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  • Possible Urine Neg for prescription will I be dismissed?

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    Old 08-28-2009, 10:24 AM   #16
    Leo123
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    Re: Possible Urine Neg for prescription will I be dismissed?

    At least
    Quote:
    Originally Posted by Executor View Post
    Yes....If a patient "fails" the UA, then they are sent a certified letter dismissing them immediately, and they cancel any pending appointments they may have. The letter does say that a "wean" script is available to titrate them down. They also block the person on the computer from making any future appointments. I've personally seen small stacks of certified letters waiting to go out....Sitting on the receptionists desk or whatever. The secretary told me once that they dismiss at least a couple of people every week.

    If the UA shows up any street drugs or "illegals", they turn your name over to the DEA. They don't mess around, that's for sure.

    While some may disagree, I have to say that I support their strictness, because it ensures that they will stay in business and that my care is not threatened. I hear too many stories where patients show up for their appointments and a sign is on the door stating the office has been closed.
    That would totally suck showing up to my PM office for a scheduled appt. ony to find a closed door sign from the DEA or something.

    At least they are providing a weaning scriot if you do get kicked out whcih is somewhat decent.

    All I'm saying is lets say someone was a drug addict and they got hit by drunk driver while crossing the street one day and now on acount of that they are in the most severe pain because there back is messed up.

    Just cause that person is a drug addict does not make his health issue and pain any less real or does not mean he is faker.

    It's just that Ilm coming from the point of view of how it feels to be in severe pain and not have any help for it. And I know most of us on this health board have experienced that at least once and we know how bad it was. It's actually torture, when we can be helped so much by the simple stroke of a pen by a doctor on a script pad.

    Or lets even say the guy quit taking illegal drigs for the most part and then one weekend was tempted or something and had a relapse and really it was not his fault because he had the addict metality of his past and there was just no controlling the urge to do a few lines of cocaine. If he fails his random test it does not mean he is not really in pain.

    Beleive me Ex, I'm a conservative and don't get me wrong I do agree with you for the most part and I also beleive people make there own beds and hence have to sleep in them, your life is your life and the choices and consequence of those choices are your to live with and blaming it on other people is just plain weak.

    But in this case I;m a little more sympathetic because it concerns health and pain and even though people are responsible for the choces the make, lets be real we are human and as such we all make mistakes in our lives and all Ilm saying if someone does fail the drug test I think the Dr. should at least discuss the circumstances with the patient and find out what happened, rather than just sending a letter and saying you can no longer come to this PM clinic.

    Because failing a test "may" mean your a bad apple, failing a test does not 100% say you are bad apple either.

    And I really think that sending someone's private and confidential results to the DEA is a little to much. kicking them out of treatment is one thing but sending there results to the DEA a government law enforcement agency that is way over the top. (At least that is what I think)

    Now if someone was found to be selling and doing illegal activites with scripts from the PM office than by all means take him down, that is BS and that person should pay the price. But if someone made a huge mistake and smoked Marijuana one weekend, i think that is different than someone who is faking and taking his meds and selling them. The person who smoked a puff of marijuana does not mean he is faking an illness to get meds.

    I guess Ilm just sensitive to the issue about doctors thinking you are faking it has not really ever happneded to me but I know people it has happened to and i feel so bad for them

    Last edited by Leo123; 08-28-2009 at 10:50 AM.

     
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    Old 08-28-2009, 11:49 AM   #17
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    Re: Possible Urine Neg for prescription will I be dismissed?

    I don't disagree with a lot of what you wrote Leo. However, just to play devils advocate, you have to really understand the Doc's POV. For the most part, he is really putting himself out there by running a PM clinic. His Rx's are for the most part, only narcotics...And lots of them. Thus, by the shear nature of his business practice, he is watched very closely by the DEA, not to mention other law enforcement agencies.

    As a result, his entire practice, livelihood, as well as all the patients are at risk....All over one potential person committing fraud. I'm sure the Docs realize that there are some unique situations out there as you described. However, most Docs just won't take the risk. Again, I don't mean to be insensitive, but I struggle everyday due to CP. I am very grateful to my Doc and his practice for helping me get through life. I do feel sorry for some who become addicts and are thus, discharged, but the vast majority who are dismissed have other issues and don't need to be in PM...Or need to be in a different kind of PM.

    BTW, there are Docs out there, and programs for addicts who also have CP. They just have to look hard for them. And of course, they are subject to a ton of polices, regulations, and etc. So, someone who truly is in bad shape, can get the help they need. Granted, they won't have the same privileges as we have, but that's the corner they backed themselves into.

    Regards,

    Ex

     
    Old 08-28-2009, 10:53 PM   #18
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    Re: Possible Urine Neg for prescription will I be dismissed?

