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Discussion

DAU?

Last week, we had a patient on my unit (a locked psych facility), who began to appear sedated to a degree that wasn't consistent with her prescribed meds. We suspected that one of her visitors had snuck in some additional meds to her, and we obtained a urine sample for a DAU. It came back negative for EVERYTHING, including the methadone she's receiving (we dilute it in water before administering it, so I know she's not cheeking it), as well as the clonazepam we suspected she was taking on the sly. One of the nurses I work with who's been around for ages told me that methadone doesn't show up as an opiate on the DAU, and also told me that clonazepam doesn't show up on the benzo part of the DAU. My reaction was: huh? I know that methadone is a synthetic opiate, but I figured it should show up on a DAU. And how is Klonopin any different from any other benzo we'd test for? I called the lab and no one knew what the heck I was talking about. Can anyone help clear this up? :confused: Thanks!

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    Those should both show up in a urine drug screen - the lab should be able to tell you specifics of their testing process. It's a better bet that it's an adulterated urine sample. The bigger issue seems to be - how on earth can she be suspected of sneaking Klonopin? That's a pretty serious issue for a locked psych unit.

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    • Experts
    Those should both show up in a urine drug screen - the lab should be able to tell you specifics of their testing process. It's a better bet that it's an adulterated urine sample. The bigger issue seems to be - how on earth can she be suspected of sneaking Klonopin? That's a pretty serious issue for a locked psych unit.

    Ha you'd be surprised at what they manage to get in through their visitors. This isn't at all uncommon on my unit either unfortunately. :mad:

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    Both should show up on a UDS. Most likely she smuggled urine and didn't think about the baseline meds that would have to show up! I tend to treat my psych patients providing UDS's like a work injury providing a urine. I make sure that it's theres by temp, checking them, etc.

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    don't know your policies, but did anyone check blood sugar?

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