false negative for morphine but false positive for vicodin!!
I am really glad that I found this forum...I am currently in as state of shock over what just took place at my own pain management doctors office. I have herniated lumbar discs which have also caused nerve damage, degenerative disc disease and buldging cervical discs. I have been on morphine for about 4 years, extended release and instant release. Last month the doctor gave ALL patients a urine test and when I got there today he said "we have a problem"...I was shocked and asked "what?" He said "the results of your urinalysis are in and they came back negative for morphine and positive for vicodin, I can only write you one months prescription and you will have to find another pain management doctor"... I was shocked!! I said "No way.. there is a mistake!!! I take my morphine like clockwork!! Every 12 hours!! I get home from filling my prescriptions and I take out 4 seven day pill containers and label them with each date... I put each days dose in each date and they go into a lockbox. I have not and did not take any vicodin!!" I insisted he retest me. I know there is a mistake. He said "no, it's a $900 test" he also added "the problem is not with finding the vicodin but with the morphine coming back negative"... HOW?? I insisted to him that the lab must have transposed the two drugs... but he refused to retest me and has now released me from his care!!! Does anyone know how this could happen?? I always, always take my morphine as prescribed!! I did NOT take any vicodin because it violates my contract that I have with him!! (as well as I don't have it nor do I like it!!) I don't know what to do! I even had a tooth extracted a week before that urinalysis and did NOT accept any pain meds from the dentist because it would have violated my contract with him!! The only other things I have taken are fioricet which is prescribed by him for migraines, "benadryl" which he told me to take every night because I never get a full nights sleep due to the pain. Also "Orajel and anbesol" for the tooth extraction pain. I am also a large coca-cola drinker!! I am literally in a state of shock because I know these results are wrong!! any help would greatly be appreciated!!!
Thank you both so much!! I do agree with the fact that maybe it is time for a patient advocate group! All I did was type in "false negative on urinalysis" and I was completely shocked at the amount of "hits" that I got! He gave me the labs phone number, I called them and they refused to talk to me until they have a release from him, which will be on thursday. I was a veternary technician for 12 years until I became disabled due to this medical and I know for a fact that these tests are not 100% and there is ALWAYS room for human error, let alone mechanical error. If those machines are not calibrated properly then there will be an error. The one thing that I do not want is to be "red flagged" on my medical chart for something that I didn't do wrong! Like I told my doctor.... I can't walk let alone function OFF my morphine due to the excessive pain level. and If I were to ever stop taking it then I know I would be deathly sick!!
It sounds like the test was switched with someone else. When I did the drug screen, the nurse wouldn't let me take my eyes off of her pour the sample into the container and put the correct label on before they sent it away.
This is unfair and I believe you should of been retested. He doesn't pay for the drug screen. You do with or without your insurance.
I said the exact same thing to him RunningMom!! They test EVERY patient on the same day!! You are given the cup and asked to "pee" into it and "leave it in the box in the bathroom" I didnt even see them get the cup FROM the bathroom!! I am really and truly still in a state of shock!
I wonder if the pm doc is using this as an excuse to downsize on his patients. Surely he knows that this is bound to happen with their system. I'm so sorry this happened to you. I was dropped from pm just by getting a second opinion. I'd make an appointment with your PCP and let them know what is happening. Most likely they will prescribe your meds until you can find a new PM. Good luck.
Welcome to the Pain Mangement Forum. I am so sorry that this has happened to you. Unfortunately it happens much to often. As said vefore you will never know why this happen. There are stastics that say these drug screens are wrong up to 60% or more of the time. All you have to do is be on this forum for awhile and you will see numerous posts like yours. It's always sad.
Unfortunately you have no recourse. There is no protection for the PM patient, no second chance. One failed drug screen gets you booted out the door of the PM Clinic. The lab eill only give you the number results. They will not admit there could have been an error.
I know this is difficult but please don't waste any time, you need to begin looking for a new PMP. My heart goes out to you. Please keep in touch and let us know how you are doing.
