Drug Misuse in America 2019
Physician Perspectives and Diagnostic Insights on the Evolving Drug Crisis

Drug Misuse in America 2019: Physician Perspectives and Diagnostic Insights on the Evolving Drug Crisis, a Quest Diagnostics Health Trends™ report presents findings from more than 4.4 million clinical drug monitoring tests nationwide against findings from a new survey of 500 primary care physicians. The de-identified aggregated tests were performed by Quest Diagnostics on patients in all 50 states and the District of Columbia between 2011 and 2018. To our knowledge, this report is the first to juxtapose insights from both nationally representative, objective de-identified laboratory data and survey responses from primary care physicians about the use of controlled prescribed medications and illicit drugs in the United States. The intersection of these two data sets reveals greater insight into the complexity of the drug misuse crisis.

To view the report click here.

To view the press release click here.

In this report, we’ll uncover the challenges and fears facing physicians today, including:

  • 83% of physicians agree that because of the opioid crisis, it is considerably harder now to treat patients suffering from chronic pain.
  • 62% of physicians fear we will be trading the opioid crisis for another prescription drug crisis.

In response to the uncertainty, physicians have identified prescription drug monitoring as part of the solution and called for additional education and training about addiction.

For clinicians, drug monitoring can provide insights into possible forms of misuse including substance use disorders, dangerous drug combinations, incomplete treatment, and/or “diversion” – instances where the prescribed drug is not found in the patient’s sample, suggesting the patient is possibly filling the prescription but may be diverting the drug to others or opted not to take it.

The intent of this and other Quest Diagnostics Health Trends reports is to provide insights based on objective laboratory data.

About Drug Monitoring Tests and Drug Misuse

Laboratory test results provide objective information that can assist healthcare providers with assessing patients’ use of prescribed medications, other controlled non-prescribed drugs, and illicit drugs.

In the case of clinical drug monitoring, a healthcare provider will order testing and indicate the drug or drugs prescribed for the patient as well as the drug tests to be performed. Quest Diagnostics categorizes test results as “consistent” or “inconsistent” based on the presence of drugs or drug metabolites identified through laboratory testing and their alignment with the prescription information provided by the healthcare provider on the test order.

An inconsistent result – suggesting possible misuse -- occurs when:

  • Additional drugs are found: all prescribed drugs are detected, but at least one other drug, non-prescribed or illicit, is also detected.
  • Different drugs are found: none of the prescribed drugs are detected, but at least one other drug, non-prescribed or illicit, is detected.
  • No drugs are found: none of the drugs prescribed for the patient are detected and neither are any non-prescribed or illicit drugs.

A non-prescribed drug refers to a drug that is a prescription drug but which was not prescribed for the patient as indicated by the healthcare provider on the test order.

Inconsistent results can reflect potential problems for the patient and the healthcare system. Drug combining, whether involving prescription or illicit drugs, can lead to dangerous drug combinations and interactions. Test results that show evidence of a non-prescribed drug likely indicate the patient is using the drug without the benefit of a physician’s oversight. Failure to take a prescribed drug may contribute to healthcare waste, ineffective treatment, and the potential for unintentional or criminal diversion.

For more information about Quest Diagnostics Drug Monitoring for clinicians, visit www.QuestDrugMonitoring.com.