Why do psychiatrists drug test?

Psychiatrists drug test to make diagnosis, monitor your mental health treatment, or to diagnose possible addiction issues. More on why psychiatrists do (and don’t) drug test here.

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Will a psychiatrist drug test me? Yes, on occasion.

In fact, testing for illegal drugs may be a prerequisite to receiving treatment by a psychiatrist. But patient confidentiality ensures that test results remain confidential and a psychiatrist drug test can help create a foundation of honesty and openness between patient and practitioner. Here, we will discuss the significant role drug testing plays in a psychiatrist’s diagnosis and the serious health risks patients face when treatment collides with hidden drug use. As always, your questions about drug testing are welcomed at the end. We try to answer all questions with a personal and prompt response.

Reasons for drug testing during psychiatric treatment

There are no scientific tests to prove the presence of a psychiatric disorder. Instead, a diagnosis of a mental illness is based purely on professional expertise and the evaluation of symptoms, often following a 45-50 minute interview and without obtaining medical history from corroborating sources. So what role does drug testing have in psychiatric treatment? Psychiatrists drug test new or ongoing patience for some of the following reasons:

1. To complete a psychiatric assessment – Drug test results can help psychiatrists conduct a more thorough and accurate assessment and pave the way to an effective treatment plan.

2. To monitor substance abuse – Additionally, some practitioners use drug testing as a means to monitor ongoing issues with addiction.  Similar to chronic pain drug testing, doctors sometimes order drug tests to make sure that you are following medical advice.

3. To diagnose possible co-existing disorders – Substance abuse and psychiatric disorders often co-exist, and determining the appropriate course of action is essential for successful treatment. According to studies, nearly one-third of mentally ill patients have abused substances, and over one-third of alcohol abusers and more than half of drug abusers have been diagnosed with at least one serious mental condition. Psychiatrists who understand all the variables up front will correctly assess when a dual diagnosis is warranted.

Risks of hiding drug use from a psychiatrist

A psychiatric assessment that does not reflect results from a drug test can lead to complications that patients and psychiatrists both want to avoid. What are some of these risks?

1. Misdiagnosis – For one, without factoring in evidence of drug use, a psychiatrist may misdiagnose a mental illness based on witnessing side effects from illegal drugs.

2. Exposure to psychiatric medications with serious side effects – More concerning, misdiagnosis can lead to treatment prescribed for a nonexistent mental illness, and expose a person to psychiatric medications with a known list of side effects that may pose certain health risks. Some psycho stimulants, for example, are known to have caused mania, psychosis, depression, heart attack, stroke, and, in extremes cases where a preexisting heart condition may be present, even sudden death. In fact, some medications are just as powerful or addictive as illegal drugs like heroin, crack cocaine or meth.

3. Medical complications – Furthermore, patients using illegal drugs in combination with psychiatric drugs could experience additional, unforeseen side effects that misinform their diagnosis if all the contributing factors remain unknown.

Psychiatric drug testing should be in your best interest

When patients have good cause for a visit to a psychiatrist’s office, all factors related to their symptoms, including drug use, need to be discussed. The confidentiality established by the law should provide a safe environment for openness. Even so, because patients can still have reservations about disclosing illegal behavior, some psychiatrists will resort to drug testing in order to attain factual evidence in support of an accurate diagnosis.

The health risks for patients are significant when undetected drug use leads to a misdiagnosis and a potentially harmful course of drug treatment. Accurate assessments with all of the relevant factors disclosed inform psychiatrists on how they can most safely and effectively help patients with their mental health concerns.

Is confidential discussion of illegal drug use a price too big to pay when compared to the possibilities of a patient illness going untreated or suffering severe side effects from a misdiagnosis? What do you think? Is it possible that avoiding a drug test could actually cause more harm than good?

Why psychiatrists drug test questions

Do you still have questions about why psychiatrists drug test? Or maybe about the drug tests themselves? Please leave your questions, comments or opinions here. We respond to all legitimate concerns quickly and with a personal reply.

About the author
Clearview Treatment Programs provides highly individualized treatment programs for people with psychiatric disorders, alcohol and drug addictions, and dual diagnosis. Clearview operates the Clearview Women’s Center, which is specifically designed to address the symptoms of psychiatric disorders, including Borderline Personality Disorder and other disorders related to emotional regulation.


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  1. It’s good to know more about drug testing. I like how you said that psychiatrist tests are in your best interests, since they can help you. That’s something I think a psychiatrist should definitely be involved in.

  2. Would they prescribe you narcotics if you tell them that you self medicate with illegal drugs? I was diagnosed with bipolar depression and severe anxiety and was getting prescribed seroquel 300mg. alprazolam .5mg. risperdone (i dont remember mg) and hydroxine (idr mg) but this was like 5 years ago. As well im pretty sure I have ADD and really want to see a psychiatrist about my problems but i havent seen my primary in years because i hated talking to a stranger about my problems. Im just worried that if i tell them how i self medicate. They will only give me non narcotics the whole time and i dont want to ruin my chances of getting better because i have no problem self medicating if i can get the right medication for me.

    1. Hi Ricky. Lying your doctor is not a good thing.. it may cause wring diagnose. If you think that you may have ADD, talk with your doctor to run some tests.

