Text Box 1.

GH Guideline (December 2011 update*) UDT Recommendations

Patient Risk Category	UDT Recommendation
Low: < 40 mg MED/day and low abuse risk (compliant with medication plan, no personal or family history of alcohol or drug abuse, no mental health issues)	Consider UDT
Medium: 40–120 mg MED/day or medium abuse risk (personal or family history of alcohol or drug abuse, personal or family history of mental health issues)	UDT at least once a year
High: on methadone, taking >120 mg MED/day of other opioid, or high abuse risk (current alcohol or drug abuse, age ≤ 25 years, significant psychiatric comorbidity, or repeated problems with opioid medication plan compliance)	UDT at least twice a year

*The original guideline (July 2010) defined low dose as < 20 mg MED, medium dose as 20–120 mg MED, and high dose as > 120 mg MED.