Thank you all so very much for your support. It's greatly appreciated. The biggest problem here is that I am in the process of trying to find a primary care doctor. Since I moved back here I saw one doctor whom I did not like for two reasons...#1) he answered his cell phone during the appointment and continued to carry on a conversation in arabic for 5 minutes IN the room!! (he could have said "excuse me" and left the room for that) and #2) he said "do you think with all the surgeries you have had in the past you are addicted to narcotics" ... I was so shocked at that comment. But I felt I handled it appropriately by telling him "no, I am permanently disabled. I only take what is prescribed by pain management and I have a contract with my pain management doctor that states I am not allowed to accept ANY prescriptions for any pain medications at all from any doctor other than him. I ONLY take what is prescribed to me and I take it exactly as it is prescribed".. This "new primary care" doctor was supposed to set me up with "pain management" here in Massachusetts but when I checked the doctor out that he referred me to online, it turns out to be "physiatry" (been there, done that when I was first injured) it wasn't until the physiatrist sent me to pain management that they put me on time released meds that actually helped relieve the pain. Like my doctor says, I will "never be pain free, they can only do the best they can to help make it tolerable"
I am going to call my pain management doctor back tomorrow and ask to speak to him directly. After researching on the internet and seeing that a urinalysis is not even 60% accurate, I was not there to witness my own urine sample collected or marked with my name (they had me "leave it in a box in the bathroom" and also from what I can tell I am entitled to request a second test OR a blood test and I was denied both! I doubt he will comply but I guess it's at least worth the phone call. I will also call the pain management clinic he has referred me to. I don't know, I am still very, very upset and being disabled it's not easy to fight a fight thats all due to some sort of mistake or error!! Again, thank you all so much. It helps to know there are people out there who have been through the same thing and/or understand.
Sorry to say but...IMO youre wasting your time calling the Dr that discharged you. Also sorry to say that your not "entitled to request" another UA. As long as he gave you a "legitimate" (I use that term loosely) reason and 30days of meds hes well within his rights.
Put this mess behind you and look for a better Dr. BEFORE your meds run out. You may want to consider weaning yourself off the meds with this last script incase you dont get new Dr. before the meds run out.
I sincerely hope everything works out for you. I dont know what your religious beliefs are but...Never underesitmate the power of prayer
If it makes you feel better to call your PMP than do it. Don't be surprised is he refuses to even take your call, It happens all the time and unfortunately that is the usual procedure.
And think about it? Do you really want a PMP that no longer trusts you and that apparently uses faulty procedures to collect urine samples for drug screens? I certainly would not.
You are correct there are some statistics that say that urine drug screening can be as high as 80% but you will never get a PM Clinic to admit to that. They have to rely on something. They are monitored by the DEA. If they continue to prescribe narcotics to someone that fails a drug screen they risk losing their license. Please do not think that I am standing up for the PM clinics, I'm not. These are just the facts as tough as they may be to swallow. I am sincerely sorry that this has happened to you.
I encourage you to also look for another PCP. In my opinion you ran into a very uneducated and unprofessional physician. There are good ones out there.
Thanks guys. I am not so sure it will make me feel better to call him... but I am going to anyway. If for no other reason than to point out the collection procedure they used that day. I have been suffering from a severe migraine all night and regardless of what I try I can't seem to relieve the pain and nauseau (sp). I have that appointment with physiatry next week and I have the number to the pain management clinic that my old pain management doctor gave me. I don't know..... I am still shell shocked. I honestly thought I read somewhere that I had the right to request a second urinalysis and/or blood draw. Does anyone know if a problematic gall bladder would cause false negatives or false positives? about 6 months ago they went in and looked at my gall bladder and said there was a problem with the bile duct that leads from the gall bladder to the liver. (I think that's what it was). But after reading the post above about how he was "within his rights" I am feeling discouraged. Because even if I were to "wean myself off my meds" then I would be 100% bedridden and in excrutiating pain!!
If you call him, what are you going to say? That your test was wrong? The doctor doesn't have to give a client a second chance, if he even suspects you're using the medicines in the wrong way he can discharge you, no questions asked. His ONLY obligation is to supply you with 30 days of medication. I suggest you call another pain management facility instead of the discharged facility and schedule an apt. They will not prescribe you anymore medication nor will they take you back because of stuff you read from the internet.
I don't agree with the way these tests are collected, but this is the way of THAT doctors office. If you're not careful, you'll add more information to your file and no doctor will want to take you.
I'm so sorry and I hope you get this sorted out, good luck to you.
I still think you should call if it will make you feel better.
And I disagree that you will add more information to your file that would stop another PMP from taking you. That is unless you would be unruly, rude or untruthful.
We all have to look out for our own best interest. I don't believe that your PMP is going to take you back for anything and I think you have nothing to gain by calling him. But again if it makes you feel better, call. Just don't let the results of the conversation upset you any more than this incident already has.
I can't stress this enough, call another PMP and get on the appointment list. It will take time to get an appointment, especially with the holidays up on us. My heart goes out to you.
