• Michael B Ward, Sarah A Hackenmueller, Frederick G Strathmann, and Education Committee of the Academy of Clinical Laboratory Physicians and Scientists.
• From the Department of Pathology, University of Utah, Salt Lake City, UT.
• Am. J. Clin. Pathol. 2014 Nov 1;142(5):586-93.

ObjectivesCompliance testing in pain management requires a distinct approach compared with classic clinical toxicology testing. Differences in the patient populations and clinical expectations require modifications to established reporting cutoffs, assay performance expectations, and critical review of how best to apply the available testing methods. Although other approaches to testing are emerging, immunoassay screening followed by mass spectrometry confirmation remains the most common testing workflow for pain management compliance and drug abuse testing.MethodsA case-based approach was used to illustrate the complexities inherent to and uniqueness of pain management compliance testing for both clinicians and laboratories.ResultsA basic understanding of the inherent strengths and weaknesses of immunoassays and mass spectrometry provides the clinician a better understanding of how best to approach pain management compliance testing.ConclusionsPain management compliance testing is a textbook example of an emerging field requiring open communication between physician and performing laboratory to fully optimize patient care.Copyright© by the American Society for Clinical Pathology.

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