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New Rules at my doctor's office.....
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New Rules at my doctor's office.....

I just returned home, after a regular check-up with my family physician.  A new rule has been implemented at my doctor's office, that MAY be a new law here in Virginia.  I am not quite sure.  Let me know if your doctor's office is now doing this....

Now, anyone taking a pain medication that requires a new written prescription every 30 days (with no refills, like Vicodan, Morphine, etc.), must have a once a month, urine drug test.  My doctor told me that they also require a blood drug screening every six months.  She said that with me, she will only do one, once a year because I have never shown any propensity for using pain killers illegally.  She said that it was a sad fact, that people that don't use pain medication correctly, are not only crushing the tablets to "snort" it, but are not taking the drug at all; but selling them for a large profit on the streets.  

The urine test will look for the drug actually being in your system (as prescribed) and will also look for any additional drugs, such as marijuana and drugs that are not prescribed for that particular patient, alcohol, etc.  

While I have never abused drugs, I was shocked to see these new, very strict rules that are now in place; all because of people that abuse these kinds of drugs.  I have to admit that I was a little angry that patients now have to do this, even though, personally; I have nothing to worry about, because I use my medication as prescribed.  All thanks to the people that choose to use this drug illegally.  Makes you want to choke them, doesn't it?

Please let me know if anyone else's doctor's office, is doing this.  I wanted to know if this is a new law on the books, or just some doctor's offices, taking this new approach.

It's a real shame that people that are in real pain and need these drugs to have some quality of life, have to go through such stringent new rules, such as this.  A real shame.  Next thing you know, they will be asking for your passport to even obtain a legal prescription.

Heather
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405614_tn?1329147714
Holy Cow!  I've never heard of such a thing!  It doesn't sound legal to me, but I'll ask my friend that's in medicine if she's heard of such a thing!

I knew people were abusing drugs, selling them, and all that.  It does make me want to slap them upside the head, for messing with those of us that are responsibly taking pain medications for valid reasons.

Last time I got refills for my Vicodin, it was with 4 refills, I believe, and that was last month.  I see my PCP next month, so will see first hand if everyone is starting the same thing.

Friend in medicine's response:  You have right to ask for actual law by statute that requires such testing.  A single doctor's office has no right to impose such a requirement without a law being in place.  You can check with the Virginia Medical Association if you like, or look at your state statutes concerning health care.  Each state has a website containing such info.

This would be a state law, not federal, and most every law we have in US is brought about by "a few abusing something that the majority is not, thereby causing a hardship for the majority"; the minority rules, which does indeed tick us off!

Kathy
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I have a friend who is a registered pharmacist here in Ohio, and manages a pharmacy at big-box discount department store that shall remain nameless.  I'll ask her about it.  So far, I've not had that problem.  Loretta had lots of Vicodin and Tramadol in her later years, and maybe one or two other controlled substances, but I'm unaware of any such restrictions being applied to her.

I'll also ask about Kathy's friend's statement.  It would seem to me that a doctor should be free to decline to provide non-emergency service to persons who won't conform to his ideas of sound medical practices.  Loretta had a doctor dump her once for rescheduling too many appointments, when she had to reschedule them because of her medical limitations preventing her from getting to them.  It's certainly possible, though, because I do believe that there have been cases of pharmacists, for example, getting in trouble for refusing to fill certain prescriptions for their own reasons of conscience.
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I only get my Pain Medication from one Doctor, and he is my Pain Management Doctor.
This has always been his rule, 30 day scripts, no refills before the 30 days are up and never by phone. No Matter how bad any one feels, The Rules Never Change.

The reason is there are so many people who abuse these heavy drugs...  I don't know how it works for meds that don't require a Triplicate, here in California I don't know if it is a law or up to the Dr. but These are the rules for my Doctor and I have never had a problem. He always has made sure I had enough Medication to cover the 30 days, regardless if it was the Oral Morphine or the zanaflex or any drug he wrote the RX for. The Zanaflex isn't a triplicate script, but the rules still apply... It doesn't bother me.

If I need to have the dose changed before the 30 day appointment, all I have to do is call him and go into the office, he doesn't leave me to suffer until my next appointment.

