Youth drug testing has become increasingly popular in the past 25 years. It is not known whether the primary care workforce is equipped to deal with the increase in drug testing requests. The objective of this study was to examine physicians' knowledge of urine drug testing and usual practices when testing adolescents. Those eligible for the study had provided primary or urgent care to an average of 10 adolescents or more per week. Out of a sample of 1,085 physicians, 359 (42 percent) completed a survey.

The key findings showed:

• More than 95 percent of physicians reported ever ordering a drug test.
• Only 23 percent used an effective urine collection procedure that adhered to federal guidelines and other procedures that help ensure accuracy.
• Only 7 percent of physicians checked both specific gravity and urine creatinine.
• The majority of physicians did not know that ecstasy, oxycodone and nitrous oxide are not detected by routine drug screening panels.
• The majority of physicians misidentified at least one substance that can cause a false positive result, and only one quarter ordered a confirmatory test all or most of the time.

The results suggest that primary care physicians are not fully aware of the limitations of drug testing and need additional training and consultation with experts to improve their knowledge.