Thanks Tuck, (and Joshua .. it's kind of funny that you have my PM's name, call me paranoid but at this point I guess anything is possible!!). All I wanted to accomplish with the call was to ask if he was even aware of how the specimen was collected! I pee'd in a cup and left it in a box in the bathroom, I have no clue what happened to it from there!! I honestly didn't consider that stupidity on my part until this whole incident. I never in a million years would have expected this to happen to me. From what I am reading morphine stays in your system for 3-4 days, so IF I had run out of my meds then I would have been visibly detoxing right in front of him! This wouldn't be the first mistake at that office, one of which his assistant input all my medical information in another patients chart on the computer... which he caught and corrected in front of me! I guess it is a matter of principle., I don't like my reputation being scarred for something that I didn't do wrong! I have two appointments set up., one is with physiatry (maybe that has changed since 5 years ago)., that new primary (the one who answered his cell phone during my appointment and continued with a conversation in arabic for 5 minutes) is the one who set me up with them as pain management.. the second appointment is with a new primary. One who has a better rating and hopefully will treat me with a little more respect. It's hard enough to move from one state to another but being disabled makes it a bit difficult to find a primary care doctor. I kept my pain management doctor because I trusted him with my care. He WAS very understanding that all they could do was try to keep me comfortable. So the step after that is to call the pain management clinic that he referred me to. I honestly think that he does believe me that an error was made, but where he is a NP and ARNP he is concerned the DEA will audit him and he will lose his liceance. I can only hope this was a "blessing in disguise" because he was an hour and a half away and my older son would drive me to my appointments with him every month! I am unable to do that drive. I am still very stressed out about the whole scenario & I am also still nursing a migraine... but what more can I do?
A couple of years ago I had a hospital run a drug test on me and come up positive for crystal meth! I am a 50 year old highly responsible woman whose vices are cigarettes and coffee. Admittedly they were kind of astonished too, because looking at me you would find that I am very healthy, work out, well hydrated, etc. Anyway, I did the research and found that this cold medicine I had been taking for 3 or 4 days in a row had something in it called psuedoephedrine in it, which tests out positive for crystal meth ALL OF THE TIME. I don't know if they ever corrected it, but I sure as hell hate having that on my medical history.
Wow ckaye, thats unbelievable... but believable (of course). I think only those of us who this has happened to can understand a believe it!! I am EXTREMELY curious as to "which lab'" did the tests on the others who came back with false negatives! Does anyone know how I can start a poll?? My doctor gave me the name and phone number of the lab that had run mine (AIT Labs) and he also sent them over permission to talk to me about the results. The woman I spoke with said they could "do a re-test" but when she came back on the phone she said "oh, I'm sorry but we no longer have that sample, but you can have your doctor send in the rest of the sample or submit for another test" and amazingly enough my doctor "no longer" has that sample either!! and we all know that he is refusing to retest me!! So the woman at the labs said that I could "speak to a toxicologist" and put me through to a voice mail. I left my name, phone number and an explanation of why I was calling but of course they never bothered to call back.
You know, I'm even wondering if the doctor is in trouble. Yes, it would be nice to talk to other patients at the clinic and find out if they had an experience similar to yours. If it came down to it maybe you could run an ad in your local free paper or newspaper or on bulletin boards or something and see how many respondents you get - even a handful would statistically give you some kind of picture. But what would you do with that information once you got it, and how would you go after the doc? You say what the doctor did was within legal bounds in releasing you (though you challenge his reason). Maybe you could file a complaint with your state attorney general's office if you got enough people together.
More and more people are going through this. I almost lost my meds due to a drug test. It's strange I had been seeing her for for 6 years before my first drug test. I take methodone and lyrica. I take lower doses than prescribed, so often call in weeks later after it's due. I called in for my meds and she was out of town. The Neuro there wouldn't write my meds until I took a drug test, so I took it. I walked in the place next door, was given a pee bottle, no paperwork, nothing. I even asked about it and was told just to pee. So I did and left. Course I asked for my meds 3 days later and failed the test. I told them I had just seen the dentist and had 5 root canals done. I was put to sleep and given Vicoden for pain. I told the nurse I expected to fill out paperwork and would have listed the meds. As an employer at the time, I tested my employees and they would fill out paperwork stating any meds, ect. Again, I was in an agreement not to take other meds without consent, but the tooth pain was bad. I told the Dentist and he said I would be fine and he wrote it for 3 days, course I didn't expect to get drug tested. Also, I was put to sleep. Didn't matter. I was told I should've refused the pills. I told her get 5 root canals done in one day and one extraction, I was in terrible pain. I argued, didn't matter. I actually got an attorney, after a letter they reinstated me. They followed improper protocol. Still, she has been a hassle ever since. They treat you like a drug addict when I in fact take less than prescribed. If your concern is talking a red flag, a lawyer could get it off. They have a strict drug testing protocol in most states...almost always now they require you hand them the pee and watch them label it and I even now sign my labels. I would check the drug testing laws in your state and see if they followed proper protocol...sounds a little fishy to me and your bottle sounds like it mixed up with someone elses. Hard to believe you were taking morphine and it not show up. Also, that he lost the sample.
