Urine Drug Testing

I go to a pain center where I see a rotation of doctors every time I go. So it is very hard for me to build a trust with any of them. I do know what you are saying about the doctor-patient relationship and trust, when I was asked to give a urine drug test I felt dirty and bad. The doctor I saw that day assured me that it was something that had to be done due to the medication they wanted me to start and if I or any patient was to start on this drug (FENTANYL PATCH) they also would be tested.  I knew it would be clean and I had nothing to worry about but it did bother me that I was asked to do that.

hi christine, altho i understand that you may have to have urine testing, what about the people , likke me, whose drug test came back "clean" everytime, i was going to a pain clinic, but because i felt they were not helping at all, ...i wonder WHY ihad to have  a urine test every 2 weeks and then every month, because as i said i was always "clean"...this did make me feel as if the drs. did not trust me and like they were trying to "catch" me with something in my uriine that did ot belong there...it will take me a long time to trust ANYONE from a pain clinic again..another thing when i first started going to this pain clinic ( i was hit by a car while walking across the road) and because of it have chronic back pain, they prescribed 150 mg. fentanyl patch and 320 mg. oxycontin daily, i was so scared to take this many drugs, i was a zombie. at one point , i had to have a procedure and i was to be put to sleep (out patient) , they COULD NOT put me to sleep, so i had to be admitted into the hospital to have an out patient procedure..i was so scared i would awake duuring the procedure or that i would never wake again. this incident led me to take MYSELF off the oxy, i went thru such horrible withdrawals, i thought i was going to die and then prayed for death....and NOW my charts say that i OVERMEDICATED mysellf, every time i go to see a new dr. , they bring this up,,,,trust a dr.? not me not me ever again... cindi

I for one would have no problem with the urine testing and think it's a good idea. I've personally had nurses write comments in reports that "patient seemed intoxicated" - when in reality I was having neurological trouble. I would much rather have them noted the truth- it would help in getting me further along in the quest for help and a urine test could have solved that problem!

I feel it's irresponsible for nurses to make such assumptions especially when a patient has no smell about them- as I understand most drugs can be smelt by a well trained nurse. (or so I've  been told) 

However, I must add that the urine testing is not always exactly acurate. Years ago  they claimed I had used a certain drug I most certainly had not.  Luckily, this event hasn't haunted me as I am not habitually a drug abuser- it would be terrible to be accused of it and I know a lot of people with my types of disorders who are accused and dismissed.

I have however, had doctors Several times discharge me from their care with no notice and leave me in the lurch - having to go cold turkey off many drugs and putting me in dangerous positions, maybe even causing damage to my heart. Doctors who prescribe drugs would do well to make sure their patients have someone to take their place before simply terminating their care for whatever reason. Somehow, they get away with it, and frankly, it's a crime.

The last pain specialist I saw asked me 3  questions in broken english- just barely intelligible, didn't like my answers and told me I needed a neurologist, not a pain specailist- he didn't care that I would be going off of Methadone, Fioricet, and Fentanyl all in one weekend and that one half of my 2 pages of diagnoses have to do with incredible pain. There's got to be a way to hold such doctors accountable for thier actions. (but is it worth the time and effort when you only have 3 hours of functional time per day?)

Thanks for listening to me ~ it's a soap box I'm afraid~ 

Unfortunately, the opposite of trust is paranoia. Many of my colleagues are getting paranoid when it comes to prescribing opioid medications. Between the criminals and the DEA, it is hard not to be paranoid. Practicing medicine with a paranoid frame of mind can lead to irrational decisions. Admittedly, at times I start to get paranoid especially after I have been burned by yet another person that lies and cheats his/her way into more drugs. I try my best to wipe my memory clean and greet the next patient with an open, trusting heart. Just remember, that doctors are human. To error is human. To trust is human. And to be paranoid is human.

