There are several types of urinary drug screens that are generally available.

Bedside qualitative testing for drugs of abuse is easily available and can be helpful in recreational drug overdose and drug and alcohol assessments.

Laboratory urine drug screens done locally usually look for a limited number of toxins using thin layer chromatography and/or a variety of drug-specific antibodies and are often used for drugs of abuse. These tests can be rapidly performed in most centres.

A more complete drug screen, using HPLC/GC-Mass spectrometry, detects virtually all possible ingested drugs. This is often used by the coroner or medical examiner for determining cause of death. These laboratory systems are very expensive and therefore are more likely to be found in reference laboratories. Consequently, the two to three weeks it may take to get a result make this unhelpful in the management of patients.

Patients should receive a urinary drug screen if:

• patients are known or suspected drug abusers
• no history is able to be elicited about the toxin(s) ingested

The detection of recreational drug use is often useful for the drug and alcohol team in subsequent counselling.