I know my daughter who lives in another state went from Dr. to Dr. getting scripts refilled because they gave her pain Medications that weren't called for and she became very addicted, it was very difficult to get her off the drugs... and was on at least 5 or 6 (at the same time), different drugs that when abused could have killed her. She was one of the lucky ones, she finally went to a doctor who told her NO more and he slowly weened her off of them

Just think "Micheal Jackson", it's about time Doctors became more responsible to the people who put their trust in them to what is best for their well being.

I am only voicing my opinion, based on my knowledge and experience, and I understand that there will be those who disagree with me, that's OK. I just feel this is too serious of a situation. I also told each of my Doctors about my past history of addictions before I was DX. I had to do this so they would be willing to hold me accountable if I ever misused
my Medications. (run out of Meds before I should).   It's beem 23+years and I have not once had to ask for a refill before it was time... But I have no idea of what might happen tomorrow

Of course not every one has these issues, but I think it is more than we realize.

Heather I am so sorry this has upset you, and made you feel like you weren't being treated fairly or trusted. But these Rules were put in place for those who would abuse their Medications not for people like you.  Maybe it will help ease your anger if you try to look at it from your Doctor's point of view????

Love & Hugs {{{~!~}}}
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In my state  controlled substance scripts have to be picked up not called in. No refills. I had to drive to the Dr. for pain meds after my lumbar puncture.

I am in a weird situation because my Neurologist says he does not treat my symptoms of MS  only give me Copaxone and my Primary care thinks he taking care of my MS stuff, so nobody does. My MS symptoms are mine to cope with.

I have a high pain tolerance but last night was an example of how bad it is. I wrote " It is 1:05 AM and I want to slit my wrists I hurt from my neck to my toes. I can't sleep the pain is so bad ". Luckily I remembered my meditation CD. I put it on and after several rounds was distracted enough to fall asleep.

Alex
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Hey Heather,

That will incur some long term cost, huh?

Surely it has it's place, but it's painful to see such scrutiny.  I would hope the medical practice would use their best discretion in weeding out those who abuse vs legitimate patients needs.

My gosh!!!!! Yea, like Kath says, individual state medical boards should have their guidelines.  

No one should have to submit to this with no propensity to abuse. Geesh! What next!
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Alex, I will pray that your doctors will learn to better communicate with each other.  I know all too well about addictions and the like, but there is no reason that you should have to suffer such terrible pain when there is relief available.
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Excuse me, I didn't mean to offend anyone, I was simply passing on what my friend that works in the compliance end of medicine told me.

Each state makes their laws governing their state on such matters.  If such a law is voted in, then of course it is right to require such testing.  

I reacted strongly because I felt it would be an invasion of privacy to be required to supply a blood or urine sample if such a law were not in place.  I would have no problem with giving a sample if it were required by law; I never go beyond my prescribed medications, don't drink at all, and don't use street drugs or smoke anything at all.

Doctors of course have the right to refuse to treat patients for many reasons, from having a volatile personality, being too demanding, especially when it comes to medications.  I simply don't think that there's a call to test drug levels unless there is a law in place, or a patient is displaying evidence that such testing is warranted, and then they would be bound by laws regarding patient's rights.

Missing appointments is pushing it a bit, but some offices have policies about such things.  One office I went to required a $50 payment for a single missed appointment!

I think such laws would put more responsibility on those doctors that don't follow common sense and prescribe to people that are making the rounds of many doctors to get what they want, or (thinking Michael Jackson or Elvis) simply prescribe enormous amounts of strong medications simply because they are paid a whole lot of money, and aren't held accountable.

In order to receive the pain medications that I do, I have signed an informed consent letter with my PCP, stating that I will not get controlled substances from anyone but her; I keep it simple by having her prescribe all my medications, unless my dentist prescribes some antibiotics, which happens once in a blue moon.

My PCP has known me for over a decade, and knows that I would not take more than prescribed; she knows that I put an end to a problem with alcohol more than 23 years ago, without any temptation to backslide; I learned from my mistakes.

Some classes of medications cannot be faxed or called in to the pharmacy.  Some people can only receive their medications monthly from a pain clinic, and there are rules about not having things filled early.

Alex, I understand that level of pain, and am happy that meditation was able to get you through it.  I need to do more meditation, because I don't want any more medications!  Also, it would help me from having snap "holy cow" reactions, :o}

Sorry, Heather, this is a lot of words to explain that I understand your frustration with this new rule, and encourage you to check and see if it is now a law there.  I'm glad that your doctor has leeway to have you submit samples less often.

Would people in states that allow medical marijuana use be denied care if THC showed up in their urine?  Interesting subject, so many layers, like an onion.

Compassionate care is important; improving a patient's quality of life.  So is preventing abuse.  Sigh.

Take care,

Kathy

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I do have to go into the doctor's office every 30 days or so, to have a new script written with no refills.  They said that is state law.  I don't mind restrictions and I certainly do not mind randomized drug testing.  

Yesterday when I took the drug test, which I did not know beforehand that I had to take, a nurse had to come to the bathroom with me.  She stood behind a barrier.  She put blue food coloring in the toilet and told me not to flush and do not wash my hands.  When I was finished, she took the cup of urine and first tested it for temperature.  (To make sure it was at current body temperature.)  I of course, could not take my purse in with me.  That didn't bother me at all.  What did bother me, was that I am so new at this kind of procedure, that I felt like a criminal.

I had to sign that the sample was mine and intial the specimen cup to show the sample was mine.  The container was wrapped with all kinds of security tape.  The nurse that did the test, was very indifferent and very cold.  I think that's what bothered me the most.  She has to explain everything to me, because I have never had to do one of these tests, since I worked for Wal-Mart back in 1989.

Along with my regular blood work I ahve done today to check my cholesterol and A1C blood sugar levels, I will also have to submit to a blood test, that checks all drugs in my system.  This drug test will only be done once a year, instead of every six months, as they require for "suspicious patients."

When I go in this morning for my blood work, I will ask whether this is a law here in Virginia or it's something that is up to each doctor's office.  As I said, I have nothing to hide, because I take medications as prescribed.  What should last me a month, usually lasts me 6 weeks or longer.  That is evidenced in my chart.

I can see random urine drug testing, but to have to drive to the doctor's office every 30 days to submit to this, seems a bit unusual and punishing someone that does not abuse drugs.

I am offended by it and am quite angry at those people that forced the system to have to go to these lengths, with lawful citizens that take pain medication to have some quality of life.

Thanks for all your reply's.  Anxious to hear if this is being done at other doctor's offices.

All the Best,
Heather
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I understand the frustration and anger you all feel.  I just have a problem with the government telling physicians what they can or cannot require in order to prescribe a particular medicine.  While certain substances will need to have restrictions placed on them, a physician should not be taken to task by the law if he or she feels it's best to add more restrictions of their own.  If a patient finds such practices too burdensome, they can urge the provider to lighten up, or they can "vote with their feet," and go to a different provider.  The real problem, I think we can generally agree, is those who abuse drugs, legal and otherwise, and those who facilitate their abuse.

I distinctly recall having to undergo such tests in the past as part of pre-employment screening (including for my stint at Wal*Mart).  It is demeaning, and the patient is made to feel like a criminal.  I suspect that the extraordinary level of caution/security employed is specified in some federal code somewhere, and was likely written to protect us all from reckless aircraft mechanics or railroad engineers, not cashiers or greeters.

Kathy, you did not offend me.  The offense that I feel is from those broad-brush regulations that, in the name of fairness or equality, treat everyone like a criminal, and from those who really are criminal in the first place.  I work in government regulation weekdays.  I have for almost a quarter century.  I see why we need most of the regulations that we enforce, and I still see that nearly none of them would be needed if people simply acted carefully and responsibly all the time.  When careful and responsible people wind up being hamstrung by them, and the criminals always seem to be able to evade them, there's a problem with the system.
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Hi, gal. This is just a note of support. I do understand all the whys and wherefores, yet I too would feel outraged and violated in having to prove myself 'not guilty.' That goes against the legal grain in a very tangible way.

I'm fortunate not to have needed narcotic drugs, except immediately following surgery. Even then, I wind up taking maybe 1/4 of the prescription and ultimately disposing of the rest. Just don't like having that stuff around. But for those who must take pain meds to have any decent quality of life, and who have demonstrated over years and years with the same doctor that they are not addicts and/or dealers, the new policy is extremely offensive.

Will you research this further to find out what law, if any, requires it? If there really is none, that to me would mean a change of doctors post haste.

Many hugs,
ess
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I just got back from having my fasting blood sugar taken and a liver profile done, since I am on an anti-cholesterol drug and lo and behold of course....the blood drug screening.  Good thing my doctor said that instead of the mandatory six-month blood screening I only had to do it once a year.  She said that I am too "trusting and have a proven record to prove it," to put me through blood work every six months for a drug profile.  At least I feel good about that.

I asked them today, whether this is a new law or just something that is being done in  this area.  No one could give me an answer.  All they told me was that the Pain Management Center of Charlottesville, VA., had a meeting with all the doctor's about this new requirement.  I do will do further research to find out if this is a new law that is just in my State or now nationwide.

The nurse that took my blood today, said she does not like this new program, for patients that have PROVEN themselves over the years, that they ARE trustworthy with any drug that is prescribed.  She said that it even says so in my chart.  She said my doctor's notation in my chart said that "I was the ONLY patient in that small, country practice that had a clean record with all drugs prescribed."  So I left pretty pumped up, about that.

Drug Screening done for now.  30 days from now, a piddle test again, when I pick up my new written prescription for Oxycodone.  Gosh I wish I didn't have to take anything for pain.  I'd love to live my life on an aspirin every now and then.  The pain I suffer from MS, has really taken it's toll on my life.  I don't believe in suicide, but I've been in so much pain, I had wished I was dead.  I've even begged the Lord to take me.  Now...that's some pretty bad pain.

Thank you ALL for your comments and thoughts about all of this.  We, as patients, I believe, have to stand up and protest.  Punish those that abuse the drugs and leave the rest of us, PROVEN ones alone....

Heather
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I think that having this type of testing is beyond what is necessary. My Doctor doesn't do any testing just doesn't write more than a 30 day script, and requires an appointment for refills.
Again just my opinion. Some times things are taken to an extreme..
I am so sorry you and others were put through this... Maybe if you tell the Dr. how this made you feel he will rethink this testing policy??? It sounds way over board to me...
Again I am so sorry for what you had to go through to get your medications..
{{{{~!~}}}}

PS: I totally understand about MS PAIN... I wouldn't be able to stand this pain without the pump and oral Morphine.. even that doesn't give me much relief any more... I am so sorry for what you are dealing with.. Know that my thoughts and Prayers are with you Daily as well as the hugs {{{{{~!~}}}}} This Dr might serve his patients better by working with you one on one, and not put you through what you went through this time. I hope you'll talk to him..
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I have searched one site after another and can find no "law" that has just been implemented or any other State Mandate, for this new testing.

I need to go back to the source to find out.  My doctor's office.  I also would like to know if this is legal.  They certainly aren't testing people sitting on a street corner for illegal drugs in their system.

Heather
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not to be the real cynic here HEather, but is it possible that your doctor is doing this *mandatory* testing to bring extra income into the practice?  Think about how many additional office visits and copays and insurance payments this practice will get.

Something here just doesn't pass the sniff test - something stinks about this!
Lulu
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Ooh, Lu, you could be onto something there.  I hope not, but it sure sounds like a possibility.
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Lulu, I was wondering about that too.... this is going to add up to a LOT of extra, previously unnecessary office visits, and a LOT of extra insurance claims and copays. It's grimy, and I would be questioning it too. I tend to think there's a reason why Heather didn't get an answer the last time she asked.... for so many people to be just following a rule, you would certainly think they at least would have some answer as to why the rule is there, and where it came from. I have to wonder.... are the staff and doctors in that hospital or clinic being tested every thirty days?  If patients needing the meds are required to be, then everyone on staff should be required to be too just due to the fact they handle and have access to the meds. It can't be countered by stating that the medical personell are too trustworthy, considering that trustworthiness has no bearing on how the patients are being treated!
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I did find out that the Pain Management Center of Martha Jefferson Hospital in Charlottesville, VA., are the ones that started this policy to keep track of all people using powerful pain relieving drugs.  There has been a huge increase in this part of the state for illegal pain killer usuage.  This is there way of keepin track of those that are on these kinds of medications.

