Frequently Asked Questions

Prescription compliance monitoring (drug testing)

We encourage all of our providers who prescribe narcotics to monitor their patients. Below are the answers to some questions about this process. For more information, please call us at 1-800-282-7644 and ask to speak to a network representative.

Why does Summit ask physicians to administer urine screenings for prescription compliance?
Between 1990 and 2002, accidental drug-related deaths increased by 218 percent nationwide. According to a national study published in the 2006 American Journal of Preventative Medicine, Dr. Leonard J. Paulozzi and Dr. George W. Ryan found a strong correlation between this trend and the increase in opioid analgesic sales in the U.S.¹

This indicates that many patients are not taking their medications as prescribed and, even more disturbing, raises suspicions that medications are being diverted onto the street. To address this, Summit recommends that patients who are taking controlled substances for pain management be monitored for prescription compliance.

What medications are most often misused?
Both natural and synthetic opioid analgesics are in high demand as street drugs. Of drugs in this category, oxycodone and methadone are most frequently linked to accidental drug-related deaths. Slow-release formulations, such as OxyContin®, can be particularly dangerous because many users dose themselves too often or crush the pills to enhance the “high.” Vicodin® is a popular choice among young people.

Is the problem really that big?
In April 2006, the U.S. Department of Health and Human Services issued a memorandum on prescription drug abuse. Below are a few statistics from that release.²

  • The 2002 National Survey on Drug Use and Health (formerly known as the National Household Survey on Drug Abuse) reports that 6.2 million Americans ages 12 and older are current users of prescription drugs for nonmedical purposes. An estimated 4.4 million use pain relievers specifically.
  • Alcohol and prescription drug misuse may affect as many as 17 percent of older adults.

In 2007, a study was conducted using urine screen data from 470 patients at an urban teaching hospital.³

  • Of the patients tested, 45 percent had abnormal test results.
  • Most of these patients had unexpected drugs in their systems, and 14.4 percent were taking prescription drugs that their treating physician did not know about.
  • 20.2 percent were using illegal drugs.
  • 10.2 percent of those tested were not taking the appropriate prescription drug.

How do I start the testing process?
Summit has contracted with Ameritox to perform toxicology tests for our injured workers. If you would like to use Ameritox, call (214) 684-5189 or visit

Note: If you already have a prescription monitoring system in place, we appreciate your diligence and support your efforts to provide the best quality care for your patients.

What happens if a test shows that a patient is not taking medication as prescribed?
You have several options. At the very least, the patient should be counseled and continue to be monitored. You may choose to discontinue prescribing narcotics and other addictive medications. Summit discourages discharging noncompliant patients from your practice whenever possible. If you have a case you would like to discuss, please call us.

Other than investigational purposes, is there a benefit to testing?
Testing can offer excellent guidance for treatment. For instance, if the patient is shown to be taking the medication as prescribed, but yet shows no improvement, you can be confident in changing the course of therapy.

Is testing a requirement?
No. You may periodically receive reminders from Summit about testing recommendations, but compliance monitoring is always administered at your discretion.


¹ Leonard J. Paulozzi, MD, MPH, George W. Ryan, PhD. “Opioid Analgesics and Rates of Fatal Drug Poisoning in the United States.” American Journal of Preventative Medicine Volume 31, Number 6 (2006): 506-510.

² Prescription Drug Abuse, National Institutes of Health (9000 Rockville Pike Bethesda, Maryland; April 10, 2006).

³ Michna, et al. “Urine Toxicology Screening Among Chronic Pain Patients on Opioid Therapy: Frequency and Predictability of Abnormal Findings.” The Clinical Journal of Pain. Volume 23, Number 6. (February 2007): 173-179.

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