Written by
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
angela, even tho you said to reply WHEN i trust a doctor again..i am replying anywya..i still do not trust any drs. exept my own g.p....i don't even SEE my dr. at the pain clinic, i see his n.p., he is so busy doing injections, that i , as well,(i'm sure) his other patients don't even get to see him. on my last visit, i demanded to see and talk w/ my dr. to know if they even thought there was anything else they could DO with my back..besides medication!! he was not too happy that i demanded to see him, thus putting him" behind schedule", in his injections!..he still, because he has not even looked, touchedor even asked me what was going on w/ my back, has not given me any hope of my back ever being "fixed". i am so tired of taking medication and not getting any other results..and this , besides having a urine test..is why i don't think i will ever trust a dr. again !...i wish you well in whatever pain you may be experiencing and hooping that YOUR dr. is doing what he supposed to be doing!
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 understand your being scared but imagine being a chronic pain pt. who would never hurt their dr but he dd not care about hurting me and like drs who can just dismiss yu i have no recorse i tried everything to prove my innocence i had this docfor 10 years and i cant seem to trust or get over it i am actually seeing a shrink to get on with it.
god bless
angela
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.
HERES A QUESTION FOR U DOC! HOW IS IT THAT A PESON CAN TEST POSITIVE FOR AN OPIOD SUCH AS DILUDID WHEN HE NEVER TOOK SUCH A MEDICATION AND WORSE THAN THAT IT WAS GROUNDS FOR TERMINATION OF THE DC PATIENT CONTRACT OF A VERY NEEDED DAILY MEDICATION OF 40 MG A DAY OF OXYCODONE? THERES SIMPLY HAD TO BE A MISTAKE FALSE POSITIVE ETC FURTHERMORE A SECOND CHANCE & OR FURTHER TESTING SHOULD HAVE BEEN ALLOWED ONE ETC!
This just happened to me 7 days ago!!! And I pleaded to have another UA done because this is completely false and defamation of character. The Dr. refused to order one and dismissed me from care. He wasn't even my PCP and now that my primary Dr. is back from vacation, he won't call me back. I am suffering!!! Did you find out anything as far as the law or knowledge of what I should do. I don't deserve this 
Dear Doctor:
UDTs are only good if they are given randomly. I get one every month when I go see my doctor. I have been on methadone for 12 years and am a very low risk patient - never asked for early Rx, never lost an Rx, never have called crying, never have do anything to make me high risk. But, for the last 12 months, I have been given a UDT. And, I have to pay for it! My insurance covers some of it, but it costs me almost $400 each and every month. If the UDT was given randomly, I wouldn't mind, but I know I will have it every month on the same day so if I wanted to get "high", I could and they would never know. So what do you think of this? I think the clinic wants to make money off of me and that is why.
i think they want to make money of you too, my self i used to go to a clinic and i decided since i had to go every month on the same day and be seen just for a stupid UA then why go there? so i found a Dr who looked at me and knowinly by looking at me new that i wasnt lying about my problem, he gives me my meds 3 days in advance and no questions asked, i get methadone and oxycontine once a month, i dont have to see him unless i have a problem, and i just call the office 3 days before i am going to run out and they will have them ready at the front desk, that way i dont have to have a physical or waste money cuz i dont have ins. at this time, so he has them ready all the time, an no contract, because i have never lost them, nor missused them either. and he trusts me, sometimes if i am leaving town i will call earlier then my time, but if your leaving town thos meds are easier to get at the same drug store all the time cuz they know you. but yes pain clinics are there to make money infact one i went to asked what hotel i was going to be staying at and actually called to see if i had a reservation or not for that day i was leaving town, i was so humiliated that i told them i will never come back again, and there bedside manner is awful. I am sure they didnt care, but to actually call the hotel MY Gosh, how stupid of them. i am a 55 yr old women what the hell? why would i lie about leaving town,? idiots. some Dr's are so into them selves it makes me sick, and i actually think that these are the Dr's that are taking the drugs themselves, Dr's take meds all the time, and are high all the time, and i feel those are the ones that are the cruelest to there patients, because they can get them when ever they want, and to make there patient suffer is a joy, sorry but that is my beliefe
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 am a truck driver and have been for years. I have 3 herniated disks in my back. Disk-disgenerated disease, along with two heniated disks in my neck. Arthritis in my knees, spine, hands, ect.
