Failed drug test at Pain Management D.O.

Failed drug test at Pain Management D.O.

Welcome to Spine-health’s Chronic Pain patient community. You can also read doctor approved Chronic Pain Articles and watch Chronic Pain Videos.
54 posts / 0 new
Last post
Seaofredkc
Offline
Last seen: 1 year 3 weeks ago
Title: Member
Joined: 08/29/2013 - 11:09am
Failed drug test at Pain Management D.O.

Hello there, I am looking for some advice on what options I have when I've failed my drug test with my PM D.O. I was sent by certified mail my discharge from my clinic and when I went in for my next appointment to talk to him about things he would not even talk with me even though the letter sent to me said, "The only way I can keep seeing you and giving you Rx for methadone & oxycodone is if you seek out help for your drug addiction." So I started seeing a licesened therapist with 30 years experience 10 years specialist in drug rehab like the letter said yet he would not even give me a chance to explain myself. I found out in 2011 when I started having hip pain that I had a disorder called Avascular Necrosis and in march of 2012 my left hip was 85% rotten and was replaced, at that time my right hip was 15% rotten and I was told to try to deal with the pain for as long as possible through PM and then we will replace the right hip as well. Without my pain meds I am unable to take care of my 2 small children now that I am a stay at home dad thanks to my disorder. The reason I failed the drug test was completely my fault and only a 1 time mistake. My wife and I were going through a very tough divorce and I was 32 years old living at my grandmas house unable to contact my wife or children by law and I was not dealing with this well. So I made the mistake of visiting a old friend who I knew was still using Meth and I stupidly used not knowing I would be taking a drug test days after. My wife and I are back together now and I have not had a drug problem for many many years I just made a mistake that ended up costing me a lot more than I ever knew. I know that my D.O. will put this on my permanent record and that no other PM clinic will take me because of this, but I truly need my pain meds to live my life. And the strong Rx's that I have been on for going on 2 years are gone cold turkey, no steps down, just gone. So now I get to deal with chronic pain with no meds and deal with withdraw symptoms from narcotics. Emberised by this, I don't know what route to go but I fear the worst for the future. What will my other doctors do like my phycratrist or my primary? Will they drop me as well? Is there any way I will ever be able to get my meds back? Will this failed drug test be there forever and will any/every doctor be able to see it? If anyone has any advice please respond with some good news for me. Thank you for reading.

advertisement
Liz
Liz's picture
Online
Last seen: 6 min 13 sec ago
Title: Moderator
Joined: 12/30/2008 - 8:41am
welcome to spine-health

I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and continues to grow.
Here are just some of the highlights:

- Detailed medical libraries of Articles and Videos that address almost every Spinal Conditions and Treatment

- The Wellness section contains articles, tips and videos to help patients after surgery and also to help people avoid surgery.

- Under the Resource tab, there is a section Doctor Advice Health Center which can be invaluable.

- As a bonus, Spine-Health provides these patient forums. Here is where you can meet thousands of other people who understand and can relate to your situation. You will soon become part of the Spiney family who provide comfort and the advantages of a Support System. You are now part of this family that is approximately 20,600 International members and growing daily.

- It is very important to understand the Forum Rules to make sure all of your posts do not violate any of the rules.

- As a new member, it is helpful to understand the 'makeup' of these forums, how to make posts, tips on adding images and much more. You should read Forum FAQ

Here are some you should take a look at:
Read before you post
Tips for Newcomers
Understanding the rules

All of this will help make your threads better and improve the times and quality of responses you will receive.

If you have any questions or need assistance, you can use the Private Message facility to contact any one of the Moderators on my team:

dilauro

tamtam

Liz

Sandi

Jellyhall

sandi
sandi's picture
Offline
Last seen: 10 hours 25 min ago
Title: Moderator
Joined: 06/20/2008 - 12:53am
Seaofredkc

