Problem with Pain Management doctor

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Since: Jul 07

Chicago

#1 Jul 9, 2007
Ok the story is i'm 21 yrs. Old and a little over 2 months ago I had a back surgery, where my discs were completely removed and replaced. A few weeks after my doctor told me to go see a pm doctor, so I did.

As a person, my pm was a nice enough guy, although I didn't like the way I was treated there. When I say that I mean whenever I would call in for a refill on my pain medication, I would be told I could not receive it unless I made an appointment. As a result I would have to be in there every other week. The last time I saw him was this passing saturday. However, the last time I saw him before saturday I was given a urine test. When I asked why, the nurse specifically told me it was just to make sure I was taking my medicine correctly, so I said ok.

Well, on saturday, when he finally comes into the room to see me, he goes "well one of the main reasons you are here is that you tested positive for thc." my jaw dropped to the ground. I will flat out admit that I am an occasional user, although I have actually used it more frequently than normal after my surgery for reasons I will soon discuss. I was never once told I would be drug tested in such a manner, nor was I ever drug tested in the past( I have had 3 other back surgeries in the last 3 years). My main reason for usage of the drug was when I would run out of my pain meds and would not be able to get into see the pm for several days, the marijuana would help ease the pain and also would ease the slight withdrawal symptoms I would feel.

So he tells me that he cannot give me anymore refills until I pass a drug test, and said if I knew I would not be clean on that very day, I would have to come in within 7 days and take one or I would be dropped from their practice. This just flat out shocked me. I am not a heavy drug user and if I had known I would be tested for it, I simply would of never used it. The problem is not stopping the drug, the problem is that I know that it takes a month to get this out of your system, and I won't be clean within the time limit I was given. I know I made a mistake in using the drug, but I would figure they would at least cut me some slack and give me the maximum amount of time it takes to leave your system before making me take another test. Especially since my surgeon tells me it will be 1-2 months until I am recovered, I can't be without pain medication.

Now this morning I was able to get ahold of my doctor(the one who did the surgery) and he agreed to give me a refill of pain medication. I told him that going to the pm every other week in addition to physical therapy was too expensive, so I said I was going to stop the pm until I finished therapy, and the doc said ok, which is actually partly true, but I wasn't about to tell him I failed a drug test, I didn't want to be seen as a druggy. Apparently, the pm said nothing to him about what happened, and I would think if he did it would be a violation of my privacy right? However, I know eventually my doctor will ask me to go back to pm and there is no point in going back to my current pm doc because I will be dropped by the practice if I fail the drug test or they will not let me come back if I wait until after the time limit they set is over.

So I guess my question is, would the best move just be to find another pm doctor? If I did, would my old pm be allowed to tell him about my failed drug test? Or, as I said, would that be a violation of privacy? I am not going to smoke anymore just in case the new pm doctor decides to test me , but I just want to make sure this past incident isn't going to prevent me from getting pain medication refills from other pm doctors. Since I am nowhere near being out of the woods yet from this surgery and will need pain medication in the weeks to come. Any advice would be appreciated.

Since: May 07

kansas city

#2 Jul 12, 2007
That's messed up. I am 28 and I suffer from cervical spine stenosis, i also smoke pot. I am also on a pain contract, which stipulates that I can be drug tested anytime. I did not think, in fact I know that you can not be drug tested without consent. If you are not on pain contract, I would ask why I was even drug tested to begin with? I would just find a new doc. I too, had to find a new doc when I found that my old doc was not sympathetic to my needs. I would find documented studies here on the net to validate my need for marijuana as an alternative medicine. I would not tell my new doc about my previous failed drug test and would refuse any such test in the future.

“Hey there”

Since: Oct 07

palos park

#3 Oct 19, 2007
i am so soryy that you guys are getting under treated for chronic pain

here are some links to help you inform yourself as to the laws and ethics of proper pain management. print out as much info as you can and bring it with you to your doctor.
you deserve quality health care and should not get less than what you deserve.
if i were you, i would change pain mang docs til you find one that is not so condicending! they are out there!

also, please read any contracts you may have signed when you became a petient. docs sneak alot of extra rules into these contracts that we are not aware of.

www.aapaimange.org
www.painandthelaw.org
www.aslme.org
www.pain.com
www.patientadvocate.org
www.painpolicy.wisc.edu
btchyone4u2002

Bedford, NH

#4 Apr 15, 2008
I have to go to a pain psychologist because my primary care said that i violated my pain contract. I have never failed a drug screen or anything on that contract. But when I had surgery, and my other doctors prescribed meds and i called the p/c office my physician never recieved 2 of the notes. Needless to say she was on medical leave due to a surgery so I had to leave all the messages with people that covered for her. When she got back the shit hit the fan and I have to see this pain psyc. to clear my name and keep my meds going. I also Have had 2 surgeries in 2 years on my feet that. My discs are screwed up and I have been diagnosed with RSD.
Disabled from MVA

