Controlled substances, including opioids, benzodiazepines, and medical cannabis, are commonly prescribed for the treatment of chronic pain. Urine drug screens (UDS) are often used in clinical practice to test for the presence of prescribed drugs to monitor compliance. Understanding how to appropriately interpret the results of urine drug screening is critical to providing effective patient care and maintaining patient trust. Pharmacists in various practice settings can play important roles in urine drug screenings.