Primary care doctors screen only a small percentage of their patients prescribed long-term opioids, despite the risk of abuse, addiction and overdose, according to researchers in New York. Their study found lax screening even in patients who are at high risk for misuse of opioids, including those with a history of drug abuse or dependence.

Medical News Today reports that fewer than half of patients taking opioids see their prescribing physician on a regular basis. The researchers, from Albert Einstein College of Medicine in New York, studied medical records of more than 1,600 primary care patients while they received regular prescription opioids for chronic pain not related to cancer. They found that over an average of two years, only 8 percent underwent any urine drug testing overall, and only 24 percent of high-risk patients had a urine drug test. Patients at higher risk of misuse of opioids were not seen by their doctor any more frequently than patients at lower risk of misuse, the researchers report in the Journal of General Internal Medicine.

The study found that while 23 percent of all patients received two or more early refills, those at greater risk for misuse were more likely to receive multiple early refills. The researchers recommend a standard plan of care for all patients on long-term opioids, including urine drug testing. They also advise regular office visits to evaluate patients’ response to opioids and signs of misuse, and setting up and sticking to a refill schedule.