Dental Professionals

The two meanings of drug monitoring

Drug monitoring can be confusing, as the term accurately applies to two different systems of evaluating controlled substances.

Drug monitoring can refer to Wisconsin’s Prescription Drug Monitoring Program or PDMP which is a system set in place to track the dispensing of controlled substances by pharmacies and practitioners to patients in the course of treatment.

The same term is also used when referring to lab tests to determine if an individual has used controlled substances.

This system uses blood, urine and hair samples to check for drugs and their metabolites.

Wisconsin, like most states, will insist on the random use of these tests to verify abstinence for licensed professionals disciplined for drug or alcohol use.

This discussion concerns the monitoring of individuals for the presence of controlled substances.

When a health professional is brought to the attention of their respective regulatory board and a diagnosis of chemical dependency is made, the regulatory board can choose to allow the individual to continue to practice based on the prognosis of the individual’s treatment provider, the willingness of the individual to comply with the treatment plan guidelines and continued, random negative drug monitoring.

In situations where a practitioner has gone through treatment and is given a restricted or limited license, the process of drug monitoring allows the state to demand, at random, tests of blood, urine and hair to look for traces of these drugs or their metabolites.

The Wisconsin Dentistry Examining Board has the position of ensuring all practitioners of its respective profession are practicing unimpaired. Drug monitoring is one way to follow a
recovering professional. All cases are looked at individually, but in a situation where there has been no patient harm, the typical contract or limited license includes monitoring provisions to ensure public safety.

After five years, these provisions are reviewed. In some cases, an unrestricted license is issued and in other cases continued monitoring for an unlimited time period can be demanded by the DEB. The state has full-time attorneys and advisers to help licensing boards recommend the most effective plan in each individual case.

Drug monitoring is also an effective treatment modality for the recovering professional. It
serves as a deterrent or rational “stop sign” to prevent irrational, impulsive behavior in early
recovery. It can act as solid evidence in any situation where impairment due to substance
abuse is suspected.

Based on the frequency as mandated by the DEB contract, the individual must call a state contracted laboratory every day. If the response from the laboratory states this day is a monitoring day, the individual has four hours to report to an approved collection facility where a witnessed blood or urine sample is given.

From this sample, the laboratory results are sent to the board representative for
evaluation. On occasion, a hair sample is taken which can provide information on drug
use during previous months. Depending upon the request of the board or the individual’s therapist, the sample can be evaluated for multiple substances. There is even an alcohol enzyme test which can evaluate alcohol use, weeks after ingestion. The cost of these tests is paid for by the licensee.

Any medications taken must be reported by the prescribing practitioner to the board representative and all positive results are further investigated with more refined techniques to eliminate any false positive results.

Drug monitoring, whether it is related to the PDMP or ordered by licensing boards and addiction recovery therapists, is all meant to improve the safety of the public by observing and evaluating the use of controlled substances.

The ability of these medications to minimize pain and anxiety make them an important treatment modality; however, these medications can also cause significant problems from misuse and must be dispensed with caution.

Dental Professionals

WDA