An Understanding of In-Home Drug Testing

Christopher Altman, PharmD, provides an understanding of the in-home drug testing.

Christopher D. Altman, PharmD: Chris Altman, clinical manager of Immunizations and Clinical Programs at Rite Aid in Harrisburg, Pennsylvania.

We don’t receive a lot of questions about drug testing at the pharmacy. If a patient is seeking a kit, that’s usually when we’ll see the questions. Because they’re located so close to the pharmacy counter, oftentimes patients are coming in there, they’ll see the ranges of tests, and that will spur the questions. Typically, we don’t see patients coming in knowing exactly what they want, grabbing, and going. When they come in, they’ll have questions, but it’s not something we see often or on any kind of common basis.

Generally, the customers we see who are buying the kits are parents, caregivers, or family members with some suspected drug use in the house. I don’t see a lot of patients buying it for themselves. Generally, they’re buying it to test a caregiver or a loved one who they think is possibly using medication.

Usually, when we see the customers who are purchasing the kits, they’re using it because they want to test someone because they’re suspecting some diversion. Let’s say they have a medication at home, and they’re suspecting someone else in the house may be using it. Oftentimes, it’s going to be a parent testing their children because they suspect their children are using medications or drugs outside of the home.

As an abuse prevention tool, the kits really help to give that baseline knowledge to the caregiver or person who’s checking for use. I think that’s a big piece of it. There are a lot of questions as a caregiver, parent, or guardian. If you don’t know the answer, or if you don’t know that they’re using, it’s hard to help those individuals. I think it helps knowing, if there is behavior that’s unusual for an individual, if it is being caused by drug abuse, and that kit gives them that baseline. Also, once someone knows that the potential to test is out there, it may cause them to rethink using the medication because they can get caught. There’s a potential where, if they do use, someone is going to be able to go back and say, “I know you were using,” and be able to take the next steps to help them.

I’m very comfortable with discussing drug testing. I think it is something that is a needed tool when we’re talking to patients, and a needed tool to make sure that the patients can test and know if there is drug abuse. With the current climate we’re in, that is such a high point that pharmacists are being asked to help. The comfort level there is really in knowing that it is providing help to the patients, so having those conversations is benefitting them. That really helps increase my comfort.

My biggest concern with the kits is making sure that they are going to give an accurate response. That’s something that’s shared among other pharmacists, as well. It’s important to know that if we are using these kits and the patients are getting a response back, it’s going to be an accurate response, because either direction can be painful to a patient. Whether it’s a false positive or a false negative, it’s going to influence decisions and make it very difficult for us to have a good conversation and achieve our aim here, which is helping those patients with drug abuse. 

I think there is a stigma around drug testing. For a parent testing a child, it’s almost like admitting that your child is using medication. The stigma is there that you may have failed that child, failed to protect them from potentially having drugs available to them. There is a stigma even if you’re testing another loved one—maybe it’s not even a parent or a child. You have to have that conversation with the person that you’re testing to say, “I think this is possibly a problem and I want to know so I can help you.” I don’t know that it always comes off that way on the other end, so the person being tested may not see it as testing because you want to help them, but because you don’t trust them or you think they’re behaving oddly. That really drives that stigma behind it.