If you can't afford a lawyer, legal aid may help. It sort of depends, you can't force a Doctor to see you, but losing your sample, .....I would talk to legal aid.
To: Armistead1424, I agree with TrayCee that your case is different, because you did break your PM contract. I had an extraction the week prior to my test and I refused the prescription because I knew it would violate my PM contract!! and the tooth was fused to the bone!!! It was excruciating, but that is why I used SO much orajel and anbesol! I numbed the heck out of the whole area for the full week.
To JoshuaY46013: Thats a good question the lab said they throw them out after 10 days.
To Group: I have been researching the whole situation ever since I got home that fateful day and I have discovered so many areas for questioning. Not only was I not present when they picked up my sample and labeled and packaged it, BUT I DID NOT even see the form that they submit to the lab for testing which is supposed to list any and all meds taken and it's apparently supposed to be signed by me!! I had been to the emergency room two weeks prior to my appointment where I was diagnosed with pneumonia and bronchitis., I immediately let my PM doctor know that they had put me on pills for the cough, I even handed him the bottle!! he said that it was fine for me to take them. (I have been wracking my brains trying to remember the name of that drug) benzotate (maybe??).. could that have showed up in a U/A as "vicodin" or could that have interfered with the morphine?? and here is the biggest question mark...
I was treated six months ago for abdominal pain, they did blood work and ended up bringing attention to my gall bladder. So they did an unltrasound on the gall bladder and also did the tube (where they put you under anesthesia) and it showed that my bile duct leading from the gall badder to the liver (or vise versa) was blocked. Can this interfere with my body's ability to process the morphine, thus resulting in a false negative??
There is also the question of which U/A test the lab performed.. if it was the ImmunoAssay test then that is extremely inaccurate (according to all the research I have done)... but if it was the Liquid Chromatography-Tandem Mass Spectrometry test (which i highly doubt) then it would mean that was not my sample that was tested.
I have an appointment tomorrow with a new primary (uggh) and on wednesday I have an appointment with Physiatry. I am not willing to just walk away from this without exhausting all means to prove my innocence!! Not when I take my medication every day and I can't walk without it!! Literally!! I am 80% bedridden WITH meds, but without them I am 100% bedridden.
So the sample could have been mixed up with someone elses. but my biggest issue is that I was not present during the labelling and packaging as well as I did not even see what was on the form that went with that urine sample. The toxicologist never called me back, so I am calling the lab again tomorrow, I want a copy of the report and my doctor already gave them permission to talk to me about it. I could barely "pee" when they tested me and I told his assistant as I was walking out the door that "I don't know if there is enough there to test, it didn't even go above the thing in the cup" and she said "that's ok"... if the reports states "how much" of the sample was recieved, I may be able to tell if that was my sample by the amount. I am also again going to contact his office however, I am getting together a letter stating all the facts, including the form that is submitted to the lab and the fact that I did not sign that form. I am under the impression that the form lists any and all meds taken and the patient is supposed to sign it stating that is the truth! I will fax it to his office. I know alot of you think this is a waste of my time and it probably is, but I certainly don't want to be thrown into a group and labelled as something that I am not!! I have been going through my old records and reading "no abuse or misuse by patient" at every single visit. And there still is none of that!! I do not abuse or misuse my meds! I am adamant that I don't "violate" my contract by taking any meds from any doctors including the dentist!!
I am finding myself extremely curious about the problem I had with my Gallbladder and the bile duct and IF that had anything to do with the false negative. As my PM doctor said he didn't have a problem with the vicodin in my system (which I didn't take any vicodin so I don't know how it came back that I did) he had a problem with the morphine not showing up! So I wonder if the problem with my gallbladder and the blocked bile duct has anything to do with the lacking morphine that I take everyday.
As I said earlier gallbladder disease would interfere with the drug screen. If it was your urine that they tested and they used the correct test and their was no human error the morphine should have shown in your urine drug screen. I too have done extensive research on the reasons for false negative and positive drug screens over the past 18 months as we have so man questions on this issue. There is much information available on www and some of it is conflicting and difficult to understand.
The one fact that is undeniable is called the chain of custody. It has been protocol for years since the eighties when we required pre-employment drug screens. Chain of custody means proper documentation, confirmation and handling of the urine sample from the very get go.
I had to physically hand my urine sample to the technician, watch her label it, sign the label and the additional papers attesting to the fact that it was indeed my urine and that the proper protocol was used to obtain it as well as identify it. It also stated that it was my urine that in the container. That is the correct and legal protocol for collecting urine samples for drug testing, not placing your cup in a turn style and walking out of the facility. That is the part of your ordeal that I find so troubling.
UA's are not kept. Every lab has their time limits, some are 5 days, some 10 or 30. Due to the mere volume UA's cannot be kept indefinitely. In my opinion it is not suspicious that they no longer have your sample.
Thanks Tuckamore. I was just coming on here to post the most recent activity. I contacted the lab again yesterday and spoke directly to the toxicologist. (who was extremely understanding and very helpful). He said "well, the meds that they have listed in section 5 that you take daily have MSIR (morphine sulfate instant release) and Addrall" I said "no, I am not on adderall (adderrall)!!" he said, "well, it sounds to me like they filled out two forms for two patients with two specimens in front of them, and athough this is not proper protocol or procedure it is certainly NOT recommended because it leaves too much room for human error, Since we no longer have the sample here to re-test I would cotact the doctor and tell them that there are medications listed in section 5 that you are not taking and a retest is recommended" (thank you jean from ait labs) So, I took his advice and contacted my doctors office again. This time to let them know about the mistake on the lab form and the fact that medications were listed that I am not on. This is where it gets good. I got a call back from my doctors office saying "I spoke to the doctor and he said that you signed your initials to the specimen cup"....What? I said "I didn't sign my initials to the cup.. they told me to pee in the cup and leave it in the box in the bathroom, but they never had me initial it!" and her response was "thats part of our forms of identification that we use. We require two forms of identification which is why we have you initial the specimen cup and the form" I told her "I was not asked to initial anything!" her reply "thats impossible, because the lab will not run the tests if the form and specimen cup are not initialed and WE will not do that for you" again I told her "I was never asked to initial anything!! I was told to pee in the cup and leave it in the bathroom, I spoke with the toxicolgist and there is medication listed in section 5 that I am NOT on and even he said that it looks like two forms were filled out at the same time and that leaves the possibility open that there were two samples which got mixed up". Once again she said "well, I will leave a note for the doctor, but there was no morphine in your system so I don't think he will call you" At this point in time I am livid. Are you kidding me?!! I called the toxicolgist back, got his voice mail and left a very polite message. I am now wondering how I find out what initials are on that "form" and if they even look at the specimen bottle for initials. I am sick to my stomache. The mistake is found I have NO doubt in my mind. BUT I know they are covering one of thier own employees backside. I knew from the minute he told me that there was no morphine in my system yet they found vicodin that there was NO way those were my results and now that I have the facts it sickens me to realize that he would rather keep an incompetent employee than a patient that had thier trust in him for years and has been wronged in such a huge way!! This is a HUGE mistake. I guess I don't expect them to admit it. And all of this during the holidays when it is much harder to get an appointment. I have enough meds for the next 3 weeks only because I immediately started researching this mistake. I only hope I can get in with a doctor who will prescribe the meds that work!!
I also went to my new "primary doctors appointment" yesterday, another laugher... they "put me in the system" but "did not have me down for an appointment" and even though I showed the girl at the desk the piece of paper and I said "I have an appointment on "december 21st at 10:45 am with dr. ________" she said "I'm sorry, but all they did was put you in the system". Like my mom said, "does anything ever go right for you?" .. I guess not.
This is where it actually gets even better! I called the toxicologist back today regarding what the doctors office said about me "having to initial the specimen cup" and the more I thought about it (I am up most of the night every night because I wake in pain. I get no more than an hour and a half sleep at a time) the more I realized that I was positive that I did NOT initial the specimen cup... BUT I could not remember and I was beginning to think that I DID sign A form. I am not positive, but I could swear she said "this just gives us permission to send in the specimen" and me being the bubble head and trusting patient that I WAS would have signed it (I had my scripts in hand and was ready to go and fill them).
So I called the toxicologist back.. he informed me that "no, they do not require patient initials on the specimen cup itself but they do require that the doctors office list two methods of identifying the patient on the specimen cup. for example a patient id number and date of birth corresponding with the requisition form, that way there if by any chance they have two "joe smith's" they know which sample belongs to which "joe smith" but no, they don't need the specimen cup to be initialed. They do of course need the form to be signed. However, my specimen cup had already been destroyed" (which is understandable.. my testing was done in mid-november.) He brought up the image of the requisition form and said "it has been signed by you." (whether or not it is my signature, I don't know yet) but I am assuming that it is. After all... I don't think it would have replayed so many times in my mind if I had not signed the form. but I know I did not initial the cup!!
