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Old 09-14-2003, 03:26 AM   #1
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SFangel HB User
Unhappy Fentanyl & DEA/State Medical Board-mandated blood or urine tests

Hi,

I have been using Duragesic (fentanyl patches) for the control of my severe chronic pain for a year.

My doctor told me that she might have to have my urine or blood tested for fentanyl so that the DEA and State Medical Board know and believe I am really using my fentanyl patches. My doctor totally trusts me: she knows I am really using my patches, not selling them on the street.

However, I heard that fentanyl is not detected in the urine or blood if a search for drugs "in general" is done. Fentanyl can be detected in the blood or urine only if the laboratory searches for fentanyl specifically.

Is that true? What should I do? I do not want Duragesic to be taken away from me by my doctor if the blood or urine test comes back negative for fentanyl.

Thanks.

[This message has been edited by SFangel (edited 09-14-2003).]

 
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Old 09-14-2003, 07:37 AM   #2
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Angel,

I have never heard of this before.. I dont think the DEA has the right to request a drug test. Patients have privacy rights which would not permit the DEA to question our legitimate use of pain medications.

However, I do believe it is in the pain contract you sign with your pm doctor in regard to testing your urine, etc. I believe the contract states that you agree to provide a urine specimen if your dr. request it.

I dont believe pm dr's do this routinely, only if they suspect a patient might be abusing their meds, etc. Unfortunately, a few of the bad apples effects us true chronic pain sufferers

Have any of the other posters heard of this testing by the dea?

Chriztene

[This message has been edited by chriztene (edited 09-14-2003).]

 
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Old 09-14-2003, 09:57 AM   #3
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Hello
i have been on pain meds for the last 11 years Percocets for 5 years and Oxycontin for 6 years. I have never been requested or even had it mentioned to me that any kind of urine or blood tests were needed to check for the DEA. This is the first time I have heard of it.
Don

 
Old 09-14-2003, 10:29 AM   #4
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savysac HB User
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The DEA can in no way force you to take a **** test to detect the presence or lack of any nacotic painkiller in your system. Even if they could, how would the lack of a drug in your body prove that you sold it on the street, it cant. All it can prove is that you didnt take the drug within a certain time frame.

Whoever told you this is either lieing to you or trying to manipulate you. As a patient prescribed a certain drug, I can choose to either take it according to my doctors orders or I can take it when I want to. No government agency, no matter how paranoid it may be about narcotics, can force a legitamatly prescribed patient to do anything, period!

There is truth to the notion that your PM Doc can request a **** test at anytime. This will depend upon your narcotic med contract that you signed, however, you can refuse that test too, but as a result, your pm doc has the right to refuse to treat you any further.

We are not living in communist russia, we as citizens of this country have privacy rights.

peace
terry

 
Old 09-14-2003, 11:41 AM   #5
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twisten HB User
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If your doctor told you that, I would be wondering about her motives if its not true. I would speak to her about your concerns. Only she can say why she told you that.

------------------
Hmm where should I begin?? Crohn's disease, sacroiilitis-crohn's related, scoliosis, spina bifida occulta, chronic myofascial pain, tmjd and migraines. Still waiting for bone scan and bone density test to tell me what else is wrong with me!! Too many surgeries to list!!
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Crohn's disease, scoliosis, chronic myofascial pain, migraines, Osteoporosis, Trigeminal Neuralgia.

 
Old 09-14-2003, 12:45 PM   #6
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Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
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Hey Angel, It's not uncommon for PM practices to do UA's to determine if the patient is using illicit drugs or to insure the patient is actually taking the drugs prescribed by the doc. I doubt the DEA would have the power to mandate this in only one state.

If you use the patches as prescribed you should have nothing to worry about. Doctors looking to ensure their patients are using their medication properly know which test to ask for. I don't understand why you would be concerned if you do indeed use the patches as prescribed? A legit patient should have nothing to worry about. Good luck, Shore

Your doc may just be implimenting a new policy and using the DEA as an excuse. The DEA has a web site and a new policy as you describe would be posted at their site.

PS, As far as finding info about your current meds or other meds, because other people repond so completely different the best place to obtain medical info is from the manufacturer. Every one has a web site with the full prescribing info and all the info on their clinical trials. I'm not saying folks shouldn't ask questions here. I'm just directing you to the horses mouth

[This message has been edited by Shoreline (edited 09-14-2003).]

 
Old 09-14-2003, 04:35 PM   #7
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SFangel HB User
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Hi, everybody

Thanks for the information.

Chriztene, I am certainly glad to hear that the DEA has no right to order a blood or urine test for drugs.

