“Using a patient’s positive test result for ethyl sulfate, I was able to talk with her and learn she was using alcohol to cope with some emotional issues in her life. Now I can monitor her more specifically with this information in mind and provide care to address the other concerns that were driving her toward alcohol consumption.”

Leveraging Definitive Testing to Overcome Adherence Barriers in the Treatment of Individuals with Co-occurring Substance Use Disorder and Mental Illness

Providers at Unity Health – Clarity Health & Wellness in Searcy, AR, are monitoring many aspects of their patients mental, physical, and social health to help inform decisions regarding toxicology testing. Sarah Ramsey is a psychiatric Nurse Practitioner, and her patients sometimes exhibit behaviors consistent with non-adherence, prescription abuse, diversion, and non-prescribed medication use. The behaviors manifest as relationship issues, job performance struggles, and other expressions of a non-effective treatment plan. Definitive testing has been able to clarify why this is occurring in many cases and allow Sarah to have open conversations with her patients.

Aegis’s BioDetect analysis has been helpful in promoting patient honesty as well. In follow-up to Not Expected BioDetect results (which can indicate sample substitution with synthetic urine), Sarah circles back with the patient to let them know their sample “had a problem” in hopes this will open the door for them to share more.

Another area where definitive testing has been particularly helpful is in differentiating amphetamine and methylphenidate ingestion. Sarah treats multiple patients with attention deficit and hyperactivity disorder (ADHD) and understanding whether they are ingesting the prescribed medication and not ingesting non-prescribed or illicit substances is essential for safe prescribing.

Sarah described a particularly complex patient with a strong history of non-adherence. He has baseline psychosis with exacerbations that align with substance use. He was previously prescribed clozapine, but due to non-adherence, his treatment was not successful. This documented non-adherence based on definitive test results helped justify the need for long-acting injection therapy with paliperidone.

 Whether patients come into the practice with known addictions or information comes to light later in their care because of definitive testing, Sarah is ready to address emerging issues with the objective data provided in the results. “Using a patient’s positive test result for ethyl sulfate, I was able to talk with her and learn she was using alcohol to cope with some emotional issues in her life. Now I can monitor her more specifically with this information in mind and provide care to address the other concerns that were driving her toward alcohol consumption.”

Sarah Ramsey, Nurse Practitioner
Unity Health – Clarity Health & Wellness provides outpatient behavioral health services.