Urine drug screens in overdose patients do not contribute to immediate clinical management

A prospective study assessed whether routine urine drug screens might alter the management of overdose patients. Urine was collected from 107 patients with a diagnosis of deliberate self-poisoning seen in the emergency depart ment (ED) of a teaching hospital. The mean age of patients was 36 years (ra nge 13-86 years) and 64% were female. All patients recovered after standard investigations and management, which did not include knowledge of urinary drug screen results. Two hundred ninety-seven compounds were detected in th e 107 urine samples. Twenty percent were drugs administered in the ED, Sixt y-five percent of patients were found to have taken more than one drug. Ben zodiazepines were detected in 18% of samples, paracetamol in 10%, and alcoh ol in 8%. Sixty-one drugs, in 35 people, were identified that the patients did not report taking. Of these, paracetamol (10), benzodiazepines (9), and tetrahydrocannabinol (8) were the most common. All patients in whom parace tamol was found had already had paracetamol detected in blued and appropria te management instituted. If the results of urine screening had been immedi ately available this would not have affected the management or outcome of a ny patient.