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The Plan to Introduce LDTs into the Healthcare System and Require Doctors to Drug-Test all Patients

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The ASAM White Paper:

"Encourages wider and 'smarter' use of drug testing within the practice of medicine and, beyond that, broadly within American society. Smarter drug testing means increased use of random testing* rather than the more common scheduled testing,* and it means testing not only urine but also other matrices such as blood, oral fluid (saliva), hair, nails, sweat and breath when those matrices match the intended assessment process. In addition, smarter testing means testing based upon clinical indication for a broad and rotating panel of drugs."

Coercion and Control Through Loopholes

Forensic Laboratory Developed Tests were introduced through a loophole that bypasses the FDA-approval process. The LDT pathway was not designed for drug and alcohol testing but for innovative clinical tests with low risk, such as those for rare diseases, that the more costly FDA route would otherwise prohibit. An ASAM physician used this loophole to introduce the first forensic LDT in 1993 and in the past the number an types have increased at an alarming rate. None of these tests require proof of validity.

As a physician-patient relationship renders drug testing "clinical" rather than "forensic" the consequences become "treatment" rather than "discipline." And it is this loophole that is the real reason behind all of this. A positive "forensic" test in most employee random drug-screening programs today will result in an "assessment" for substance abuse. Most EAPs allow a choice in where that assessment takes place. The model this system is based on, Physician Health Programs, does not allow choice as evaluations are mandated to "PHP-approved" assessment centers; a rigged game.

A positive "clinical" test will result in the same thing under the ASAM White Paper proposal. But the assessment will be at an ASAM facility and if a Substance Use Disorder (SUD) is confirmed it will result in mandated abstinence of all substances (including alcohol) and lifelong spirituality involving 12-step recovery. And by using the healthcare system as a loophole and calling this testing "clinical" rather than "forensic" the ASAM will have successfully introduced widespread testing of a variety of Laboratory Developed Tests of unknown validity while removing the safeguards provided by forensic testing including chain-of-custody and MRO review.

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M.D, Harvard Medical School, Massachusetts General Hospital (1997-2013) Geriatric Medicine, Internal Medicine

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