  3. My state-funded mental health clinic just did some lab work on me–a blood test for thyroid function as well as blood counts & the like to figure out why I’m so tired & not responding to medication. The P.A. also ordered a urine test but didn’t say what it was testing for. I’m not prescribed ANY controlled substances through the mental health clinic: just Prozac & Topiramate. Is it possible they’re drug testing me without my knowledge or consent?

    I don’t use any illegal drugs, but I do use substances that are likely to show up as illegal drugs (namely Benzedrex which shows up as meth on most drug screens and a full-spectrum CBD oil that might show positive for THC). This has me terrified.

    What happens if I get a false positive? Can I demand the sample be sent off for confirmation? I cannot afford to have something like ‘methamphetamine abuse’ written in my chart because I DON’T use meth. Nevermind what else they could do if they believed me to be using hard drugs. I’m also applying for SSI/Disability on the basis of mental illness so this could potentially harm my entire case. Again, I do not use meth or other illegal drugs but I’m almost certain the test will show that I do.

    This is a time-sensitive question so any help is appreciated!

    1. Hi Wilona. Yes, you can ask for confirmation test for false positive. Consult with a laboratory technician to explain you what have cause the positive results. Sometimes, food or other medication may interact and cause false positive.

  4. I’m on 4 blue Xanax a day. Been on them 28 years! My psychiatrist wants a drug screen. I do smoke weed to get a appetite. Will he cut my prescription off or is he just looking to see if I am taking my medication

  5. It is appalling to me how drug users are treated within the mental health system. The fact that someone does meth (or any other substance) should not preclude them from getting access to healthcare, whether it is mental or physical, regardless of “stated policies.” I mean, lots of people eat refined sugar that is terrible for their teeth, but can you imagine if all of the dentists just suddenly stopped seeing these patients and addressing their cavities and said it was because you “kept using?” Just appalling. I think the mental health system needs to take a long, hard look at how it co-creates self-fulfilling, and often disastrous, prophecies in certain patient populations and then blames patients almost exclusively for that outcome.

  6. I tested positive for meth back in October at my mental health facility. I know it was a big mistake. All my prescriptions were canceled. Im diagnosed with PTSD on account of my father sexually abusing and raping me over a period of three years when i was young. I desperately need my Lexapro, Abilify, and Xanax. Will i ever be able to find a doctor willing to help me?

    1. Hello Kathy Jo. I believe he shouldn’t. After all, their job is to help you deal with issues and if smoking pot is a part of the picture…well, no judgements should be made on your behalf.

  7. @Nicholas: No, you’re not a criminal, but getting as much information related to a mental illness is key. A drug that one is taking could be having absurd side effects, therefore if a Psychiatrist concludes a mental illness would mean an incorrect diagnosis. However, if you are drug tested, this can rule out alternative explanations. It’s not mandatory, you have the right to refuse.

  8. We drug test our OP behavior health patients. The way our policy stands, if they test positive for street drugs, we discharge them unless they get into rehab. We have a very high Medical Assistance population. When discharged they may find it difficult to find another psychiatrist. Are we doing the right thing discharging these patients or better off keeping them in treatment?

  9. what a bunch of BS … how many people will go untreated because of these drug screens…drug testing the mentally ill is wrong on so many levels. I refuse to have my life monitored via PEE CUP. I AM NOT A CRIMINAL.

  10. Hello ???

    I’d suggest you seek counsel from your state attorney general’s office. The legality of the actions can be addressed with help from this department.

  11. I signed a consent form giving my doctor permission for urine test, I wish to change that because it is invasion of privacy and it is a signal that there are trust issues. I don’t want to be in that situation at all. If a doctor has to go to those extremes… don’t you think its better not to prescribe the drug in the first place? I don’t trust this doctor and if I want to get an independent test, I feel that I should be able to do this. Is there any particular reason why a psychiatrist would refuse and independent test and also is there any reason why I cannot see forms I signed in the past? This doctor is refusing to show forms that patients have signed in the past. Furthermore, isn’t there another conversation to be had before a doctor takes such drastic measures? because there are two sides to the story. There is too much worry, anxiety, and paranoia around drug abuse or drug prescription abuse. Things like is she addicted? Is she abusing? How many do you have left? or shes not taken her meds and spending the kind of money that my pharmaceutical reps require. Or maybe she is taking other things as well. To add insult to injury there is always the show that they put on at the front desk to intimidate patients when they have made monetary astronomical mistakes. Like slapping me with forms that make me feel like I am the lowest form of life. Last but not least. I am bi-polar, whatever that means in the world we live in where this diagnosis is handed out like candy. I suffered horrible mood swings for most of my life and I would be dead if I had not found symbyax. What you should realize is that some of us are for real and the stress around my meds are starting to wind me up, I know, because I wouldn’t be writing this so please consider how stressful this is to those who are for real. Now I am not trying to get your sympathy because when my motor runs and runs the victim card does not come into play at all.

  12. Hello Noel. Each person is evaluated on a case-by-case basis for co-occurring disorders. Don’t try to undertake tapering and withdrawal on your own…but seek medical counsel from experienced professionals instead. Good luck! We wish you all the best.

  13. So someone with A dual diagnosis would have to stop using drugs approximately one month before starting drug treatment which may take as long as 6 to 7 weeks to get to a therapeutic level. How is that supposed to work? Is it a good idea to take someone with mental problems off of medications that may be helping them to control themselves and go cold turkey for up to 10 weeks to get help from the medical establishment. That sounds like a good policy

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