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February 28, 1977

Urine Screens in Monitoring Methadone Programs

Author Affiliations

Bureau of Laboratories Pennsylvania Department of Health Philadelphia

JAMA. 1977;237(9):869-870. doi:10.1001/jama.1977.03270360031004

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To the Editor.—  The recent SPECIAL COMMUNICATION by Gottheil, Caddy, and Austin entitled "Fallibility of Urine Drug Screens in Monitoring Methadone Programs" (236:1035,1976) presents a number of points that deserve serious comment. In general, it appears that the investigators were not completely informed concerning the operation of urine drug testing programs and the agencies that regulate this clinical laboratory activity. This letter is intended to clarify and augment the data presented in their article.The first item that requires elucidation relates to government proficiency testing and regulation of laboratories offering urine drug analysis services. Although it is true that the federal Center for Disease Control (CDC) proficiency testing program has no provisions for preventing laboratories that perform unsatisfactorily in proficiency testing from conducting these analyses, the authors do not mention, and are perhaps unaware, that many state health departments also conduct proficiency testing in their respective jurisdictions and use such