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Drug Testing in Pain Management Practices

parasthesia7819pparasthesia7819 Posts: 2
edited 11/15/2015 - 2:44 PM in Chronic Pain
Well, the end of the road for my current PM Dr is coming to an end. Today, I received a dismissal letter for the first time ever. The rub is that I didn't have any illicit or non-prescribed drugs in my urine. The rub is that the drugs prescribed were either not there or very, very low.

Here's the story: I have had 13 surgeries. I have paresthesia in my left foot from tearing my plantar fascia. I have paresthesia in my right and left pinky and ring fingers. I have had cubital, carpal, and Guyon's canal surgeries in both hands, elbows, and wrists from working in IT as a computer technician/repairman. I have permanent ulnar tunnel syndrome in both hands. I have had an inguinal nerve transected from my second inguinal surgery. The first was for an inguinal hernia. The third was for scar tissue removal. The fourth was for mesh removal that was installed when the hernia was originally repaired. This has been the main reason I have sought pain management. All my symptoms entail pins and needles and burning, stinging pain.

I have smoked marijuana for years and decided to vent today to see if I could get some support. I have about a months supply of meds, so I am looking for a new PM doctor. I am fully amazed at how strict adherence to compliance can cause PM doctors to dismiss patients. I experimented with drugs when I was in high school. I had no idea that through my surgeries, and recurring chronic pain, that I would need opiates for temporary relief of the symptoms. I basically found a way to pass all the urinalysis. It involved taking 3 herbs 3-4 hours before the test, and drinking a lot of water, too. I did this by purchasing the drug test kits, and cross eliminating the different herbs that are listed in cleanse products you buy at head shops. I bought the individual herbs on amazon. This has worked for two years until recently, I perhaps, drank too much water, therefore masking even the drugs I take from the PM doctors, too. It took 3 tests of only one out of two drugs not showing up for them to send me a dismissal letter. It makes me feel that they only care when the numbers are right. It has nothing to do with humanity. No appointment face to face to even explain the numbers. I have seen this doctor for 3 years. I have only had one other PM doctor which I left on my own to find better treatment during my divorce when my ex-wife became involved with my treatment. It's one thing to be in pain most days, it's another to feel that pain management practices see us as numbers that when not added up correctly, they kick us to the curb with no treatment option but to hope we will be accepted without their judgment added to the next doctors request for records. Anyway, has anyone out there been in my place and found another PM doctor successfully? I wonder if this second PM doctor will include my compliant non-compliant urinalysis information.

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--- Ron DiLauro, Spine-Health System Moderator : 11/15/15 20:42 est



  • SavageSavage United StatesPosts: 5,427
    The relationship we have with our pain management doctors is so important.
    They expect honesty from us for them to treat us most effectively.

    The face to face conversation you might have had to explain ridding your system of marijuana may not have been helpful at all.
    And the explanation of herbs taken, if interacting with prescribed meds, causing them not to show in urine testing, may not have been helpful either.

    All my doctors want to know everything I'm taking, even if I think it benign, such as vitamins and in your case herbs.
    Many things can interfere with prescribed meds, and that's not even addressing the marijuana.

    I would suggest being very honest with next PM doctor. If you were to tell him about you marijuana use, he may tell you to stop. Or he may prescribe, as its legal in many more states now.....if you live in the States.
    But I doubt doctor would okay illegal substance as he can not join you with "dirty hands"... legally put.

    You obviously need pain control, so very best of luck with your new PM doctor!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • I don't want to get involved and respond to this post...but at the same time I just can't say nothing.

    You have a right to come to this forum, just like me. You are in pain as am I. You are frustrated with your treatment and have a right to vent. Pain sucks. It can make a person crazy. I know about pain and I'm so very sorry for yours.

    This is a judgement free zone...but gosh I get to say my two cents: your choice to lie to your pain management Doctor is the reason I have such a hard time with my pain management treatment.

    Back in 2002 when I had my first fusion I was prescribed narcotics to help with pain and recovery. I needed them for 2-3 years following the surgery. I was easily able to get them and eventually stopped needing them, great for me.

    Now, 2015 and I'm drug tested every single month. I have to track every single pill and I'm in honest conversations with my pm that formally were reserved for my husband solely. My pm knows every intimate detail about me.

    I'm recovering from my last fusion and have every expectation to be off narcotics and ending my relationship with my pm in the year because I will be healed. I'm pretty sure the chronic nature of my pain is over.

    But in the year I have had to hire a pm and endure the infringement of my personal space and life I feel like a drug user. It is unbelievable to me, because I'm a lady. I'm a gentle woman who is a homemaker and a volunteer in my community. I have never used an illegal drug in my life. I never will because I follow the laws of the country I choose to live in. I'm beyond frustrated with the idea of peeing in a cup once a month. It makes me feel untrustworthy.

    Then I read your post. And now I realize why I have to endure the monthly urine tests.

    I have to agree with savage. In order for you to have successful pain management, you will have to be honest and intimate with your pain management Doctor. It is the only path to healing. If you are not on that journey...then you are not trying for remedy but instead you are distorting and misusing the service provided by the physician.

    This in turn defines for me why my pm is urine testing me. What choice does he have if his other patients are not being completely honest?

    Your post at least helps me understand that my pm doesn't mean anything personal against me when he urine tests me. He simply has no choice but to do so to protect his practice and welfare. He went to school to become a physician to do no harm. It is his oath. I just cannot believe there are people who would lie to said pm and risk his ability to heal.

    I will share this post with my pm doctor at my next visit so he understands that I have developed a new understanding for his job and can finally empathize that he (my pm) has a daunting job as it is to relieve my pain. I never fully understood until now what risks he was facing.

    And again para..I wish safety and healing for you. I do hope your pain dissapates. I do hope you find a doctor who can help you and really encourage you to experiment with truth and complete honesty when you meet the new doctor. Bring him or her your post and see what they can do to get you pain relief in a responsible and legal way.
  • There are several things that are problematic in your original post, starting with your apparently feeling it's totally acceptable to adulterate/manipulate your urine testing, by using things you found researching , which leads me to think that you are also misusing the medications.
    You seem to think that because you successfully manipulated previous testing, and it took three tests to result in your dismissal, that your doctor owes you a chance to explain. Most pm offices would have dismissed you the first test, not waited to give you other attempts to manipulate the testing further.
    I don't necessarily like having to undergo compliance testing either, but it is situations like this that have created and support the reasons why it needs to be done.
    I have always taught my kids that your choices, decisions and actions dictate the outcomes/consequences of any situation.
    I suspect that this manipulation of testing is going to follow you and if you are fortunate enough to find another doctor willing to treat you with anything other than opiates, you can expect far more stringent controls in place.

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