Dr. Christina Lasich, MD

I was under the understanding that doctors were obligated to do random testing under federal guidelines. I am a chronic pain patient and I am neither offended or afraid. If I have nothing to hide why would it bother me. I am thankful the doctors trust me enough to prescribe the medicine and I will do whatever it takes to keep their trust. It is two-sided. Those who left your practice have to make me wonder.

I agree with the testing, I just don't like having to pay for them.

Why should urine testing be any different from blood tests, saliva test, skin tests, etc?

Actually, urine testing is the only one done in privacy!

Besides, you're giving away something you really don't need!

I believe that the majority of those against urine testing are those that are abusing...

I had a doctor who I had been seeing for some time. He moved out of state and started UDT. I had no problem with this. I have been on percocet for about six years. I have never taken more than I was suppose to. After my second drug test I recieved a letter that he would no longer be my doctor because I was noncompliant. I call to speak to him to find out what the story was but he wouldnt talk to me.

I wish I didnt need pain pills but I do. To leave me cold like that without at least explaining to me and giving me the chance to ask or explain something was very child like.

I dont mind the UDT  or blood test for that matter but I also think it should be random not everytime you get a new prescription. (unless you havent seen the doctor in awhile)

Hi Christine, I would like to know more about the contracts that our family doctors, if we don't choose pain management doctors are drawing up. Let me start by saying, I lost a son to mixing drugs and fentanyl patches which I had never known of, 5 years ago. I know all of you are watching us for our own good. I wish there could be trust, too, but know the problems out there.

After signing this contract, I take Loritab and Valium, besides many other meds for diabetes, kidney stones and infections, high blood pressure, depression, etc. I have had lithotripsy about 5 times and recently had my parathyroid gland revomed because I was producing too much calcium in my blood. Fibromyalgia and arthritis, allergic to  Ansaids, sciatica, chronic pain and have just begun taking Loritab instead of Darvocette. After that minimal background, I went to the clinic and my Doctor was gone. the PPA who saw me said I had shingles and refilled my pain meds. I have taken 2 a day for 2 years. When I saw my Dr. he informed me I had violated my contract by accepting a refill from his protegee.

I was shocked, and apologetic. I took my bottle to show him. It said take 4 times a day, but I never did because the nurse would always say it was to early if I called before 30 days. He was surprised, it was his prescription and changed it to 3 times a day.

These were innocent miunderstandings. At almost 66, I don't really understand some of the rules and respect my doctors. I see a urologist at least 2 times a month and my family doctor regularly for blood tests as he is watching my blood workups for A1C and my platelets are dropping. Can you possibly lay down some of the rules to abide by, as I thought since this was his name was on the prescription, it had been checked by him. It's confusing to many of us. Thank you for your time and consideration and I'd like to live in a world where we could trust one another also. I've not had a UA as far as I know although I have pus and blood constantly in my urine at my urologist's office. I just finished 7 Rocephin shots and a bottle of antibiotics in a row and am waiting for a culture to begin another. This has gone on for 2 years, then I broke out in shingles. The meds are helping but the pain is pretty constant. It has changed my lifestyle. I would love to be healthy, but am thankful to God for what I can accomplish as my sister is a breast cancer survivor and my brother is dead from pancreatic cancer. I don't want to disappoint my doctor, so I hope I have the rules down. If you need to add to what I have learned, feel free to do so.

Now, I will not answer specific questions like "Will such-and such drug show up in my urine? or "If I take such-and-such, will my urine be dirty?" Such specific information is usually gathered for the wrong reasons.

I will say that I do test on the first visit because that is part of my initial evaluation as a gather information on how best to treat someone. "Dirty" urine can be falsely negative or falsely positive; so I try to look at the whole picture and come to a reasonable conclusion without jumping to the wrong conclusion (hopefully). A discussion with the testing kit manufacturer and/or a pharmacist may be required to understand the real meaning of a "dirty" urine. Usually, when I present the results to a patient, the truth comes out naturally. It goes something like this: Me: Why does your urine test show this? Patient: Oh yeah! I forgot to mention... In a non-threatening environment, honesty does happen.

Dr. Christina Lasich, MD