The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

Editor, – The article by Dimitri Gerostamoulos (Aust Prescr 2013;36:62-4) omits to mention the limitations of urinary drug screening.

Urinary drug screening does not identify the use of synthetic narcotics such as pethidine and fentanyl, a class of prescription drugs which are often abused. Most doctors do not know this.

These drugs can be detected and confirmed by hair analysis which is not mentioned in the article.

Sometimes incomplete coverage of the important issues related to an article can, by virtue of their omission, be problematic.

Mark Schulberg
Mediscreen Clinic
Hawthorn East, Vic.

Author's comments

Dimitri Gerostamoulos, the author of the article, comments:

The comments from Dr Schulberg are valid in that some drugs will not be picked up by standard urine testing. However, as stated in the article ‘Consultation with the laboratory is useful to find out which compounds can be tested as well as for interpretation of negative or positive findings’. A practitioner cannot just assume that all substances can be tested in urine.

Hair analysis has its own issues and cannot compare with the immediacy of urine testing for rapid detection of drugs. It is useful for retrospective drug analysis in cases where the normal avenues of blood, oral fluid and urine testing are not available.