Let me see if I can answer your questions- and if I understand your situation correctly. You are 32 years old, have AVN in both hips, have had one hip replacement and trying to hold off on a second one for as long as possible, but were seeing a pain management doctor in the meantime. You were taking methadone and oxycodone as your long acting and immediate release medications to manage the pain but during a tough period in your marriage, you and your wife separated, and then for some unknown reason, you were prohibited from contacting them or seeing them ( restraining order? ), and you met up with a friend who used, and so you used crystal meth and then wound up going to see your PM doctor, who gave you a drug test and you failed due to using crystal meth?
You have a previous history of drug abuse, but are stating that you are clean now, other than for this one time?
Have you had any other issues with misusing or abusing the other meds that you were on? Any at all? Taking more than prescribed, ever? Failed any other urine screen? Early refills, or multiple doctors? Running out early?
You and worse yet, your previous history sets up all kinds of red flags, and this failure of the urine test just adds another one to the field. Especially given the drug that was found. Was the proper amount of your regular meds found in the test? The Methadone and the oxycodone? Or was there too much or too little?
There are areas of this country where meth use is rampant, and when users can't get their D.O.C., they resort to opiates to get their high, so this test result might just make things very, very difficult for you.
AVN is painful, I know, I have it in my wrist but there are other treatments that they can offer you , such as injections into the hip to help manage the pain in the meantime, and physical therapy.
Your best bet is to contact an addictionologist in your area, and get an evaluation done to determine whether your use of these substances is in fact for pain or what, and see what they recommend. They may make a recommendation to put you back onto meds but with stringent controls in place, weekly or biweekly prescriptions, urine tests at every visit and surprise ones in between, pill counts both scheduled and not, and a new contract, spelling out the ramifications of not sticking to your contract.
No PM doctor, nor any doctor needs to give a patient a tapering schedule or a month of meds once they discharge you. The reality is is that YOU broke the contract, therefore he owes you nothing in continuing your care or tapering you off the meds. And yes, he can contact, your other doctors to let them know that he dismissed, you and why. Those urine results are a part of your permanent record, and depending on if he sends copies to your other doctors or not, they can also become part of your records there as well.
I am not sure how much methadone and oxycodone we are talking about here, but if you have any of them left, it would be wise to split them and taper yourself as much as you can.

“I know that in life there will be sickness, devastation, disappointments, heartache - it's a given. What's not a given is the way you choose to get through it all. "

― R.Jones

dilauro
dilauro's picture
Online
Last seen: 59 sec ago
Title: Moderator
Joined: 06/16/2008 - 9:41pm
Sandi said it all

Once that mistake was made that cause the test failure, it iis with you and can hang over your shoulder all the time. In today's medical environment, health insurance, DEA, etc. everyone is a bit timid regarding Narcotics.

I wish I had any more advise other than what Sandi told you....

I've known people who failed their urine test almost 10 years before all the DEA crackdown, and still to this day it almost impossible for them to find a doctor who will prescribe another narcotic.

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

sandi
sandi's picture
Offline
Last seen: 10 hours 25 min ago
Title: Moderator
Joined: 06/20/2008 - 12:53am
One other question

which doctor would not let you explain yourself? The PM clinic doctor or the addiction doctor you were referred to? The good news is that you were not dismissed right off the bat. In most situations, you would have been. The fact that the letter did not outright dismiss you, means that he is still willing to treat you but that you must also prove that you are being treated for the substance abuse issue.
I suspect he was angry at the substance that turned up in the test, as well as what he felt was betrayal on the part of your relationship with him and you.
But I would make a point to offer him an explanation and believe me, he will know if you are being honest with him . So don't lie in any way shape or form when you do sit down with him.
I would tell him just as you did here, what went on , and why you did what you did, and that you are seeing dr xxxx for that issue, and want to prove to him that it was a one time slip that you won't be repeating and discuss what you plan to do to prevent it

“I know that in life there will be sickness, devastation, disappointments, heartache - it's a given. What's not a given is the way you choose to get through it all. "

― R.Jones

thoracic spine pain
Offline
Last seen: 4 months 1 week ago
Title: Member
Joined: 03/28/2013 - 2:30am
Do you realise how dangerous methamphatine is?

Methamphatine is probably the most dangerous drug that you can take. I have been told it is eight times more addictive than heroin and could be responsible for you current condition. Years ago I attended an autopsy where someone had been taking methamphatine and his brain was so fried it fell through the doctor's fingers like mush. It is so dangerous to your body and mind. It has the opposite effect of opiods, speeds you up instead of having a calming effect, so taking it for pain seems counterproductive. It fries your brain. Once you have seen an autopsy of someone on speed you would never contemplate using it. They give Ritalin to ADHD kids and that seems to have the opposite effect - it slows them down - but have you seen the guy who invented this condition admit he made it up on his deathbed. I did a whole Uni semester on labels they give children that carry through to their adult life. Guess being an ex addict carries it's own label and judgements.

