New Worry

Hi tom,
I have peed in a cup 3x. I have been in chronic pain for five plus years. I do not mind the test, in my opinion they are checking to see if we the chronic pain suffers are not taking the meds and selling them or taking additional meds like street drugs or doctor shopping.
In my opinion it is for our protection.
But this is a bit off topic, I would like to see all medical professionals and pharmacists do weekly ua's as well.
This is the two professions that have access to abuse thus putting the blame on the ones who truly need them. Just my opinion. I am not implicating any one, but feel it would be a good employment procedure.
Cloe

Hi, Tom,
I was subjected to this with one pain specialist. I was asked to do it at the initial visit, and for several visits after. I was told every patient had to be asked so that they were not accused of discrimination. Funny thing is this was one of the Interventional Radiologists who only did high tech procedures - no prescribing. But I guess he wanted to make sure we weren't doing other drugs. I was initially upset when I got the explanation of benefits from my insurance and they did not pay for what amounted to a several hundred dollar test. When I called my doc and said there was no way I could afford it, they said not to worry, that they picked up the tab. I ended up leaving that doc because his staff was so rude, and always let things pile up so that I spent a lot of unnecessary weeks waiting for various procedures, etc.

So far, I've not yet been asked for a urine screen but the one prescribing is my neurosurgeon's office. It's surprising because they mail me scripts every month and never question anything. I have to see my PCP tomorrow about another condition and it's the first time since my surgery, and since I've been on daily percocet, so I am holding my breath they don't try to change anything or write my neurosurgeon saying I shouldn't be on all these meds, blah, blah, blah.

Sorry, a bit of a rant! But I think it varies with the docs office, and I don't think the urine screens are uncommon with pm docs. But it still makes you feel like a criminal. I have had to do them for employment purposes in the past, but just at initial hire.

Others here have also said they had trouble with being shorted with scripts and have started counting them before they leave. You know we wouldn't be such PIA's if we were treated with dignity and respect!

PaLady

Tom;

I too am one of the fortunate ones as to not having to take a UA since my very first visit with the Pain Doc. But that could all change soon as this move and all could be a real pain in the bum so to speak with the constant UA's. I am really not worried about it that much as I take my meds as prescribed and do not fear that they will cut me off. But somewhere in the back of my mind it does worry me as I too someday's forget that I have already taken a Percocet for the pain an hour before and will do the same thing as you. Hubby has had to take over the pain meds as far as dishing them out so that I won't forget to take them or won't go over the alloted amount and I too feel as though I am burdening him with this. He picks up all my meds and I count them when he gets home to make sure that there all there. If not I call the pharmacy and they go through their count and tell me yes or no as far as whether I got the right amount.

It's silly really, but I have been shorted a few times, but they usually tell me we owe you XX amount and that they didn't have enough in their stock to fill it completely. But as long as it works out in the end...that's all that counts right? I am on a first name basis with everyone in the pharmacy which makes it easier for me as far as who I need to speak with about the shortages and my Pharmacy orders their supply for my refills two weeks in advance before it is time to refill. Of course so do I......I am required to call my pain meds in 10 days in advance and I usually am pretty good at doing that but sometimes I too forget and will call them in 4 days in advance forgetting that its 10 days. In which I have to sneak into my extra supply just to make sure I have enough to cover for the days that I am short.

Until my next post..........yours in pain

Scarred

Most UA's just test positive or negative if the drug is in your system or not. They don't test for the AMOUNT itself. It is possible to do so, but that would be a blood test and it is much more expensive than just a simple + / - urine test.

I too have been tested w/ a urine drug screen...2 years into being a patient at my pain management dr's ofc. I was never tested until I started seeing the new dr...I went in for appt like normal and then they said "by the way, before you leave we need a urine sample to send for drug testing"...I was shocked and nervous (my husband is a long-term smoker of marijuana..over 20 years we've been together)*we've been together since 15 years old!* now, we have a 14 year old son,10 year old son and 4 year old daughter* but this is his "drug of choice"..ANYWAY, he smokes in bed right next to me and blows it towards me...I've smoked it many years ago, but don't choose to now, but I was soooo worried about it showing up in a drug screen. well, fast-forward to my next appt all the while thinking this would be my last appt....he NEVER even MENTIONED IT at all! That was a few months ago and have not been asked for another one...I thought for sure it would show up...but I guess not! I do know that a urine screen cannot detect "levels" as far as when you take a dose/missed a dose...that would be a blood test and would be very expensive as the other reply said... 

Tom,
This almost sounds like it could be a legal issue - if people are being cut off from pain meds just becasuse of this new procedure - and perhaps it's not being implemented accurately....I don't know. Maybe worth talking to that attorney you know?

PaLady

Pa Lady: talk To Ya when time gets closer. Iam appearing in downtown Butler doing my Disco thong dancin. Then go'in to Heinz field look at the crowd and the parking lot and then hobble to a local speakeasy and watch the game in comfort. Tom

Hi Tom,

I've been very lucky. Both times that I have been in pain management, I have not been subjected to a urine screen. I have offered to take one , several times in fact, but have never been asked to or had my offer of taking one accepted.

I do know that my PM's office tests people all of the time. I also know that they have caught many diverters through the testing. I also never have had to sign an agreement/contract for pain meds. Why? I have no idea, actually but that's been my experience.

