physicians who order drug screens can review the package inserts provided to the laboratory by the manufacturer of the immunoassay to determine the sensitivity of the assay for detecting oxycodone, ecstasy, and other specific substances.3 Another important question, which the authors did not address, is whether the physicians obtain informed consent before performing laboratory screening for drug abuse.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and
Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early
dhildhood mortality and growth failure data and their association with maternal
Thank you for submitting a comment on this article. It will be reviewed by JAMA Pediatrics editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.