does this upset you

Im not saying anyone here does this. I know we are all in true chronic pain. It just upsets me that because of people who abuse pain meds us true chronic pain suffers pay the price. after 3 yrs of not being with a pm . I had to go back under a pm's care for severe pain from my herniated discs pressing on my nerves the process is quite different I felt like I was a criminal because of all the hoops I had to jump through to get my pain treated. I had my picture taken and when I walked in the door drug tested. I was never drug tested in the past when I signed a pain contract. I guess now in my state you have to visit a pm every month til you get on a maintenance dose meaning more copays. It just bugs me that we are made to jump through hoops cause of people that are not pain want to abuse drugs.

Roccyd...I am in VA too:) I think our law now is at least one time a year for the urine tests (but as you said, there are some Drs. who choose to do more) and the pill count at each visit. I go every 3 months and the nurse does the same thing before the Dr. comes in, just asks real quick, "did you bring your bottles?"...yep.....but they never count as I've been there since 2006.

Kim..the taking a photograph is actually a really good thing as I had a terrible situation at the PM before the one I have now. I've written about this before but will tell the story. I was out of town in NC visiting my Dad and had called them to ask if my husband could come by to pick up my prescription (he had stayed behind) as I was going to be out of meds in two days by the time I returned. They tell me that I already picked up the prescription that morning!

I said it was impossible as I've been in NC all week long so it wasn't me! They got all huffy...said they would call back. When they did they said, "Nope...it was definitely you and the nurse said we know it because it was a blonde with a ponytail"..Well..I said it was certainly not me and that could describe a lot of people....Did they get a signature??? NO!!

To this day I think that this one nurse was diverting meds!...But they refused to believe me even when I said I have proof of dated photos, credit card receipts for gas and food with signatures all showing I was in NC and there was no way it could have been me.

If they had required a signature that would have solved everything!!! So my PM requires this when picking up prescriptions as well as showing our ID....Same with my Pharmacy which is great so something like this can't happen again!

I don't mind doing anything that is asked because I realize that unfortunately the death and overdose rate of prescription medications has increased 10 fold over the last years. These things also make it easier for my PM to concentrate on those of us with real chronic pain and weed out the rest.

The key is for people to understand what their own state laws are as they can be different than what the CSA (Controlled Substances Act) is which is Federal Law.

The other thing I agree with is that only those Drs. who aren't PMs if they are to continue treating those in chronic pain with controlled substances, get proper training and certification to do so. I prefer my PM in the plain fact that this is all he does. He is Board Certified in PM and is up to date on all the latest meds, procedures, and treatments. Just like if I had a kidney issue, I would see a kidney specialist...As great as some PCPs or other Drs. are....CP is not their speciality. **NOT a diss to anyone's Dr. or if they choose otherwise...just my own opinion for my treatment.

So for me, I don't see a urine test or pill count a big deal in the scheme of things. I just look at it as part of the process dealing with very potent medications and chronic pain treatment.

I agree Roccyd...I feel very blessed as well to have the PM I do!!

Kim..I really hope that you can develop a good relationship with this new Dr...

Post Edited (Snowbunny21) : 2/17/2013 3:33:37 PM (GMT-7)

my pm does not do pill counts unless its something you are bringing back in to get a new prescription. i never even thought about that but im sure it wont be long. i have also never been treated like that either. the only place i have ever been treated weird is at the pharmacy. sometimes you take a prescript and you can tell the look on there face when they first look at the meds. at my pain clinic everyone there is really sympathetic. now i have heard people talking before about being treated like poop when their drug test came back dirty. then they treat not nice at all. i have not ever seen it with my own eyes though. the people telling the story could have been exaggerating though. which if i had that happen to me i for sure wouldnt have been telling a story to begin with.

It hasn't happened to me thankfully...My PM sends out the test to a lab that uses gas chromatography mass spectrometry which is extremely sensitive and accurate. I drink close to 12-14 glasses a day of water.

I'm assuming that yours was a "dip stick" type test that is basically a yea or nay for things and can be unreliable.

What I always recommend is that if your Dr. does random urine tests...to always bring in your bottle of medications so that they can do a count to see how many you have left because their concern with a "negative" test is that someone is selling their meds. This would at least take care of that issue with them seeing your pills.

Also you can request to do a blood test right away which would show more details but it only works if you do it that same day of the urine test.

Did you end up staying with this Dr. or did they dismiss you completely?

I wasn't dismissed. I'm pretty sure it was a pretty cheap urine screen. After I gave the sample to the nurse I went back to the room to wait to be excused. The doc stuck his head in the door and asked if I had taken my meds yet. I had already taken my morning dose and answered yes. He gave me a funny look and told me to go (he gave me my monthly script).
Fast forward 3 days and I get a call from him saying it came back negative and did I adulerate the sample. I said no as I would never do that. He said the specific gravity of my urine was suspect. I did notice during that entire week my urine was really dilute, which I attributed to the massive volume of water and diet pepsi I had been drinking due to the extreme heat. He told me to give another sample that day. It was 3:45, I was over an hour away from the lab, and the lab closed at 5. I hauled butt back to the lab to give another sample. After not hearing anything from the office for a few days, I called to see what was going on. The nurse said don't worry, the 2nd one came out fine, the 1st sample was contaminated, etc.
When I went back to my next appointment the doc asked me what happened to the 1st sample. Since I had no idea I just assumed it was dilute due to the fluids, but still no idea why it came up negative. The doc insisted that I must have put water into the sample, more or less accusing me of doing something to the sample, etc.
He never did pill counts, but I brought my bottle in just to show him. At any rate, he asked me what happened at the next several appointments, but I still to this day have no clue what the heck happened. He continued to prescribe the meds, but always had a weird attitude.
I have an HMO so they cut costs everywhere, so at the time, I was stuck with this particular doc. When I first started up with him, he ordered a full blood and urine screen that came out fine. After that, just random urine tests. So I'm guessing it's a cheaper less accurate test.
Is there anything else I should have done?

the drug tests here is atleast 4 times a yr. my new dr requires you come in every month for refills til you reach a maintenance dose. we will have to sacrifice things just to afford the copays for the monthly visits. I wouldnt be complaining if it was every 3 months . It's hard also cause have to find rides cause my hubby cant keep on taking time off to work to take me.

I still find it unreal the way you guys have to jump through the hoops that you do - I think this sort of thing is unknown in Australia, but perhaps we have a much lower incidence of drug abuse than you guys do in the US.

SB - I do agree with your ideas about non-PMs needing further training, or at least some sort of further authority... My GP looks after all my meds, except for when I'm starting something new, or the couple I'm on that require special government authority (can only be prescribed by a specialist and dispensed by a hospital pharmacy) - but it's reviewed twice yearly - and I am also reviewed twice yearly by another GP to ensure he is not over prescribing...and of course my specialists oversee everything anyway...