AOL

#5 Apr 18, 2008
I am 47 and have been permanently diabled from injuried receved in a MVA over 10 years ago. I have seen several doctors in these years and they all have prescribed narcotic pain meds which do help me. I was recently given Levitra from my doctor because I had heard they give more sexual desire and performance. The doctor on the next visit said that the pain meds may be causing low testoterone levels and he said after blood work my levels were borderline to just a little low. He said in order to continue my meds I needed a intramuscular testostyerone shots and Andrgen patches. The doc said no bad side effects, so it was like a ultimatum! The shot made me very sick the next days and then I began having extreme restlessness, irritability, insomnia, and very hyper. I developed a URI and went to see anther doctor for a second opinion. The doctor foudn LEU in urine, gave me Cipro and Felxeril for the abdomen contractions. I went back to my regular doctor and he said he diodnt want to see me anymore and to find a new doctor. The other doctor did not prescribe me any narcotics, but my regular doctor said I should have came back to him, He about killed me ! Now I am looking for another doctor who will continue my pain management. I feel like I was rejected for getting second opinion. My regular doctor said I should have came in that morning, I went to their office and he doent get in until 12:30 and the new doctoir they had hired was in another town that day. So I went to my follow up visit with the second doctor. I feel I have not violated my contract nor was I doctor shopping, I receievd no pain meds from the second doctor and was just kicked out basically. I would appreciate some input into this situation as I feel I have been dropped for no good reason and will have a hard time finding another doctor to continue my medication management due to the DEA's war or pain med prescribing doctors. Please email me at stallard08@wmconnect.com with any help or suggesstions you might have.
Trans Am Expert

Akron, OH

#6 Apr 18, 2008
Yup. Penalized for the second opinion. Ethical isn't it?
confused

Hurleyville, NY

#7 May 24, 2008
I have had along standing back pain issue. My pcp thought that although vicodin was working to keep things under control I should see a PM. He promptly tried facet injections to diagnose and thinks I should try rhizotomy as "it might help" I have been taking long acting non narcotic pain releif for a while tono avail quality of life is poor at 41. I said schedule the surgery and lets give it a try (although I have a large cyst in my kidneys which I wonder if thats not the problem, but no one seems to be worried. Anyway we schedule the procedure and doc says we need a urine sample and you are good to go....ok
next day front office calls wanting co-pays up front to the tune of $500 ( I am unemployed)...no can do.....lets put it off.....then I get the bill. The urinalysis was a drug screen. WHY was I given that, must less without my knowledge. There was nothing there, but I have been fighting pain for years and depression is getting the best of me to continue the fight to feel normal once in a while.....anyone have any suggestions> I think steo #1 would be to change PM Dr;
amy

Lawrenceville, GA

#9 Jul 10, 2008
I am going to a pm doctor who so far has been pretty good. all of a sudden on my last four visits i hane been given urine drug screens. i only had a problem with one of them when i ran out of my hydro early so i tested negative.( i truly think that my little bro was stealing them, but if you tell them that it just sounds like and excuse,) I have an appointment in six days and i can almost guarantee you i will have a drug screen. i wil test negative for percs because i ran out early on a recent three week trip to Canada. not quite sure how, maybe some were taken, i don't know. on top of that i took a couple of ativan and xanax to help with the anxiety on planes trains and automobiles (don't laugh) i am not sure what to do about this. i really do take my meds as prescribed. should i come clean befoe the urine screen, or wait and see what the results yield? any advice would be appreciated.
old guy

AOL

#10 Aug 7, 2008
people need to band together and stop these ridiculous tests..

we are not criminals, but people who are in pain..

It is none of the doctors business what someone does when they leave his or her's office..

If they are selling their meds or buying illeagle drugs it is a matter for police, not your doctor.

I am close to telling them to keep their pills and start using alcohol.. At my age I cannot pee on command and it is humiliating to say the least.

I will be willing to sign any legal petition to stop this lunacy and have it sent to the appropriate courts.. I cannot believe that this is not unconstitutional.
pinkarmstrong

Athens, TX

#11 Aug 9, 2008
I just happened to find y'alls posts and wanted to add my comment. I too go to a pm for neck problems. Yesterday I was given a cup and said "we need to get a urine sample". It made me so nervous even though I knew I wasn't doing anything I shouldn't. I agree with Old Guy, we are not criminals but people in pain and we shouldn't be made to feel like druggies. I don't understand why the DEA is so worried about the doctors giving out pain meds when they have a lot more things they need to check into. We have enough to deal with without being made to feel like criminals.