I have been there on mornings when they are getting the 8:30 am phone calls from pharmacists and doctors offices regarding patients getting multiple scripts , or doctor shopping. Been there when they have cut off other patients as well and it is never a pleasant experience to witness, because usually those that are being cut off are not happy about it.

I know there is a new company out there that many offices are using that tests the urine sample in a lab, that gives a level in the urine. They ask when the last dose was taken and it averages out a normal high and low for a particular drug and then gives that patients number. If a patient falls under or over that average, it flags that particular outcome.

I also know that the same company also tests for other drugs like cymbalta, lyrica, pregablin ( neurontin), along with the narcotics, so they can check far more drugs than just narcotics.

The bill is outrageous from my reading others stories about it, but the company supposedly has a number the patient can call, which offers a discounted "fee" for the testing.

As far as whether I would be offended or not........no, I wouldn't. I'm an honest pain patient, I try to take my meds as scheduled, if anything, I may miss a dose once every week because I finally fell asleep for the first time in a few days....but I figure that I am no better than any one else and if that is what makes my doctor confident in prescribing my meds for me, then so be it.

Sandi

Wow, this is a scary topic, isn't it? It's one of those issues where it unfortunately seems like many of the people who ultimately suffer are not the ones who should. That small percentage of pain patients who are "pretenders" faking their way into our world with deviant intentions have put us in this position and sadly there are bound to be some true CP patients who pay the price. In some respects, I almost feel sorry for the doctors in that regard. I can't imagine how someone could fake the constant pain, but then I think about how we all work so hard to fake feeling fine... I think it must be hard for the doctors to know how to weed out the riff raff. In another thread someone said they'd rather see 10 people who didn't need meds get them than 1 person who needed them go without, and I'm inclined to agree, but with the way the government is targeting doctors these days I imagine our docs have to worry about their livelihood with every prescription they write. Scary.

I am one of the fortunate ones who has never had to do a UA or blood test (except during a clinical trial I did). I don't think I'd be too worried about it if it happened as I take my meds exactly as prescribed, but like PaLady I have some that are PRN and those might vary a bit in my levels. I would hope that the doctors would take that into consideration when they read the results though. I would be upset if such a test were required and then not covered by my insurance, though. That could get prohibitive quickly. Even if the tests were only $35 a pop, with my fixed income I just don't have an extra 30 or 40 bucks laying around every month.

I wish there was an easy answer for this - a way to weed out the diverters and druggies and ensure adequate treatment for those of us who are truly suffering and have a medical need for the medications. This is actually one reason why I wish more of us had access to the pain pump technology. It seems like a good way to fix a lot of these problems. It is supposed to provide pain control with smaller amounts of medication so that patients have fewer side effects, and of course it would be impossible to divert those meds or take them faster than prescribed. I know the technology isn't perfected yet, so it isn't a perfect answer, but maybe someday we will get there. I can only imagine how wonderful it would be to not have to live tethered to the medicine chest any more!

Ry

Hi Tom,

Ameritox or something along that line is the name of the company doing that testing, if that helps anyone. I did some reading on their website, and it is a bit frightening since it advertises itself as a way for doctors to protect their practice first and foremost, and does testing for many things that you wouldn't expect an ordinary drug screen to look for.....

I do understand your feelings about your friends and pain management Tom. I would hate to think that someone in pain can not be treated properly for it as well.

I have seen both sides of the fence when it comes to PM. The abuse side of it, far too often, even with legit pain patients, and those who just abuse the system period to get drugs.....it's scary and it's sad. I have seen those who come into the office limping and groaning, and then see them outside, with a huge smile, walking across the parking lot to their cars, and the limp and grimicing is all gone. I've been there, when someone who is obviously taking too many of their meds, comes in, cursing and swearing because they "ran out" or "lost them", or "someone stole them", and the doctor won't replace them.

I understand it from the point of view of the patients, but I also understand it from the point of the doctors as well.  Those who do abuse their meds, create problems not only for themselves but for every other patient in that office.

I know that some PM's have contracts that are strict and they do not tolerate any deviations from their contract, and I know others who will have some flexibility in their contracts and their interactions with their patients.....

There has to be a balance, in being able to treat patients who really need pain meds, and preventing those who abuse the meds from getting them.

I don't know what the answers are, but I can see things from both sides.

Sandi M

Hi 123: thanks i am over-tired right now but many thanks and i will read them right after i "try" and sleep. This post from You is one of the things I was hoping that someone would know about and would advise all of us. I believe this new testing will be done nationwide so i am trying to warn my fellow pain friends to watch their usage. Again thank you, Your friend in pain and the life it gives you, Tom

Don't get too excited about "pump technology." Like a lot of "treatments" out there these days, these are being pushed not because they're so great for patients, but because they bring lots of money and reduced complications (DEA attention etc) for the docs themselves.

Lots of people are now regretting being suckered/pushed/bullied into having pumps installed.....a vast majority are now having to have the pumps cut out of them and are back at square one because the #1 supplier, Medtronic, recalled most of their units due to potentially LETHAL catastrophic failure or any one of a huge range of subtler failure conditions which could rob patients of effective relief without any way for the patient or the managing doctor to know!

Pumps are extremely dangerous, a classic cop-out, and a cash cow for the pharma-tech companies.....but for most patients, they are far from the best possible solution.