The Need

Although drug testing occurs in nearly every addiction treatment setting, there is a lack of evidence-based guidance regarding test frequency, test interpretation, and which drugs to test for. Drug testing practices vary widely.

Drug testing has been referred to as “the technology of addiction treatment,” but like any technology, its value depends on whether it is utilized correctly. Inappropriate testing practices can alienate or traumatize patients, produce inaccurate results, and pose risks to patient safety.

The inappropriate use of drug testing not only compromises clinical care, but it opens the door to fraud, which can have extraordinary costs to third party payers, taxpayers, and at times the patients who are receiving care.

The Solution

In collaboration with the American Society for Addiction Medicine, IRETA developed an Appropriateness Guide describing drug testing practices that are supported by empirical evidence and clinical expertise. One of the purposes of this document was to clarify appropriate clinical use of drug testing and, in so doing, shine a light on drug testing practices that are clearly outside of these boundaries.

To determine appropriate clinical practices, IRETA utilized the RAND/UCLA Appropriateness Method, which has a higher level of methodological rigor than consensus methods.

IRETA also provided technical assistance for disseminating the document and creating supplemental educational tools.

The Results

The document was approved by ASAM’s Board of Directors in 2017. A summary of the recommendations are available in the Journal of Addiction Medicine, and the full consensus document can be found online.

View a summary of the recommendations published in the Journal of Addiction Medicine

Access the full appropriateness document


After the completion of the Drug Testing document, ASAM engaged IRETA to develop a clinical guideline on the management alcohol withdrawal.