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drug screen/pain management
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drug screen/pain management

the dilemma I've found myself in has been causing me a lot of anxiety and I am in need of some input. last week I went to my pain management doctor for my check up and to get a refill on my meds. he did a drug screen on me and everything came up negative except I was "presumed positive" for cocaine. I don't consider myself an addict, just a person who was on vacation and went out with my cousins for a bachelorette party and we we're drinking and "partying" that weekend. now my vacation is over and im back to the daily grind and wondering what will happen. I need my pain meds so I can get through the work day then do the extracurricular activities after work. oh, I did leave with my pain script that day.......
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3197167_tn?1348972206
Not sure what input you are needing here.  You say you are not an addict and you left you PM dr with your pain med script?  What is your dilemma?
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Avatar_f_tn
The problem is? I'm slow today?
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Avatar_m_tn
Your doctor now knows that you're capable of doing highly addictive illegal drugs and your worried that you might get cut off from your pain meds? The only way you're ever going to know what your doc is thinking is to ask him "what's your opinion of me doing cocaine? Will that affect my prescriptions?" Being totally honest with him/her is WAY better than invasive. Engage, clear the air...
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480448_tn?1403547723
Well, if your PM doc made you sign a contract like most do, then he could very well dismiss you.  Most PM docs have a no tolerance policy for this kind of thing.

My advice to you is to be honest about it, don't try to lie.  Just tell him that indeed you used cocaine and then ask for another chance.  Tell him you'll be willing to adhere to any requirements he gives you. No guarantees, but you probably have a better chance that way than trying to lie about it.

If your pain meds are needed, and you're not abusing them in any way, then it only makes sense that you shouldn't do anything to jeopardize that.  That means no coke, no weed, no anything that would show up on a screen that wasn't supposed to be there.  Also, in order to not risk losing your PM doc, you must be compliant, meaning taking your meds as Rx'ed, not missing any appts, that kind of thing.

IF you happen to be abusing your meds in any way, then you really need to do some soul searching to figure out if you're going to address it or not.  Addiction is progressive and will only get worse.  Just putting that out there.  I understand that a lot of people seeing a pain mgmt doc certainly don't abuse their meds nor do they have an addiction problem, but a lot do, it's worth mentioning.

We have a great pain management forum also to check out if you'd like input from those folks as well.  Many of them deal with pain management docs.

http://www.medhelp.org/forums/Pain-Management/show/53

Good luck.
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1855076_tn?1337118903
I'm in pain management but always read here to keep on top of things.  And this forum was so helpful when I wanted off my meds.  (And now I go on and off; like when my BP couldn't be brought down because of the pain, despite 2 blood pressure meds.)

I get doing some coke (or weed or whatever) recreationally is different than someone abusing drugs (though personally, it's not my things; I'd rather eat cake.)  But if you're in pain management, you will find yourself kicked to the curb if you break your contract.  One of the reasons people in pain management have trouble finding doctors that will treat them is because many doctors are afraid due to diversion of the pain meds.  And it is a legitimate, serious issue.  But so is chronic bad pain.  No one should live their life in terrible pain.

It's best to try to stay at the lowest dose possible.  Otherwise you may find yourself in a situation where you are so tolerant that if you have a surgery, they will not be able to cover your pain.

Share on the pain management forum, though it's not like it used to be.  I would be very careful with your doctor.  You may want to confirm you are still under his care.  If the test you took first was a preliminary result, it's possible if they get a final result you may be dismissed as a patient.  If it were me, I would talk to my doctor.  Good pain management doctors are hard to find.  If he is going to dismiss you, ask for a taper on the meds while you search for a new doctor.  (Which will be difficult because you'll have been red flagged.)

You just have to realize you can't have it all.  You can't be in pain management and still play with other drugs or alcohol on the side (my doctor says no alcohol, which is fine for me because I don't care for it.)  

Just curious but do you ever run out of your meds early?  Addiction is a slippery slope.  Many people start out using pain meds for a legitimate injury/pain and find themselves one day drowning in addiction.  I really keep myself in check because I don't want that to happen to me.  And believe me, it happens to the best of people.  

Also, just FYI, sometimes pain meds actually increase your pain.  It is a real condition called hyperalgesia and it's happened to a lot of people.  Considering what I was on at the height of all my surgeries, what I take now is pretty minimal, but if I had to choose one drug, I'd pick ibuprofen.  It really helps.  I don't have the best pain control, but I'd rather live the way I am now on very low doses than the way I was before.

Pain management comes with lots of conditions.  Hopefully you can work this out with your doctor.  It's hard to really comment on anything specifically since you don't mention what kind of pain you have and what meds you're on.
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Avatar_n_tn
'Recreational drug use', what a crappy delusional way to describe trying to enjoy yourself by abusing scrip or illegal drugs. User and enablers love it as it attempts to downplay an obvious problem.

