Mental Health Monthly #7: Urine Toxicology in the ED

<p><span style="font-weight: 400;">This episode of Mental Health Monthly we will be discussing drugs screens in the Emergency Department with Dr. Justin Romano and Eddie Carillo. Dr. Justin Romano is a current psychiatry resident and Eddie Carillo is a licensed mental health therapist. Check out their podcast <a href= "https://www.buzzsprout.com/711825">Millennial Mental Health Channel</a> on all major podcast platforms. Shout out to Dr. Dave Marshall whose grand round presentation this was based on. </span></p> <p><strong>Key Points: </strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Try not to judge your patient based on the results of their drug screen </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Drug screens are used a lot; they are not always accurate </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Based on one study there was no significant change in outcome, treatment, disposition or psychiatric course when a drug screen was obtained </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Specific good uses for drug screens include new onset of psychiatric symptoms </span></li> </ul> <p><strong>Educational Pearls: </strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">1 in 8 ED visits are due to psychiatric complaints which is up 44% since mid 2000’s </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">63% of new psychiatric complaints had a medical cause </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Physicians use drug screens commonly in the Emergency Department, but often do not understand their limitations and are often not using them in the most clinically effective manner </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Urine is by far the most commonly used in the Emer