    I think there is no greater adversarial role that PM doctor v. Chronic pain patient. And it is the illegal and irresponsible behavior of some addicts that has caused this to be. When somebody obtains narcotic pain meds under false pretenses and sells them on the streets, I think punishment should be swift and severe. On the other hand, many addicts are being successfully treated for chronic pain, and are responsible with their meds. Nobody sholud have to live in pain - addict or not. I hope it all works out in your favor.

     
    Old 08-31-2009, 06:27 PM   #19
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Just wanted to comment on the drug testing. My PM does a VERY extensive test. I was sent a bill for over $1,000 almost $1,500. On the lab "receipt" it was broken down with the chain of command and the cost for each step of the process. It was a VERY LONG list. It isn't just a positive negative test, it does look for amount of the narcotic(s) and if the level is consistent with your prescribed dose and how you take the meds daily. It tested for about 80 drugs (some by generic and name brand???not sure what that means). So it looked for the presence and level of both narcotic and non narcotic meds.

     
    Old 08-31-2009, 06:58 PM   #20
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Quote:
    Originally Posted by tattoos View Post

    Just wanted to comment on the drug testing. My PM does a VERY extensive test. I was sent a bill for over $1,000 almost $1,500......

    It isn't just a positive negative test, it does look for amount of the narcotic(s) and if the level is consistent with your prescribed dose and how you take the meds daily. It tested for about 80 drugs (some by generic and name brand???not sure what that means). So it looked for the presence and level of both narcotic and non narcotic meds.
    Yes....I've heard stories like this before re: companies like "Ameritox." Here is a fairly recent thread that goes into lots of detail re: the concept.

    http://www.healthboards.com/boards/showthread.php?t=604239&highlight=Amerit ox

    I'm no expert, but as I said previously, this seems like overkill to me....Not sure all that data is really worth anything, much less the extreme cost.

    Regards,

    Ex

     
    Old 09-01-2009, 08:27 AM   #21
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Or it seems like overkill or a way to charge an extra $1500.00 to the patients.

    Like you said Ex, there is no way to determine what dosage the person is taking based on a variety of factors, so whats the point really,

    MAKING $$$$ for the PM office is all I can think of. Like I said I've been to a couple PM clinics and know of the procedures at a few more large PM clinics in the LA area and I have never heard of such a thing. They are positive negative tests.

    Just my opnion

     
    Old 09-01-2009, 09:21 AM   #22
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Quote:
    Originally Posted by tattoos View Post
    Just wanted to comment on the drug testing. My PM does a VERY extensive test. I was sent a bill for over $1,000 almost $1,500. On the lab "receipt" it was broken down with the chain of command and the cost for each step of the process. It was a VERY LONG list. It isn't just a positive negative test, it does look for amount of the narcotic(s) and if the level is consistent with your prescribed dose and how you take the meds daily. It tested for about 80 drugs (some by generic and name brand???not sure what that means). So it looked for the presence and level of both narcotic and non narcotic meds.
    WOW, did you abuse your meds at one point? That is a lot of money to check every patient like that. Mine Dr said that unless they have suspicions or your test was iffy, that they test just to make sure you have the meds you are suppose to have and check for illegals. There is a drug cup that does that, so they don't have to send it out anywhere. It would cost them too much money to test everyone like that.

     
    Old 09-01-2009, 11:34 AM   #23
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Every patient gets it on one day at random times during the month. Never abused the meds or had any problem with the doctor. Actually it was in the initial contract we signed that he uses this sort of test. The day I went in every patient received a baggy with a cup. I answered questions and it was sent off. I guess it's his standard for his practice. Maybe it's because of his years in practice and he's one of only a handful of pain docs around here. He used to own one of the largest PM clinics in the state, in another town, awhile back (his wife is also the psychiatrist in the practice). In the last few years he downsized, I guess due to age and possible soon retirement (ohhhh noooo), and has just the office I go to. I have only been with him for about 16 months and only had 1 test done. He told me when my bill came the company would have to "eat it"...I am on disability. He also started giving me scripts in advance so I thought that meant they were comfortable with the patients compliance. Perhaps he has lasted so long because of his strictness. The contract was very strict too...I was blown away by it, but again, I had never done PM. Not only does your spouse/significant other (which I don't have) have to sign and agree to the rules but my mom had too (I am 33). She helps me out with my medical bills/taking me to the occasional appointment(s) if I am physically unable to (the case the first few months). But anyone directly assisting me needed to be informed and fill out the paperwork before I started.

    Last edited by tattoogirl; 09-01-2009 at 12:52 PM.