I think that my doctor feels “pressured” by the DEA and State Medical Board to order a drug test because she may somehow have to prove to these 2 organizations that I am really taking my narcotic meds. I guess she thinks that if the narcotics I am using show up in my blood or urine, it means that I am really taking my narcotic meds. Then the DEA and State Medical Board will not accuse her of prescribing narcotics to someone who is not using them and is possibly selling them on the street.

I believe the drug tests are done more to protect the doctor rather than as a requirement of the DEA and State Medical Board.

You said: “Patients have privacy rights, which would not permit the DEA to question our legitimate use of pain medications.” We, chronic pain patients, know that we are legitimate users of narcotic pain meds, but the DEA and State Medical Boards do not know this. We could be drug abusers, for all they know. I guess this explains why doctors could feel pressured into ordering a blood test.

I took a look at my pain contract. There is nothing about requirements for blood or urine drug tests. My doctor trusts me: she knows I am really using my narcotic meds for the relief of my severe pain.

Terry, you said: “All it can prove is that you didnt take the drug within a certain time frame.” Is fentanyl (from Duragesic patches) not supposed to be present in the blood or urine 24/7?

“No government agency, no matter how paranoid it may be about narcotics, can force a legitimately prescribed patient to do anything, period!” You are right! However, they can give a lot of trouble to doctors who prescribe narcotic meds to patients who do not take them.

I do not want my doctor to stop prescribing Duragesic for me because I refused my blood or urine to be tested for drugs.

Twisten, I will ask my doctor what the purposes of having a drug test are. I hope it has nothing to do with the DEA and State Medical Board.

Shoreline, even though I use my fentanyl patches as prescribed, I am concerned because I heard that fentanyl is not detected in the urine or blood if a search for drugs "in general" is done. Fentanyl can be detected in the blood or urine only if the laboratory searches for fentanyl specifically. I am worried that my doctor will not remember this and order a blood or urine test that will not detect the fentanyl present in my system.

I wonder if the drug test is a new policy of my doctor’s clinic. I wonder why she would use the DEA as an excuse to order a drug test. I will ask her.

 
Old 09-15-2003, 11:02 AM   #8
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whaleylaker HB User
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Hi there. My Pain Dr. "requested" I take a drug test. He mentioned how the DEA monitors opiate perscirptions closely (especially Pain Dr.). I don't think that the DEA mandates the test it just puts the Dr. at ease if he/she is ever questioned about sripts by 'Big Brother'.Take are Lake P.S. this only my 2 cents worth of opinion and if I'm wrong please don't ask for change TaTa4now

 
Old 09-15-2003, 01:26 PM   #9
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Hi Sfangel...

You mention that you 'are concerned that your doctor might forget that the test need to be specifically for fentanyl' and just a 'general' test that won't show you're taking the fentanyl. I would think that w/b highly unlikely. First of all, your doc probably has had to deal w/ situations like this in the past and, secondly (correct me if I'm wrong) don't the blood tests or urine tests test for 'opiates'? Would fentanyl qualify for that?

Shoreline - you are our resident expert on the chemical make-up of many drugs as your past posts attest to. Can you shed some light on this 'dilemma'? Thnx!

Good luck SFangel.... http://www.healthboards.com/ubb/heart.gif

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI -normal-but pain still-began taking vicodin
2/8/02 - 2nd baby born - Csection-healthy girl
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - slight bulge L3-L4, DDD, neural foramen,Superior aspect S1 and L5 Nerve root involvement-Neuro Refers to PM for ESI's
(2 Rt Transforaminal,1 lumbosacral,3rd one numbed tailbone little
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Performing doc oversedated, False Negative
7/8- Dept Head ClCl consult
7/28 - ClevelClinic for Facet Injection, changed to Caudal Epidural after seeing xray of displaced coccyx;also,coccygeal manipulation
8/12 - 2nd caudal inj/no coccyx manip
8/14 -coccyx manip AGAIN
9/25 sched appt to begin tx on Disc Tear @ ClevelClinic

 
Old 09-15-2003, 06:32 PM   #10
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SFangel HB User
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Hi, everybody

Whaleylaker, I knew that the DEA monitored closely any narcotic painkillers prescriptions

You said: "He mentioned how the DEA monitors opiate prescriptions closely (especially Pain Dr.)." What about primary care doctors? Are they monitored for opiate prescriptions as closely as pain management doctors?

"It just puts the Dr. at ease if he/she is ever questioned about scripts by 'Big Brother'." I agree with that.

Karen, you asked: "Don't the blood tests or urine tests test for 'opiates'? Would fentanyl qualify for that?" Fentanyl is an opioid rather than an opiate. I do not understand why doctors say that the laboratory should test for fentanyl specifically rather than just test for opiates in general.

 
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