The Law of Unintended Consequences Can Never Be Repealed: The Hazards of Random Urine Drug Screening of Anesthesia Providers

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In the current issue of Anesthesia & Analgesia, Rice et al1 provide a special article that revisits compulsory random urine drug screening (RUDS) in anesthesia providers, an issue that has long been contentious among anesthesiologists. The authors posit that, in this population, widespread RUDS should be mandated in an effort to curtail the risk to patients who are exposed to health care providers at risk for substance use disorder (SUD). Although there can be no doubt that those with ready access to potent sedative, hypnotic, and analgesic drugs have a significant and dangerous propensity to abuse those drugs, and—along with the general population—have a shared risk of alcohol abuse,2,3 we disagree with Rice et al1 that RUDS is an appropriate response. Instead, we propose an alternative solution for limiting the adverse consequences of drug diversion and abuse by anesthesia providers.
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