I must say WOW, what an understanding person. It's obvious to me that he knows someone in that office made a mistake and he told me that he believes this is not my sample and that there was a mix up BUT that is "speculation" on his part. HOWEVER... he said he would call the doctors office for me and tell that that there was a drug listed in section 5 that I am not taking, therefore, hopefully starting the chain of getting them to have me submit a new sample for testing. Now,,, he and I have been speaking everyday, today we spoke at least 3 times where HE called me all but the first time. He knows that I called the doctors office yesterday and informed them about the error in section 5. He immediately called me back after speaking with them and he said, "okay, I spoke with ___ and informed her about the error of listing a medication you are not taking in section 5 and she said that NO they were not aware of this error. Now hopefully you will be getting a call from the clinic asking you to go back in and resubmit a new sample" I told him thank you, reminded him that I had called them yesterday about the error in section 5 and that thier reply was "it came back with no morphine in your urine and you have to intial the specimen cup" they also said that they "would let the doctor know" and I never heard back. I also gave him a huge thank you so much and I told him that I felt as if a "huge weight was lifted off of my shoulders because now even if they don't retest me, they HAVE to document in my file that you called them and informed them about this error!!" We both exchanged "happy holidays" and he left it with "if they have any questions they now know to call me directly, and I will tell them I think they should resubmit another urine for testing".
Wow... I am amazed. This toxicologist went way above and beyond the call of duty!! and when you consider that he is working for THEM and not me... he must really think a mistake was made on thier end.
I was so anxious earlier in the day because I had made an appointment with a new pain management doctor for a consultation (which was scheduled for new years eve!) I was going to have to call for a letter from him stating what meds he wrote scripts for, how many, etc, etc.
I also know that IF I were to go back to him.. I could never trust them again!! I learned the most valuable lesson ever, and that is when I "pee in a cup" to hold onto that sucker like it's made of 24 kt gold until it's packaged for the lab!! It's so sad that doctors we put all of our faith and trust in, can shut us down and not even give us the benefit of the doubt. As opposed to a new employee who has made significant errors in the past.
You have my comments on your journal post therefore I will only add again that I am sorry that this has happened to you. You must feel some vindication however now you must try to get this placed in your medical record.
You may want to contact the Manager or Director of the clinic. They all have one. At the every least you should be able to write the facts down in a rebuttal to the failed drug screen and ask that they be placed in your medical record. Be sure it is factual with the chain of events clearly defined as well as dates and names. You may also write a summary or a conclusion at the base of the letter including your suppositions based on the facts that are contained in your letter.
I will be interested to hear if the PMP ever returns you call. My guess is he won't.
I am so sorry this happened to you. I know what you're going through. My doctor died in an accident back in Sept. and I went to his replacement on December 7. I am on a variety of medications, including Vicodin and clonazepam (for two years). She said she needed to do some blood work on me and get a urine sample. I said fine. I had no idea she was going to do a drug screen (it didn't even cross my mind. I thought she was testing my kidneys or something!) I've never had a drug screen before so I had no idea what was happening. I never signed anything. When I got to the bathroom I had to search for the cups! Then I when I found some I just peed (sp?) in one and then realized I didn't have a pen so I just put it in the turnstile (?) to the lab area. I know, dumb. But I had no idea what was going on!!
Five days later I received a certified letter from the doctor stating no Vicodin or clonazopam were found in my system so she could no longer write me prescrptions for them. I was in complete shock. I called numerous attorneys and the best advice they could give me was to write a letter of dispute and ask that it be put in my file. Which I did. Then I found a new doctor. I was lucky. I made an appointment for two days later and told him everything and showed him the letter from my doctor. He wrote me my prescriptions and did acknowledge mistakes are made. The most important advice I can give you is to write a letter as Tuckamore suggested, get a copy of your medical records for yourself and your new doctor and to be completely honest about what happened to you when you see your new doctor.
I agree, I hate having this "red flag" in my medical file but as my new doctor said "mistakes are made" and every doctor truly knows this whether they decide to acknowledge it or not.
I dread this stuff, as well as having to find a new Dr. and jumping through all the hoops again to maybe or maybe not have your pain issue addressed, this despite documentation up the ying yang, etc. If you read the published papers and the periodicals, there is supposed to be a "pain protocol", and if a doctor adhered to it, there should be no problems with the law, patients, etc. But it isn't the case, as all of us here know. It is a damned crap shoot. I myself wish I could walk away from it, but then I have to deal with not wanting to live any more....Rats!
