Poppy Seeds Signal Limitations of Urine Drug Testing Protocols

Appropriate care for patients with chronic pain is complex, requiring a thoughtful and holistic approach to pharmacologic intervention, as well as appropriate monitoring when opioids are employed as part of a multimodal regimen. The urine drug test has become an expected standard when longterm opioids are prescribed, but it should be remembered that this test is not intended to be punitive. It is ordered to promote patient safety (Dowell et al., 2022). Recent literature and events surrounding the effect of poppy seeds on urine drug test results have drawn attention to the risks of misinterpreting this test (Bloch, 2023; Lewis et al., 2021; Reisfield et al., 2023; Temple, 2023). Misinterpretation of urine drug tests creates a potential for unfounded accusations from health care workers toward patients, thus, undermining therapeutic relationships and intensifying stigma. Such circumstances may also preclude chances to offer patients needed interventions. Therefore, a valuable opportunity exists for nurses to mitigate untoward consequences by developing a robust understanding of urine drug testing, destigmatizing chronic pain and opioid use, advocating for patients, and enacting change at both an individual and a systems-level. (c) 2023 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Automated summary

Appropriate care for patients with chronic pain requires a comprehensive approach to medication intervention and monitoring when opioids are used. The urine drug test is a standard practice for long-term opioid prescription, but it should be viewed as a means to promote patient safety rather than punishment. Recent discussions on the impact of poppy seeds on urine drug test results highlight the risk of misinterpretation, which can lead to baseless accusations, undermine therapeutic relationships, and intensify stigma. Nurses have an opportunity to mitigate these consequences by understanding urine drug testing, reducing discrimination against chronic pain and opioid use, advocating for patients, and driving change at both individual and system levels.