     
    Old 09-01-2009, 05:37 PM   #24
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Quote:
    Originally Posted by tattoos View Post

    Perhaps he has lasted so long because of his strictness. The contract was very strict too...I was blown away by it, but again, I had never done PM.
    I think you're probably exactly right. When PM docs go to seminars and continuing education classes (on pm), they are strongly encouraged to adopt new policies. The local DEA office also works with PMs to "recommend" certain ground rules.

    Conversely, those Docs who have lax rules, usually end up with an publicized case (or two). Unfortunately, these type of Docs unintentionally attract problem patients because word gets around that they don't drug test, have lax rules, & etc. And, these patients are the ones who end up getting caught up in a sting somewhere, OD, or whatever. When this happens, it can bring the entire practice crashing down. Docs have to be strict in today's environment.

    Regards,

    Ex

     
    Old 09-03-2009, 11:58 AM   #25
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Ya, I think that's what it is EX. He's like 67 (I would guess) and I noticed, on his wall, diplomas for MD, PhD, Neurosurgery, Neuro Psychiatry, and Pain (something) Management. At first, he was really cold, thought he didn't like me. But I think he was like that because he was checking my intentions etc...After the 3rd visit he was much more personable and didn't make me feel kinda scared to see him like in the beginning. Also, I and the other patients, have to see a counselor (not sure her exact title) for 1 hour every time I see him. I have a question but I think I have to do a different post for that. Thanks.

     
    Old 09-03-2009, 01:06 PM   #26
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Wow Tattoos your doc takes some extreme measures.

    If I may ask why does he make you see a counselor for a whole hour and what does this counselor and you talk about.?

     
    Old 09-03-2009, 01:35 PM   #27
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Quote:
    Originally Posted by Leo123 View Post
    Wow Tattoos your doc takes some extreme measures.

    If I may ask why does he make you see a counselor for a whole hour and what does this counselor and you talk about.?
    Well she basically does the whole appointment. Like instead of talking to the doctor she goes over all your medical tests, what's going on, emotional life/coping skills, pain levels...all the stuff that usually do with a doctor (so I didn't list all). And then she goes in with the doctor (while I wait in the waiting room) to discuss the treatment plan and then I go in to the doctor and he asks a few questions and writes the scripts. It rotates...when I am in with her the doctor sees the patients she has seen (so it's usually quite a longggggg wait). Plus some of the non "narcotic" pain management goes directly to him. Like some of the patients deal with psych meds too. And some of the patients see the Psychiatrist there (his wife) and then him.

     
    Old 09-03-2009, 05:55 PM   #28
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    Re: Possible Urine Neg for prescription will I be dismissed?

    Quote:
    Originally Posted by Leo123 View Post

    Wow Tattoos your doc takes some extreme measures.

    If I may ask why does he make you see a counselor for a whole hour and what does this counselor and you talk about.?
    This is becoming more and more common in PM. PM Docs have learned to use counselors as a valuable tool in fighting CP. As you've seen in other posts & etc., things like depression, anxiety, low T, and a host of other issues often accompany CP. A good counselor can be a big asset re: coping strategies & etc. They also look for signs of addiction and will advise Docs when they think things may be amiss.

    Regards,

    Ex

     
    Old 09-03-2009, 11:04 PM   #29
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    Re: Possible Urine Neg for prescription will I be dismissed?

    It's become almost a game of cat and mouse with the DEA. Thanks to the never-ending (and prefectly useless) war on drugs, the DEA expects pharmacists to report situations if they think doctors are prescribing inappropriately. So doctors really have to cover their bases when it comes to prescribing long-term usage of narcotics. The UA's and other tests that many PM's require is more so that they can prove to the DEA that their prescribing is appropriate, and that the patient is not just an addict seeking narcotics to get high.

     
    Old 09-20-2009, 08:11 PM   #30
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    Re: Possible Urine Neg for prescription will I be dismissed?

    I got real real sick about 3 years ago...I couldnt keep anything down or in, if you know what I mean ,...so I KNOW that that was making me withdraw at the same time...When I was finally able to lift my head without puking, I called my PM and told the nurse what was going on...She immediately called in anti nausea suppositories...I cant think of what theyre called..I have more in the fridge...Starts with a V...Anyways, my PM said to NEVER go on like that ( my spouse was out of town for a week...I was too sick to call anyone...again, I KNOW that the initial bug started the downward spiral of the withdrawl) ... but anywas my PM has left a standing 12 suppositories prescription for just such things....He said when people are sick and cant take their meds, they may go thru this and the suppositories would help.....AND HOW !!!....I wanted to DIE !! ( figurativly speaking) ...But I LOVE my PM for being so caring to tell me ' dont EVER do that to yourself again....) He cares !!!......Ok off my 'I love my PM ' box !! ..HA !!

    But your meds should be readable in your system for a few days
    !!

     
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