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February 28, 1977

Urine Screens in Monitoring Methadone Programs-Reply

JAMA. 1977;237(9):870-871. doi:10.1001/jama.1977.03270360031005

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Shoemaker and Sideman apparently feel that we were overly severe in our appraisal of the fallibility of urine drug screens. They recommend that those seeking laboratory services select facilities with established reputations for excellence and require information regarding their scores on proficiency tests. Furthermore, they point out that several states have established licensing, approval, and regulatory procedures which go beyond and are more effective than those of the CDC. Actually, the laboratories evaluated in our study had excellent reputations, received consistently outstanding CDC ratings, and were situated in one of the states they mentioned. Even under these circumstances, the level of accuracy obtained was entirely unacceptable. What level of accuracy should we expect, then, from laboratories of lesser reputation situated in less regulated states?

They suggest that on-site proficiency testing to observe how samples are analyzed approaches "blind testing" in effectiveness. At the same time, they have no