I have seen the same doctor for 16 years. I needed my prescription filled. 90 vicodin, 90 flexeril, 4 klonipin at night for sleeping. When I asked for a refill they said I needed to see my docotr and follow up with her. I did, and that's when they decided to throw this pain contract in my face. They asked me to urinate, and I could not because when I arrived at my doctors I went to the bathroom immediatelly, before I was called in.
I passed 20+ drug screens in my life. I never failed one! I have been drugged screen to death. I was offended by my doctor not being up front me with. They should have said..."We are giving you a drug test." They want me go every month for screening??? Gas prices are 5.00 dollars a galllon and climbing! I was treated like a criminal that day, too. Because i could not go to the bathroom, I simply walked out.
I will call on Monday and tell them I did not appreciate them not tellling me why I was really coming in. The medical field is a crock of do-dooo!
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)
I believe that many doctors are scared out of their wits by the government agencies responsible for overseeing their practices. They are afraid of lawsuits and/or losing their licenses.
Yes, there are unscrupulous doctors, but they are in the small minority. There are also noncompliant patients, but they are also in the small minority.
It seems ironic that the FDA allows doctors to prescribe medications that are known to be harmful to our kidneys and livers, yet they spend inordinate amounts of time and money regulating drugs that are beneficial, with little or no side serious effects.
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.
Opioid use contracts are pretty universal for pain management practices. The written terms and language does vary from office to office. Generally, most contracts state that the patient understands that he/she is not to receive precription opioids from another prescriber.
I consider these contracts to be legally binding agreements between me (the doctor) and the patient. In other words, I agree to prescibe these medications in a responsible manner and you (the patient) agree to use the medications in a responsible manner. The contracts are good tools for clarifying policies and beginning a dialogue if there is a problem.
Contract violations are handled differently from office to office. I have a "two stike" policy. One clear violoation is cause for a strong discussion. A second violation is grounds for discharge or discontinuation of opioid medications. Things can get very heated; but most responsible, honest people do not have problems with urine drug testing or opioid contracts. Again, I wish a lived in a world without the need for such tools.
Dr. Christina Lasich, MD
I appreciate your very complete answer to my questions. I certainly didn't know that seeing a doctor in training under my physician was a violation but was glad to learn and have it verified. Thank you for answer. My doctor is very good and I have much respect for him and would not want to lose him. Hopefully, this will help others, also.
i agree with you and you seem very reasonable. but do you think a first time visit should be tested? they did it with door open. i was told if it comes back wrong, they wont see me again. they told me to call in week to see if they will take me. meantime gave me a two week supply.they made me feel a little like a druggy, no offense to anyone. i keep my pills locked up, have teenagers. but, they don't know me personally, i have been dealing with pain for 7 years now. maybe my result wont be right, then i am banned? what do i do?
I understand that doctors want to make sure patients are taking meds as prescribed. Do you think doctors should be able to shut you off of your life saving pain medicine because of a little marijuana? I live with pain 24/7 without any breakthrough medicine. When the pain is unbearable a little hit of a bone goes a long way to relax me. I find the pot less disorienting than booze and much more effective in relieving the pain and the appetite is always stimulated. Why is the DEA going after my little bit of relief? I have been in chronic pain for my lower back for 10 years,is my doctor being forced by the DEA to test all chronic pain patients that are on long lasting medicine? Are all doctors mandated to do this or is it up to the individual doctor?
All doctors who prescribe pain medications are required to "monitor" for inappropriate use. Urine drug testing is one tool used to monitor, prescription tracking is another. The acceptance of marijuana is up to the individual doctor.