The Pain Management Center has claimed that people that are prescribed these pain killers, are not taking them at all, but selling them for a large profit on the streets.  They are now checking patients to make sure that the proper amount of the prescribed drug is actually in the patients system.  This assures them that the patient is submitting to the requirements.

I also signed a drug agreement with Martha Jefferson Health Care Systems, some time ago, that I would not obtain any of these medications from multiple doctors or hospitals and in that agreement, it says that I agree to be tested at any time.  There was nothing in that agreement though, that I would tested every month through urine and blood tests every six months.

This part of VA., is where the University of Virginia is.  It is a school and a teaching hospital.  This is run by the University of Virginia Health Care System.  They are working in conjunction with Martha Jefferson.  So both health care system's are doing it.

I am not sure of it's actually legaility, but I am checking on that with my family attorney.  He works in Baltimore, MD., so he is busy looking up the law in Virginia and said he will get back with me.  He said that he feels that the testing is excessive, especially if I continually test as "clean."  He said that they have access to my medical records since I first started taking pain medication and can see how often I get a refill, etc.  He said that this alone, should tell them that I take it as prescribed.  So I feel that a few drug tests should be sufficient to know that the drug is indeed in my body, in the amounts that it is precribed and that should be that.

Thank you ALL, for posting your opinions on this subject.  Next I am going to find out if my insurance company is billed for all this testing, then contact my insurance company.

Thanks again, everyone,
Heather
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I would call your insurance now.  I would refuse to pay any copays to the clinic for unnecessary testing.Tell them if they want to make up expencive rules, they they are going to have to pay for it, not you or your insurance.  I lived in northan Va (Faquier County) for a while; they can be rather snooty when it comes to rediculous rules. If your insurance deems it unnecessary testing, they can refuse to pay for it, and if your doctor has signed an agreement with your insurance, he will have to accept what they say.

Just a thought.  I am with you in the disgust.  I don't mind paying for my sins, but don't falsely accuse me or treat me as a criminal when I am innocent.
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I am a woman in my 50's who has been on strong pain meds. for over 20 yrs.  I have never abused these drugs, & like you I wish I never had to take them!  I have never had to ask for an extra prescription because "my dog ate my meds."  which I guess is a common excuse.  My poor Chihuahuas would be dead if they ate my pills!!  Anyway back to the point. In the first week of January 2010 I had my first Dr.s appt. of the year & low & behold I had to take a urine drug test!!!!!  Like you I was shocked & not happy.  I don't believe in drug tests unless there is probable cause.  I don't believe you should be guilty until you prove yourself innocent.  It should be the other way around.  Matter of fact it is!  The fourth amendment of the constitution says your accuser must prove your guilt, YOU don't have to prove your innocence!  It also states that you don't have to bare witness against yourself.  It sounds like a witch hunt to me!!
Anyway I live in Arizona & the nurse told me that this was a new law that everyone had to enforce in ALL states.  That anyone that takes these kinds of meds. have to take a drug test once a year.  She did not mention anything about a blood drug test.  Which sounds to me like "big brother" is sticking his nose where it doesn't belong.  The nurse gave me a variety of reasons.  Such as, you may not be taking your meds. & instead selling them.  Or if you are complaining that your meds. don't help they can see what's in your system for your weight & height & adjust the dosage.  I was in such shock that I don't remember the other excuses.  My test wasn't quite as humiliating  as yours was.  She just gave me the cup & sent me to the bathroom alone.  Then again it's not like there was anyone else there to switch urine with anyway.  And like you, I had no idea that this drug test was going to be done that day.
I have nothing to be guilty about, but it's the principle of the whole thing.  And if we refuse, what happens then?  The Dr. won't give us our meds. & we have to find a new Dr. who may or may not do the same drug testing.  I like the Dr. I have & I have a lot of medical problems.  I HATE going to new Drs. & explaining all my problems all over again & having to build a new relationship again.  Not only that, but sometimes it's hard to find Drs. that will prescribe narcotic medications.
Heather, make sure you get a copy of your test results.  I get a copy of all my tests.  It's good to have, you just never know when you might need it.  When I go to pick up my test results in the next week, I'm going to ask them if they have a written copy of this new law that I can have.  If there is anyone else out there that has had to take this test at their Drs. office, please let us know.

DesertGirl246
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