Since: Aug 08

Olivehurst, CA

#12 Aug 30, 2008
Reading about all the frustration and outrage that people have had with their pain management doctors, I thought that that a look at the MD's point of view would be helpful. I am a board certified PM MD. I don't condone or condemn the actions of the other PM's, but passing along a little information may help shed a little light on what has happened to people who have had difficulty.
Urine drug screens are part of the standard treatment in most pain clinics. I understand how these tests can make you feel violated, but my license, my career and 14 years of medical education are on the line. The DEA holds ME responsible for managing the narcotics I prescribe. Making sure that the patients that I give these to are actually taking them and not selling them to high school kids falls on my shoulders. And the courts can be viscious. Physicians who prescribe narcotics for pain can get into a lot of trouble for doing the right thing by their patients. Check out:
http://www.aapsonline.org/painmanactionsagain...
We have to show that we have a mechanism for dealing with misuse of narcotics and a plan in place for dealing with narcotic misuse. All of us are walking a narrow line, and the price paid for being able to continue to prescribe these meds for my patients includes some rules and some urine testing. Believe it or not, we also find these tests unpleasant and embarassing. But I don't know another way to have safeguards to protect myself and the insure that the 99.9% of my patients who are not abusing can continue to be treated. If you think things are bad now, 20 years ago, chronic pain management with opiate narcotics was almost unheard of.

Since: Aug 08

Olivehurst, CA

#13 Aug 30, 2008
The link from my previous post was cut off, please see:

http://www.aapsonline.org/painman/actionsagai...
disabled in S Florida

Pompano Beach, FL

#14 Sep 9, 2008
The problem appears to be rooted in our failed prohibition and war on drugs. It didn't work against alcohol in the 30's and it isn't working now! Another problem is that there are no advocates for the PM physicians. We want them to treat us but how many of us have contacted our Congessmen and told them to have the DEA "back off"!!I am considered a right wing conservative but as a chronic pain patient I believe this whole issue would dissappear if the Federal Gov't would worry more about the terrorist threat than those few drug addicts that slip in and thru the pain management system. An on duty injury forced my retirement after 27 yrs with a large Fire Rescue Dept. Numerous pain clinics, surgeries, epidurals, Phys Thpy, etc failed to control my pain. I resisted taking narcotics because of my experience with treating overdoses and seeing what addiction can do to people. I didn't understand the difference between addiction and physical dependence. I thought they were the same thing. After a year of being bedridden 20 hrs/day I gave in and what a blessing the medicine has been. I am now a functioning member of my family once again. I didn't realize what an impact my pain had on my entire family. My wife says it was hell around here during that time. I have a fantastic and caring Pm Dr. who has no problem prescribing the pain medicine as long as I am responsible and YES, give a clean urine periodically. We now want to relocate to another state to be near our family. My workers comp adjuster refuses to make the calls to locate a doctor in NE Alabama. She says she will give the approval but I have to do the work. EVERY office I have called refuses to discuss whether the Dr wiould continue my treatment with medication. How does one who is physically dependent on a medicine up and move without prior knowledge if the treatment will be continued. The medicine is both a blessing and a curse. I have a life once again but can't relocate to be near my family.
Autumn

AOL

#15 Sep 12, 2008
yesterday I had a random drug test taking at my doctors office.
the day before this I did smoke pot.
someone gave me very little to help with the pain. I have never smoke or did any illegal drugs in my entire life.
I can't believe the timing. I was hoping that by smoking I would be able to get some pain relief, and not have to use as much pain med's, this was my only goal.
I'm afraid that if they find this test positive that they will infact take away my treatment for pain. I know for a fact that I am unable to live in intolerable pain. I was denied pain medication and longed for death. I wasn't depressed, I was in agony, and now there is a chance that I may loose my medication.
I am on Kadian, I know that this is a poweful drug and never thought in my life I would be on it. but it gave me my life back and now I'm afraid I will loose it
rosc

Pittston, PA

#16 Sep 12, 2008
Just add another drug war victim to the count, I'm experiencing the same thing as all the other previous posts :<
Rae

Reading, UK

#17 Oct 10, 2008
Yep me too and i'm in england. i moved house (5 miles from my old home) so had to change doctors. I was at the original doctors my whole life (30 years) ive been in agony for 26 of those years.
Finally got pain meds kinda suitable for my type of pain after 10 years of being bedbound and suffering and the new doctor wont give me one of my drugs (oxynorm)
I dont use it everyday, but during relapses it can make the difference between getting up and walking about to screaming in agony all day lying in one position.
New doc wants me to try loads of 'other drugs' instead. I've done that my whole life!!! and through working with my original doctor found what works best, now this new doctor who doesnt know me from adam is gonna take my life away... again.
I feel like giving up
Bobbi

Watertown, NY

#18 Oct 10, 2008
I am a military wife and have had trouble seeing a constant doctor, due to military moves, doctors receiving orders, etc. While in Germany I was actually sexually assaulted by a doctor while my husband was in Iraq (all investigated & documented). After that, my husband and I agreed that I need to return to my hometown for treatment, in part due to the fact that he is now re-deploying to Iraq...

