It is estimated that 100 million Americans suffer from chronic pain.1 For many of these Americans this pain is debilitating, and powerful prescription opioids are necessary to provide relief. But as the incidence of opioid prescribing has increased, so has the incidence of misuse and abuse. According to the Centers for Disease Control and Prevention, in 2008 poisoning became the leading cause of accidental deaths in the United States — and 40 percent of those deaths involved opioid analgesics.2 Non-medical use and abuse of prescription painkillers costs insurance companies $72.5 billion each year, the CDC estimated.3

Medication monitoring (sometimes referred to as compliance monitoring) is the testing of a patients urine and/or blood to determine if that patient has taken the medication he/she was prescribed and is not taking medications or other substances that he/she was not prescribed. It not only helps physicians identify opioid abuse, but also can provide clinicians with critical insights to help them evaluate patient medication adherence and identify potentially dangerous drug-drug interactions. Further, it is a critical strategy to manage the growing national problem of medication access to medications for the patients who rely on them.

An emerging consensus among many professional organizations recommend routine and random urine drug monitoring as a part of treatment of patients on chronic opioid therapy (COT). By monitoring patients, physicians are able to gain more information about a patient’s medication use, which enables them to evaluate whether that patient might have issues with misuse, abuse or diversion, or be susceptible to dangerous drug-drug interactions.

Learn more about the body of evidence and the professional organizations that recommend medication monitoring for patients on chronic opioid therapy.


1- Committee on Advancing Pain Research, Care, and Education, Institute of Medicine, Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research, The National Academies Press, 2011, available at:

2- Centers for Disease Control and Prevention, Drug Poisoning Deaths in the U.S. 1980-2008, available at:

3- Centers for Disease Control and Prevention, Prescription Painkiller Overdoses in the U.S., available at: