My Dr. gave me a mouth swab test!

Question

Ok, I am going to break dOwn everything that happened at my dr.s appointment.(Please keep in mind I was out of my perscription 3 days early and doctor did not know this) I went in to see doctor and he did the usual rutine, left the room but came back with a cup and told me to pee in it, I couldn't go so he said ok well we can do a saliva swab test instead. I asked what for and was told to make sure there are no drugs in my system that shouldn't be and to make sure what I am perscribed is in my system, ok i took the swab and rubbed it around in my mouth handed it to the dr. He left the room and I was waiting for about 10 to 15 minutes( keep in mind I believe it was just random day for every1 there, not just me, I believe all other patients that day were being drug tested also)The dr. came back in the room,he never said anything about the drug test to me, just wrote me out my perscription pain med(percocet)and I left. ?#1. Was he waiting for the results from the swab test before he came back in. ?#2 Is it possible he could have givin me my percocet without seeing the results of my drug test first(me being unsure about how long results take for a swab test and if a doctor would have swab home testing kits and perform test right at place just like they do with the urine tests)... Thankyou every1 for taking the time to read and answer these Questions!!!

jmflbanko · Answer

This past week I visited a new pain management doctor. I sure wish I'd seen him years ago. The first and second thing they did was a urine test and a DNA swab. I got the urine test reason, cut didn't understand the swab  until I researched it. The DNA will tell the doctor which drugs  you may have an adverse effect to, and which are more likely to help you. I spent one year with a very well known university's pain management center, and they NEVER DID THESE TESTS. I cannot account for the number of drugs the doc gave me that were ineffective. Cost me and certainly cost my insurance company $$$. More importantly, it's kept me in pain!  

The results come back in two weeks, and I'll see the doctor again. Here's hoping he can help because no one else has.

FibroFoggy75 · Answer

ALWAYS make your pharmacist count your meds WITH you before you leave the pharmacy. I've had all kinds of problems with psych and pain meds running out too soon until I make the pharmacist count them WITH me. Only when we both agree that the count is right do I pay for the meds.

Bethiepoo2 · Answer

DNA testing can only be a good thing! It will help the doctor understand how you metabolize meds. Some people have problems metabolizing certain meds and will continue to suffer to matter how much they take. This is just a tool that docs are starting to utilize to help you. It's not too measure the meds in your system!

phomp63 · Answer

I go to a pain clinic, on one occassion someone from Proove DNA company asked me if I would allow them to do a DNA test；I said yes not knowing what might happen.  When the test came back it read that I don't have an addictive personality,  it said if I tell someone I am in pain I AM IN PAIN.  It covered the meds I am taking and everything looked good.  I was so thankful but not surprised the test came out good, I don't know what I would have done if it the test came back differently!

Proove Inc asked if I would take another test that would go over all medication and how my body would react to them.  I don't have the results yet.

My heart Dr.  said he didn't think that he would trust the results because DNA is a new thing.

I don't agree with him but I do wonder now.  I think if DNA test are true it would help Dr's help their patients.

The person who had this question seemed to think Doctors didn't know what they are doing.  If they are dealing with pain patients they are under the governments thumb!  They are working long hours just on paperwork and tests.  Pain Patients have a rough time and are looked at as possible addicts!  Something will have to be done.  I was a patient at Minor & James Medical Clinic since the early Nineties, that clinic kicked all their pain patients!  My question is what are doctors going to do to help pain patience get their reputations back?  I think we all are in for a hard time.....Dr's and Patience!

Tuckamore · Answer

Hello an Welcome!

I wish you would have made a new thread instead of tacking a comment onto this old one. Please consider doing so - as old threads get little visibility and comments.

That said, I wish you well and hope that  Pharmacogenetic Testing (PGT) will bring you answers and better pain management. 

I have changed my opinion on PGT to some degree. I hoping this will become a good tool in better pain management. My astute PMP still holds solid that in his belief that PGT is yet perfected. 

Please begin a new thread and help educate our members. If you need help doing so - please let me know. And please let us know the outcome of the testing and how beneficial you find it. I'll look forward t hearing more from you.

Best of Luck,
~Tuck

Tuckamore · Answer

This is a very old thread. I encourage you to begin a new one, properly titled. It will be allow you better visibility and hopefully more responses.

I don't want anyone to be confused. Today UDT are very accurate. Chromatography (metabolic analysis of urine and or blood) is the most accurate (like 99%+). Cheek swabs recently discussed here are DNA based to determine which opiates your body best metabolizes.  They are called Pharmacogenetic Testing (PGT).

Thanks,
~Tuck

Tess523 · Answer

On a positive note... Those honest pain Drs in practice today are able to help LOTS of patients, giving every one of them a better quality of life than if they weren't on the pain medicine... Once your life has been affected by pain- whether it be from an accident, inflammatory arthritis, MS, Lupus, RSD/CRPS, spinal cord injuries, or any other conditions...your life is literally turned upside down! I am living with permanent & irreversible damage from several Drs making mistakes. But I also spent my entire life, since about age 5, with everyone in my family & acquaintances calling me a hypochondriac! Fortunately, since the time I was diagnosed with Systemic Lupus, no one has EVER called me that again! It sure hurt that people didn't believe me when I told them all those years that I felt sick & miserable... Because of what was going on with my hands in HS, I found out, many year later, that I was in an active flare for all of my Sophmore & Junior years.
For anyone out there whose Drs are suspecting Systemic Lupus (who haven't been diagnosed with the disease)...  Do this to help your Dr- make out a list of EVERYTHING that has happened to you over the years that you have been sick- including anything that happened while seeing a Pediatrician. The majority of us, at some time or another, has had to switch to a new Dr. That ONE TIME of switching physicians, can cause pieces of the puzzle to be lost... A break in the investigative process. That happened to me, and it took well over 2 1/2 decades for Drs to suspect that I had Lupus. But it also included many years of unnecessary pain & suffering. I made out that very long list, that included events that took place when I was 5 years old. It is because of the delayed diagnosis, that I have much more system involvement & problems. My heart goes out to everyone that lives with chronic illness & pain! Weather changes, colds/flu/viruses, stress, lack of sleep night after night from not being able to find a comfortable position to sleep, injuries that make existing problems worse, or problems that are the cause of increased injuries... The people that are the richest people in the world are NOT those living in huge homes, driving the most expensive cars, or wearing the most beautiful & expensive clothes. The richest people are those that HAVE THEIR HEALTH! Ever since I got sick (then proceeded to get sicker), my life has changed drastically- plus, I look at life very differently now... Feeling well enough to able to get out of bed in the morning, going to the store to get groceries (or to go buy clothes), to going to a friends house when invited- these are all situations that are never easy for those of us that are sick. The deep hurt that each of us feels, when we have to say no. Then, when we have to tell ourselves "Maybe next time... Maybe next year"... That time, that unfortunately never comes. Our friends, or those in our neighborhood, who question whether we really want to be friends- all because we never get together... I have had people accuse me of using my health as an excuse- if they only knew/understood what I went thru every day... Before I got sick, I went out of my way to make friends. But after I became much sicker, those that I thought were my friends turned their backs on me, fearful that I was contagious- even though I told them I wasn't . The one situation that really hurt was this: I used to get together with other married women for penny ante poker several times a week. We had a blast! But after I got sick, they quit calling me & even avoided me. I thought I did something to get them mad. One day I ran into one of them & finally got her to tell me what happened- What did I do, that would make them not want to call me to get together anymore? Here was her reply: "Oh, you didn't do anything to get us mad. It's just that we were afraid that you would drop dead in front of us." When I heard that, it hit me like a ton of bricks. I will never forget the way that made me feel.... That was 31 years ago. But it still hurts...

Tess523 · Answer

The urine test can sometimes be wrong...one time, I gave a sample & they came in a few minutes later, stating something showed up in my blood. I totally fell apart, insisting that I NEVER EVER took anything illegal! They took a mouth swab test before I left. I called the pharmacist & told her what happened. I was terrified that they would do something else. She told me that test results can be affected by things we eat- such as poppy seeds on a bagel, or other foods. She also explained that urine tests can & do give wrong results, because of the testing unit itself, or other factors that the Dr office didn't tell you about.
The swab test is far more sensitive than the urine test, but it must be sent to a testing facility.... The Dr & his/her office employees are simply following what the law dictates- nothing more & nothing less. They must test patients on a regular basis, in order for the Dr to continue prescribing the medicine(s). If he/she doesn't, it can cost him/her their license to practice medicine at all! It is because of those crooked Drs, that there are so many laws... But at the same time, It is also because of those same Drs, that so many people have become addicted to pain medications, or their addictions became much worse. Those Drs that ran the pill mills made lots of money off patients... Their need/greed for money was more important than caring about the patient!

cpob1688 · Answer

Bingo!! For pain mgmt. doctors, it's used as an alternative to urinalysis to determine 1)whether or not patients are taking their meds as prescribed, and/or 2)if patients are augmenting their pain meds with illicit substances. A pain mgmt. doctor has no interest in your genetic markers whatsoever; it's a drug test, and that's it.

Kay4119 · Answer

I wanted to get feedback on the DNA swab. First I should mention my injury is a workmans comp injury (spinal injury)  and has turned into life-time chronic pain that will never go away, and all they do is deny me treatment, sometimes they approve the pain meds and sometimes they don't, they are a bunch of idiots and are not your friend, trust me. 

I was surprised by the nurse today at my pain management clinic with a DNA swab, I asked her what it was for. She said that Workmans comp wanted to get a sample of my DNA and also my urine.  The swab was used to examine how your body absorbs pain medication to let them know if they should try a new drug or stay with the same one. I let her do it, all the while not trusting Workmans comp, so at the end of my appointment I asked the doctor if I could get it back, as I don't feel comfortable having the state of CA having my DNA on their servers. I think it's an invasion of privacy, and I don't want it getting in the wrong hands.I understand my doctor requesting it, but they didn't; it was WC. I was afraid WC would use it against me in some way, like use it as a reason to not pay for my medication. My doctor said she didn't blame me and would not trust them either because of so many mistakes they make and they are making no efforts to help me, just make my life miserable by denying me any treatment that gives me any sort of pain relief.  The pain meds I am currently on are low-dose, working good and relieving most of my pain. Without them I would be bed-ridden and house-bound without a life. I always take them as prescribed and don't abuse them in any way, I'm very responsible. Anyway, I wanted to know if anyone else on Workmans Comp had this experience.  Thanks!

gina1959 · Answer

i recently went to my pain management dr. and they did a swab test.Will it be able to tell how i took my meds during the last two weeks of usage. like if i followed the prescribed dosage correctly or not.

Tuckamore · Answer

There is some great information on this old post. I sure wish someone would have began a new thread of this. I almost didn't read it. My concern is that many others may miss it also. 

At any rate here's what Wikipedia says about Pharmacogenetics. It is "the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects. The term pharmacogenetics is often used interchangeably with the term pharmacogenomics which also investigates the role of acquired and inherited genetic differences in relation to drug response and drug behavior through a systematic examination of genes, gene products, and inter- and intra-individual variation in gene expression and function." 

I don't know if you can refuse the have the pharmacogenomic gene test preformed. I would certainly question it if my PMP suddenly informed me he wanted me to have my genes screened. I would want to see the information on the test, in detail. 

As philnoir stated, physicians do not need a reason to change meds or stop meds, at least not one that makes sense to me. The climate in Pain Management has changed drastically over the last four years. We are now "problems" and "risks" for many physicians. It is difficult to find a provider that sincerely cares about you and your pain. So many are frightened by the DEA breathing down their necks. In reality a conscious physician that makes good medical documentation and prescribes responsibly is not in danger of losing his/her license. However so many are frightened that they are overly cautious to the detriment of their Chronic Pain patients. It's a sad situation. I don't see it improving in the near future. Lawmakers are not hearing us.

Indeed they are also utilizing check swabs for drug testing as Wobby65 stated.     

I would hope a new thread would begin if additional questions arise.

Tuck

Wobby65 · Answer

I realize this post is years old, but just wanted to chime in...they are now using mouth swabs to drug test as an alternative to urine tests. Our foster child was in drug court and they alternated between urine and mouth swabs. They told me the swabs were slightly less accurate but were more difficult to "cheat" like people do with urine tests. My foster child shouldn't have had any drugs in his system, so the swab tests he was given had nothing to do with how substances are metabolized.  All the other info posted here was great, but I suspect the OP was given a swab test in place of a urine screen to check what was in his system  b/c he said he couldn't urinate.

philnoir · Answer

I see your point, but there are already plenty of techniques to take patients off medications. In fact, in most states, doctors don't even need a reason to do so because no one seems willing to test their ability to remove a patient from drugs of dependence in the courts. This I would love to see --- what is the legal liability of a doctor who has created dependence via prescription to support detox and weaning of that patient who wishes to discontinue against medical advice, or who is denied medical treatment when they are informed of the risks and accept them? What right has the state to demand that a physician stop prescribing a particular medicine to a patient and at what dose. These cases are not being heard in our courts. 

The truth is that immunoassay (quick urine testing), and chromatography (metabolic analysis of urine and or blood) are both used to determine the presence of a medical substance in the body (immunoassay) or the presence of that substance's metabolites (chromatography). 

Chromatography is the only accurate way to prove non-compliance with medical instruction and physicians who depend on immunoassay to remove a patient from their practice, no matter how strong their controlled substance agreement may be, are looking for big trouble in our courts. 

The concept of informed consent for medical treatment is still a very strong point of law when in comes to whether or not a patient should receive a particular treatment and forms a much stronger precedent than the argument of standard of care.

Many legal techniques used in the war on drugs/doctors/opioids are double edged weapons that can be both ways by clever lawyers. Hopefully we'll see some smart young advocates applying informed consent with the same voracity as those who are applying standards of care today to deny people in pain appropriate, adequate, and effective treatment options.