However I do believe there should be protocols in place. Sorry I did not mean to have a go at you. There must be a lot of recovering drug addicts who are treated unfairly due to their past. I really don't think it should matter, if you have recovered you are a strong person anyway. We do not have contracts in Australia. The Dr believes you or not and I have had the same GP for 15 years and he is at my local shopping centre so everyone has kinda seen me before and after the accident so I am lucky to have a supportive GP and pharmacist who have seen me in all kinds of states so know I am not faking.

I just hate methamphatine with a passion. Can you get your addiction specialist to write to your PM specialist and ask him for another try. I think there should be protocols in place as well and your past should have no bearing on your present situation. Or if it has bearing on the situation it should make it better for you - you have been honest and you have been strong enough to kick a drug habit. That's not easy.

I don't want to turn into a bitter, angry person but think I was having a rough day . Like most people I am human and have flaws. I wish there was a simple answer. I wish this forum didn't have to exist, that spine injuries were simple and could be fixed easily for everyone.

shinty
shinty's picture
Offline
Last seen: 1 year 3 weeks ago
Title: Member
Joined: 12/04/2011 - 4:28pm
Seaofredkc

My only advice is to show this post to prospective doctors, as it explains your story so eloquently. It is going to be hard to find another doctor to treat you with narcotics unfortunately. You did do this to yourself, and now your paying the price. A lot of non violent people are in prison for simply using drugs, so your problem is mild compared to some. You still can get treatment for any withdrawal symptoms you may be experiencing though. Suboxone helps withdrawals, and some pain doctors even use it to treat chronic pain, so it's worth looking into. good luck.
shinty

jmhar68
jmhar68's picture
Offline
Last seen: 9 months 3 weeks ago
Title: Member
Joined: 01/16/2012 - 2:21pm
Implementing such draconian

Implementing such draconian measures without bothering to specify a clear path to redemption is not only an oversight, but inhumane. No one that is willing to seek help should be sentenced to a life of pain. Wouldn't implementing an immediate policy of weekly prescriptions, pill counts, drug screens and counseling achieve a better result?

terror8396
terror8396's picture
Offline
Last seen: 1 hour 58 min ago
Title: Member
Joined: 06/26/2008 - 1:21pm
that is all and well but what

that is all and well but what if a person is lying about his pain? back pain the the most common complaint for disability and as everyone knows, there are all sorts of people that make up their pain and complaints to get pain meds. this is why disability spies on people, taking pictures and movies. it is easy to go in and say i hurt my back and the pain is unbearable. i need to get on disability. lying about ones pain and taking meds that go against ones contract should in my opinion let the pain dr off the hook. he does not have to do anything. if you cheat, you are out and if you have to go through withdrawl then so be it. i see it so often on this site that the drs don't believe me after they have had numerous cat scans and mris that show nothing. with all of the stuff drs have to go through, i don't blame them if they dismiss someone outright. they don't owe anyone anything especially if they don't follow the contract. it is the patients fault and he must bear the responsibilities.
jon

I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.

jmhar68
jmhar68's picture
Offline
Last seen: 9 months 3 weeks ago
Title: Member
Joined: 01/16/2012 - 2:21pm
All I am saying is there

All I am saying is there should be a defined process in place that gives the honest person a chance.

sandi
sandi's picture
Offline
Last seen: 10 hours 25 min ago
Title: Moderator
Joined: 06/20/2008 - 12:53am
Doctors by law can not continue to prescribe meds

to a known addict, that is in large part why they must dismiss a patient when there is a problem with the urine screens.
Yes, in some cases, I do think that there ought to be options available for redemption, and that is why I suggested a consult with an addictionologist, and if the addictionologist doesn't feel that relapse or abuse of the meds is a concern, they can make a referral to a pain management doctor for the patient. Some are also doctors, and will prescribe meds within some guidelines to ensure compliance.
A part of the problem is the continued , ongoing misuse of medications by patients, some of it is a lack of clear communication between the patient and the doctors regarding proper use of and compliance with the use of pain medications, and part of it is addicts who are using prescription drugs. That is why compliance with our contracts is such a huge deal, and if you already have a history of previous abuse doctors are less willing to take on a patient with a history.

“I know that in life there will be sickness, devastation, disappointments, heartache - it's a given. What's not a given is the way you choose to get through it all. "

― R.Jones

Pages