I am taking all the advice and will be writing the letter of rebuttal. Of course the PM dr never called me back. I did call his office yesterday, I was treated extremely rudely (of course) and they told me that they did get the call from the toxicologist. I asked if my PM was aware of this and she said she didn't know (sure). I asked why he was not returning my calls and she said he is out of the office until monday and she said she would "send him a message, whether or not he calls you back I don't know". The pysiatrist appointment was as bad as I expected it to be. After going through the usual painful exam and having to "try" to bend this way and that, he had me lie on my stomach and he proceeded to push on every herniated and buldged disc that I have! I was completely up front and honest with him as soon as I got there and I even told him the first thing that I wanted to do was submit a U/A. He refused. He ordered a more recent MRI (my last one was 2007), told me he will not write for my migraine medication, and when he made my follow up appointment for "4 weeks" I told him I will run out of my meds by then, he said "that's your old PM dr's problem not mine, besides I don't even know if I will write for those as you are on a very high dose".....I left his office barely able to walk, it took all I had to fight back the tears I felt so my son who drove me would not see me cry (I don't think I did a good job of that) and I am still feeling the painful effect of his examination this morning. I do also have an appointment with a new pain management clinic on new years eve. When I made the appointment they said they needed my old PM doctor to fax them a letter saying what meds he writes my prescriptions for, how many, the doses and that he will no longer be writing them. I can only pray that they will pick up where he dropped me. I am growing more anxious and more depressed with each day and each doctor. I understand that there are people who abuse these drugs and there are people who only obtain them to make a profit. BUT there are those of us who are 100% bedridden in excrutiating pain without them. Its so discouraging and I agree with ckaye582 that I wish I could walk away from it, but then I have to deal with not wanting to live anymore. You hit the nail right on the head with that statement. Because that is exactly how I have been feeling since yesterday.
thanks for the support guys,. it's all that is keeping me going right now.
It will get better. These are dark days for you as they would be and have been for others that have suffered through this type of incident.
With life there is hope and never forget that. We are here to support you. You'll make it through this because you are a assertive survivor.
Try to make your meds last as long as you can. I hate to tell you this but the new PMP may not provide you with a prescription on the first visit. I hope that is not the case.
The physician you saw was wrong when he said, "that's your old PM dr's problem not mine..." It should be his concern also. Are you not his patient? He certainly took your money. Where is the human element in some of these physicians? I would find another.
Never forget that these physicians are on our payroll. They are not doing us a favor. They are service providers. We hire them to provide a service, just as we would hire a plumber to fix our leaky pipes. If your pipes are still leaking after the plumber leaves your home do you continue to employ him? I would hope not. So why continue to except less than great from a much more important service provider? He would not get one more penny from me.
Stay with us. We are here for you. And don't give up or in. You'll make it through this.
Thank you both very much. I know... I will make it. I have been in excrutiating pain WITH my medicine after how that doctor examined me. He had me lay on my stomach and pushed on the herniated lumbar discs asking "does this hurt?" ...This was after the usual exam of bending this way and that "as far as I could" and "push my hand up" (with that dead leg)... gosh, I thought I hurt yesterday, the pain was even worse today!!
I do have the appointment with that pain clinic on new years eve and I wil definately keep that appointment. I know it is only for a consultation the first visit. I can only hope that they will give me a follow up where they will write my scripts. ,I was hoping to stretch my meds out, but I have been in more pain than usual since that "doctor" pushed on the injured discs and it wasn't a gentle push it was as if he wanted to hurt me! He is supposed to order a new MRI, but they didn't call me with that appointment yet.
I have been losing all faith in doctors. Which has me feeling extremely depressed but I think it's to be expected!
It gave me a bit of hope today to have my dad come home for 4 hours. Over thanksgiving he was in the Intensive Care Unit of the local hospital, he was in a "doctor induced coma" and was on a respirator because he had pneumonia and H1N1, we really didn't think he was going to make it because he was literally drowning alive. But, he did! Amazingly enough at 80 years old he pulled through. He has been in rehab since trying to regain his strength. It was great to have him home for a little bit and we had a great christmas with the whole family here.
Again thanks guys. It's so hard to keep the faith when you are treated so obnoxiously but somehow I keep dredging forward.
You made a very interesting point. These doctors that are willing to give Pt's with errors made (that do not even know) with their test another chance but are not willing to give the Pt they have been seeing for years the benefit of doubt and retest them is horrible to say the least!