My medical situation is that I have DDD (degenerative disc disease), 2 herniated discs, and sciatic nerve problems as well as bursitis on my left side.

Upon returning to my hometown I had EXTREME difficulty getting in to get a primary care manager. A friend of mine was a cleaner in one clinic and she told the doctor my situation. The doctor then prescribed my meds (without having met me or having any documentation) until I could get an appt. with her.

I went in for the appt. in early August. I signed a pain management contract with her.At that time she told me that I would have to have bloodwork and a urinolosis done before I saw her again. She made sure to say that it needed to be done before my next appt. or she would not be able to refill my scripts.

A lot happened then - deaths in family, problems with mold in house, husband being deployed, etc. and I did not get the bloodwork done until the day before my appt. with her.

Now, to shorten a long story, she tells me I violated the pain contract by not getting the bloodwork done immediately. I am very angry about this because she did not request that it be done immediately - she said "before your next appt."

Now, not only do I not have my meds, but since this 'violation' is on my record / medical file, I've been told by several other providers that they cannot help me. I even went to the ER and the doctor there said, straight out, that I look like a 'junkie' who is doctor shopping and that if I show up there again, she will notify the therapist and social work depts.(Now, keep in mind that I have only been to the Emergency Room 2 times in the last 6 months, and the reasons were that either I didn't have a provider, or this time - that the provider says I violated the contract).

I don't know what to do. My husband is worried about me here in the states and he's getting ready to return to Iraq. I cannot believe I'm being treated like this, and yes, I will say, not only because I'm a person, but because I'm the wife of a soldier. Is this how we treat our military families?

Any advice? I am calling this into investigation and wanting to make a formal complaint.

Thanks,
Bobbi
christy

Four Oaks, NC

#19 Nov 21, 2008
take niacin pills usually 2 and drink lots of water the day before your urine test and you will test clean. i have been in chronic pain for 11 years now and i know exactly what everyone is dealing with. my pm dr gave me methadone,xanax and phenegran. during one of my urine test he told me i tested posititve for methamphenamines. I was like what is that, honestly. i have smoked pot for my pain and as for drugs that is it. i was taking herbal vitamins that had ephrine in them and that is why it showed up. I have never been so humiliated in my life. Fact is, illegal drugs would be cheaper(you would not have a co-pay,pay for office visit, urine test on insurance is about $250.00 not kidding,wasting your time with all of their bulls--- and then you go and pay for your medications to be filled and you know what that cost) that is if you wanted to take them instead of going to the doctor but they just do not see it that way. Sometimes i just want to tell those doctors they are no different than a drug dealer, it is just they are a legal drug dealer.
Lazlo Binker

El Macero, CA

#20 Nov 29, 2008
Bobbi:
In my office I use an "Opiate Agreement" as opposed to an "Opiate Contract". Contracts are by definition legal documents. And you could use the legal system to enforce it (if you wanted go to that expense and misery).
Read your contract very carefully. If there is nothing stipulating that there was a need for timeliness, then you haven't broken any contract.

My suggestion is that you study the contract thoroughly and note what the doctor's duties per the contract and what your duties are per the contract. Then decide if the contract has been violated and by who. I would have another meeting with the Dr. and, in a very calm and non-confrontational way, that you would just like to treated with respect and dignity. You may mention how difficult it is to take care of yourself and your family, about the 2 trips to the ER, about the stigmata and shame you've experienced.

If someone came to me with that and approached me this way I would be humbled, embarrassed and wanting to fix what I could.
Russ- piss test bad

AOL

#21 Nov 30, 2008
ashquin wrote:
That's messed up. I am 28 and I suffer from cervical spine stenosis, i also smoke pot. I am also on a pain contract, which stipulates that I can be drug tested anytime. I did not think, in fact I know that you can not be drug tested without consent. If you are not on pain contract, I would ask why I was even drug tested to begin with? I would just find a new doc. I too, had to find a new doc when I found that my old doc was not sympathetic to my needs. I would find documented studies here on the net to validate my need for marijuana as an alternative medicine. I would not tell my new doc about my previous failed drug test and would refuse any such test in the future.
Hey Man don't want to bust your bubble or anything but, A lot of new doctors you go to want you to sign a release of information so they can get copies of your old records so they have a history of your illness to go by. Then if pot is found in your system according to how bigger user you are it is measured by nano grams anything over 40 shows heavy use some won't even check below 20, A lot of doctors to, give you a slap on the wrist and make you sign that you were slapped on the wrist. Then they keep on treating you but hold that over your head. They would really be stupid to kick you out when they are the ones that can help you most. Good luck. hope you have a pain free day. Russell

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