Embarrassing, degrading, or beneficial: Patient and staffperspectives on urine drug testing in methadonemaintenance treatment

摘要

Urine drug testing is a routine, but debated and contentious procedure in methadone maintenancetreatment (MMT). Largely overlooked in the debate are the perspectives of patients and clinical staffabout this procedure. Using semi-structured interviews (n = 64) with MMT patients and clinicalstaff at four programmes, we explore their attitudes and perceived implications for treatment. Wedocumented varied urinalysis practices by site and with considerable disagreement regarding itsemotional impact and therapeutic value. Among patients, comments about urine drug testing variedfrom degrading to ambivalence to acceptance as a necessary component of treatment. Staff memberswho supported urinalysis and described it as beneficial stated that it provided a point of entry intopatients' lives and helped to identify possible barriers to recovery. Others believed urinalysis impededthe development and maintenance of an effective therapeutic alliance. Lack of strong empiricalevidence demonstrating improved patient outcome related to urine drug testing suggests that thisprocedure should be determined based on individual patient goals.