SickKat · Answer

I just posted below.   But that is what I am reading online.  I have the piece of paper the doctor gave me on it.  It's called pharmacogenetic testing.  I was taken by surprise when she asked to do this to me today.  I went ahead and did the cheek swabs.  I also think there may be more to this than just the whole "genetic markers" and enzymes that show.  I am reading that there are pros and cons to this testing.  Since this is so new and they are now doing this on pain patients, and it seems psychiatric patients, I can't help but wonder if some doctors will use the results as reasons to kick patients off certain medications.

SickKat · Answer

Ok, a couple of things.  If your a pain patient and suddenly find your pain doctor wants to do a cheek swab, it is most likely what they call a pharmacogenomic gene test.  It is now becoming the new thing to determine a patients gene markers and make up, to see if they have certain genetic predispositions to certain medications.  Now there is I think a different type of cheek swab test that shows I believe through your saliva what type of medication your on and is supposed to be accurate up to 4 days of taking the medication.  I think this is separate from the Pharmacogenomic gene test though.  If you were given two cheek swabs then you might be tested for both.  I could be wrong, but this is what I am reading.  Today was the first time my pain doctor did this cheek swab thing.  I have been seeing her for almost 4 years.  She said it was to take your DNA and genetic marker information of some sort, and that it tells them if you have a certain genetic make up for certain drugs being effective, and others that might not be as effective for you.  It seems to be covered through medicare which surprises me because it is relatively new.  Here is some info I found online about Pharamcogenetic testing here: http://www.labtestsonline.org.au/inside-the-lab/genetic-testing/pros-and-cons

Also here: http://blog.dnagenotek.com/blogdnagenotekcom/bid/95403/Saliva-DNA-enables-pharmacogenetic-testing-for-psychiatric-medication

I suspect with all the media and efforts by government to limit pain medication and go after pharmacies and doctors that this is the new test to try and determine if your doctor can take you off or put you on certain medications based on the genetic markers that show.  I am a bit skeptical though, because they are getting your genetic DNA material that will be forever in a medical database or in the medicare database and from what I am reading they can tell if you have a genetic make up for depression, genetic diseases, etc.  So it could potentially be used to discriminate against you if anyone starts to take this testing that route.  I am going to wait to see what my doctor has to say when they get the test back.  They took two cheek swabs from me today.  Honestly I haven't taken some of my medication because it makes me so damned sleepy!  I will be interested to see if she picks up that some of the meds are either not in my system or at a very low dose.  I will come back and let you all know when I see her in a month.

philnoir · Answer

The OP, fortuner, posted this one message in Sept of 2012, and hasn't been heard of since.

PatchesNY is probably correct -- the cheek swab was probably to acquire a DNA sample for PGT.

One of the more famous lines from Shakespeare's Julius Caesar is: 

"The fault, dear Brutus, is not in our stars, but in ourselves." 

Had Shakespeare written today, he could have been talking about genetics. Our ability to metabolize one or another other opioid-based analgesic is controlled by a specific groups of genes. The PGT looks for those genes and is a good predictor of efficacy using the various pain medications available to doctors.

This test has little to do with compliance, but will tell a smart pain doctor which opioid medications are right for you, and which aren't, based on your ability to produce of the specific CYP450 enzymes.

radrolley · Answer

expect a random drug test/pill count at least at some point if you take any controlled substance. You should not run out of your medication early. If you need to take more you need to call and follow the orders. percocets are a pretty serious controlled substance. if doctors test or do pill counts and some one ODs or pills are being sold, Drs don't want any part of it. they have to at least make it look like they are preventing drug abuse. 

also i suggest trying to switch to just straight up oxycontin. percocet has tylenol in it. some people get enhanced pain killing effects when taking tylenol or an anti inflammatory with narcotics but the less drugs the better as long as you still feel how you want.

PatchesNY · Answer

This is what the doctor was doing 

What is Pharmacogenetic Testing (PGT)?
A simple saliva test can evaluate an individual’s ability to metabolize or process drugs. Pain medications such as hydrocodone, oxycodone, diazepam and morphine utilize the CYP2D6 enzyme in order to metabolize the drug. As a drug gets metabolized, it is broken down into harmless pieces and eventually cleared. The activity of your clearance system is based on your genetic code. Once tested, this knowledge about an individual’s unique drug metabolizing system can help guide physicians.

PatchesNY · Answer

It has nothign to do with that.  These tests are used to see how a person processes pain medication and to see if there is a better combination to use on a particular person.

marycarmel · Answer

Not sure about the swab test.  I've really only heard of urine, blood and hair (with hair tests mostly used in court cases.)  Why did you run out of your script 3 days early?  Were you in withdrawal when you saw the doctor?  Have you run out early before?

I'm asking because if you're running out early due to addiction, you need to address that.  If you're running out early because your pain isn't properly controlled, you also need to address that.

You don't mention how much percocet you're taking or what your pain issue are.  One worry about taking more than you're prescribed is you may go over the limit of acetaminophen, which can cause liver damage.

Hope you'll keep us posted on the swab test.