Dr. Christina Lasich, MD
My pain Dr. just dismissed me. They claim that I have all these things in my urine. Alcohol, marijuana, morphine, hydromorphone. I am a new father of two baby girls and a full time college student. I rarely ever drink alcohol and certainly not before any dr visit especially to one that is prescribing me narcotics. I am a new patient to this dr. I have been seeing him for 3 months. I know that I never took thses other drugs for certain except for marijuana which I have a state issued medical card for. The office staff told me when I showed up for my appointment and refill that I was dismissed and that I had been sent a letter in the mail 3 weeks ago. I told them I didn't recieve anything and they game me a copy of a letter telling me why I was dismissed. When I got home I checked the mail and there was a letter from the doctors office. It was postmarked from their Pitney Bowes postage machine Dec 1 and my appointment and refill was on Dec 2. So I couldn't have got it before my appointement.. They have left me in a horrible dilema. No time to make alternate plans for another DR. This is why people are forced to go to the street for narcotics. What you don't realize is that their are people that sell 95% of their scripts and save a few for before their dr visit so it shows in their system. They never get cut off because they don't ever take any other pain medicine because they don't even take what they are prescribed. They just keep on getin those refills and makin like $2500 a month off it while people like me that actually need their pain medicine are screwed over. I didn't get to seal the urine bottle when I was tested like every other test that I have recieved in my life. I am wriring a complaint to the board of medcine next.
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
I beleive in drug testing to monitor scripts, but not when they do it every single month and then they want to throw a so called random drug test in with it.
I don't mine having a drug test, what I do mine is that they charge my insurance over $900.00 per test. Yes that's right. I'm in pain all the time and they want me to be tested every month now. I already have over a 200.00 bill for one test. And I don't have the money to pay it. Next year my husbands health insurance is going to a higher deductable. Over $7000.00 for the year. And it won't cover my meds until deductable is met. My meds will cost me over $400 amonth. I'm thinking of telling them to stop everything and just be in chronic pain for the rest of my life. I can't work and my surgeon said if I don't have surgery I will be in a wheel chair. I don't want medical bills over my head!!!
personally, I believe a good dr patient relationship is key to a well managed medical condition. I find a 900.00 per month bill for drug testing to be appalling. I would call my insurer and inform them of your concerns. I was amazed when my daughter was born and the insurance company paid for a circumcision... when i saw that i went over all the charges and found numerous charges for stuff that just never occurred. I informed the insurance company of there mistake and they looked in to it. That being said.. when my girlfriend had insurance the co pay for her blood pressure medicine was 18 dollars, and the insurance company, according to them, was paying 46 on top of that.. Well when she lost her insurance due to a job change, the medicine she was getting now was 9 dollars out the door.. What is that all about. The same thing was true with two other meds she was taking .. the co pay was more than the drug cost when she paid out of pocket, without insurance.. Makes me wonder...
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
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.
i am in same boat i am 52 disabled 20 + failed fusion low back L3-4 to S -1 bone graft didn't work , now spine is porus won't hold any screws or plates , besides two failed fusions i now have lost all cartledge in left hand so the dr went and fused that now the regular FNP i was seeing wrote scripts for me each month for 5 years now FNP quit working so new dr and yep pee test first thing now about the results i have no idea fnp quit so new doctor won't see me untill tuesday next week so im out of oxycodone and fentanyl patches out and sweating with withdrawls , happens so much in 20 years i go to emergency room and get shot of demerol and try to get relief from withdrawls now new law general family dr 's can no longer write the prescriptions for opiate meds have to go to special pain dr in clinic someplace thats all they doo i guess really puts me out hope i don't go postal on sombody with bad low back and one hand dr today called sherriff on me said didn't like my attitude when i told them i would run my truck through their office and find better help at mcdonalds they called the cops cops called me at home to tell me not to see dr any more HA F N HA im going right down ther to dr next week in withdrawls angry and out of my mind with severe low back pain im label to do any thing my wife has a order of protection from me just yelling at her in pain good untill next year if i yell at her i go to jail was told what about freedom of speech my rights are violated every time i get out of bed in the shape im in i should been dead long ago
great question miss, why not nurses, teachers who care for our kid, doctors themselfs (who abuse drugs worst then street junkies)
I am in the same boat, pee in a cup every month to get my contriled sub meds.
government has no place in your doctors office.
If you have a dr next to your name, or called a teacher, or assemblyman, or congressman, or even president, these are the people who could do the most damage while on drugs, but, you dont see them peeing in a cup.
now, question is, what are we going to do about it ? We need to stand up for our rights in this country before we lose what rights we have left !
I am just, you no, one of the "little people" as we are called by the elite. If you have a plan, you could count me in !!! Good Luck mam !!!
Jes