A recent study reveals that doctors may be missing opioid addiction patients who cheat on their medication by spiking their urine samples with buprenorphine. Rapid urine tests, commonly used by doctors, may not detect this spiking, which puts those patients at high risk of opioid overdose. The gold standard medication for opioid addiction, buprenorphine, prevents cravings and is often used in conjunction with counseling and other support. The research analyzed over 500,000 urine test results from Millennium Health from 2017 to April 2022, indicating that less than 2% of samples – from 7.6% of patients – had evidence of direct buprenorphine spiking. Suspicious urine specimens were more commonly collected in primary care doctor’s offices, and spiking was associated with increased heroin or fentanyl use. Rather than punishing these patients, doctors should initiate an open conversation with them to provide more support and care.