Let's get real. If I or anyone uses substances as a recreation we're in deep doo doo right then. Dependent, addicted, whatever; we're in trouble.

Doing so while undergoing other pharmacological therapy is dangerous and a gigantic opportunity to OD. Any physician who prescribes narcotics while a patient has a + UA (of any degree) for 'reactional drugs' is negligent and open to malpractice.
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Avatar_f_tn
Good point :). In my experience in drug testing employees when "presumed positive" a drug test is usually redone. Meaning there is a specimen identified at or above the drug threshold but hasn't been subjected to confirmation.  The Dr. could send for more testing or just let it be kind of a false positive. Not sure if he will act on presumed positive. If he doesn't you get a lucky break and maybe a lesson learned
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1855076_tn?1337118903
I think there are SOME people who seem to be able to use certain drugs, like pot, or alcohol, recreationally.  I would agree that it is rare for most people to keep drug use under control.  But I have known several people who seem to be able to manage using pot only occasionally.

We really don't know what the OP's status really is with regard to whether she's addicted or not.  Maybe the coke was just random and won't happen again.  I just didn't want to jump on her for being an addict since she wasn't asking for help in that regard.
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480448_tn?1403547723
I agree with you mary!  Not everyone becomes addicted.  Not that I would ever recommend dabbling with said substances because the risk is high, but there absolutely are people who have used recreationally and been able to walk away without blinking an eye.
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1827057_tn?1397523877
There is no question here .  Just a post about a trip,a party and an experience at a pain clinic.  ??? Maybe they will come back on and ask a question.
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480448_tn?1403547723
I agree ricart, that there is no specific question, but IMO it's pretty easy to deduce just from pulling out certain phrases what the OP is asking.  I agree that it would be nice if he came back to clarify though!!..

the dilemma I've found myself in has been causing me a lot of anxiety and I am in need of some input.

*then the description of pain mgmt and coke use, followed by this...

now my vacation is over and im back to the daily grind and wondering what will happen. I need my pain meds so I can get through the work day then do the extracurricular activities after work. oh, I did leave with my pain script that day.......


*I* assumed he is concerned about losing the pain mgmt doc due to the + cocaine result.  Hope he(she) doesn't leave us hanging!  ;0)
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1827057_tn?1397523877
The only person who would really know the answer to that is the pain doctor.
I have a friend who works at a pain clinic and their policy ranges from immediate dismissal to a slap on the wrist based on the individual patient history and the docs assessment of the severity of the violation.
  
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1827057_tn?1397523877
She says that the clinic she works for has a zero tolerance policy but it does not in reality.
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3197167_tn?1348972206
The OP stated 'I don't consider myself an addict"...hence my original post~
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495284_tn?1333897642
The writing is all over the wall~
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Avatar_n_tn
The writing certainly is all over the wall.

To read a little coke and/or pot or whatever is condoned on any addiction forum is a disservice, and all an unstable user needs to give themselves the green light. Especially by a poster with a bunch of gold stars by her name.

In addition and, pot and coke are illegal, normal people do not jeprodize their future to 'recreate' in this manner.

Nurse: your're exclaiming you agree with Mary (that not everybody becomes addicted) left me saddened. It is glaringly obvious the OP has problems with substances, legal and illegal.

I've read lots of good quality advice and suggestions from Mary & Nurse, this time they veered off course.







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4202953_tn?1377187106
From my short time on this forum I've found that everyone tries to be as non judgmental as possible to encourage sobriety and to encourage people to embrace a clean/healthy life. It's apparent that's what was going on here and they, also, mentioned that not everyone has an addictive personality, which is certainly true. If everyone had come off strong on this poster then it's 100% guaranteed that she wouldn't be back. By coming at her softer there is a chance. That's just my opinion and we're all entitled to the way we read these posts. We're all here for the right reasons :) .
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Avatar_n_tn
Okay, I can take a hint. It was nice for 10 days and I'll sign off completely.
I've re-tread everything and stand by my perspective and information.

I do wish everybody well, that's for sure.
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495284_tn?1333897642
Noone said you had to leave.  Everyone is entitled to their own opinion.
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480448_tn?1403547723
"Nurse: your're exclaiming you agree with Mary (that not everybody becomes addicted) left me saddened. It is glaringly obvious the OP has problems with substances, legal and illegal. "

I'm sorry my comments left you saddened.  I don't agree that it's glaringly obvious the OP has substance abuse problems, I don't feel we have enough info to make that call.  It's possible sure, maybe even likely, but I don't think with one post any one of us can make that determination either way.   I absolutely addressed the possibility of addiction in my first reply, to cover all the bases.  

I was agreeing with Mary's post that not everyone who uses certain substances becomes an addict, and I still agree with that.  That doesn't equate to me supporting the usage of the substances.  Nowhere did I condone that behavior, actually I made it apparent I wouldn't recommend even dabbling with it in any respect.

Like said above, we're all entitled to our opinions, and we're all here with the same purpose, to help others.  
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