I also have a question. How is a PA writing you narcotics? You stated that your doctor was a NP and ARNP in one of your post and this concerns me. The only way a NP or ARNP can even write controlled substances is if they simply write the drug and amount etc and have a licensed doctor actually sign the prescription. If this is the case then maybe you can request an appointment with the actual doctor that signed the scripts and explain what happened and at least this will be put into your file and most likely in your favor. Anytime you have a UA done it is policy to have you initial the cup itself and then have it sealed before you and then sign the paper which states which meds you take and the dosage. I strongly suggest to anyone having an UA done to request this to be done this way even if they do not normally. As we see just in our community the amount of mistakes made are staggering!
I wish you the best when seeing the new doctor. Maybe the date new years eve is a good sign as if all goes well you will start off the new year with pain management that will help you have a more productive and better functioning new year:)
Sandee brings up a good point regarding contacting the NP's supervisory physician. Prescription rights for NP's and PA's (there is a difference between the two) vary from state to state. It is an unusual practice but it is true. Each state is different.
PW my mother had pneumonia at the age of 70 caused by the Influenza A went through some years ago. I can relate. She too was in an induced coma and on a respiration for 5 days. We thought she would never make it. I am happy to report that not only did she recovery but she is still with us today. I was scared out of my mind. The lack of oxygen did cause some short term memory issues which seem to be increasing but so is her age. I wish you dad the very best. It sounds like he is out of the woods.
I also wish you the best in your consult with your new PMP. Don't judge them all by a few bad experiences. There are some great physicians out there. The war against drugs in some instances actually appears to be more focused on the war against physicians. They live with the fear of losing their license, rightly or not. So try to think positive and I hope your new PMP will be a better one for you.
I was under the impression that PA's can write prescriptions under the authority of their supervising physician. In some states, PAs are limited in the types of medications they can prescribe, but most medications (aside from "some" narcotics) are ok for PAs to prescribe.
TracyCee. I worked closely with multiple states placing NP's and PA's in clinic and other facilities. I also went to NP and PA conferences in multiple states. There is a difference in prescribing laws, not only what can eb prescribed by who may prescribe. Several years ago some states would not allow an NP to prescribe but they would an PA and visa versa.
I am hopeful that some of the laws have become more uniform however there remains a difference.
It's always a good idea to research all prescription drugs before taking them, and all drugs otc that require ID to purchase. I've learned that several drugs can cause false positive, even those that have no controlled substances in them. Obviously if your taking xanax it will show as a benzos, but on the other hand if your taking seraquel for anxiety, it has no controlled substances in it, and a patient leaflet does not tell you it can cause false positives.
Sudafed(antihistamine)-positive for amphetamines
Levaquin-(antibiotic)positive for opiates
All Antispasmodics (stomach cramping meds)-positive for barbiturates or benzos
All Antiseizures-positive for barbiturates or benzos
Antidiarrheals-positive for opiates
Some Antidepressants-positive for barbiturates or benzos
Some Anti-psychotics- postive for benzos
Some Mood Stabilizers- positive for benzos
sorry, with the holidays and my getting the "rebuttal" together and faxed out to his office. I have been a bit busy the past couple of days.
Yes, I did state that my doctor is an NP and ARNP, I am not sure IF he has since graduated to a PM doctor all together but I do think that he did. It is New Hampsire. My boys and I lived there for 6 years, but after my guy walked out on us (after more than a decade together), I couldn't make it on disability and child support, although I tried my hardest. After a long and difficult attempt to keep them up there where the schools are much better (as well as with thier friends) we came back home to my parents in Massachusetts. So, My oldest son has been driving me back and forth to his office every single month because I am no longer able to drive that far, as well as I am not supposed to on those medications. Yet another term to the contract that I adhered to all the time.
Since he has chosen not to bother to call me back, despite the discreptancies and errors discovered by myself AND the lab (who also contacted his office on my behalf regarding the errors) I can only assume that he is ignoring me. I am glad that I got the "letter of rebuttal" off to him via fax. It had all the errors, facts, etc and they are required to include that in my file, which would be forwarded or faxed to the new PM doctors office.
I did not initial the specimen cup. NOR was it collected in front of me. I now know better. I am more educated in that area and that is a huge mistake that will NEVER happen to me again!!
The gentleman at the labs has been even more helpful. He is sending me a copy of the requisition form and the results. This way here I can see exactly what was and was not listed under "daily meds". I have been contacted by a nurse (not associated with him)who informed me that he should have been aware that benadryl would cause a false negative.
I can only hope that new years eve will be a good one.
and I continue to pray that I will get the medical care than I need. It's scary.... to think the number of years that I have been on this medicine. I don't want to end up 100% bedridden due to the pain again!! They have said that "all they can do is keep me comfortable" and "I will never be pain free even with my meds" ..but if I am still in pain ON my meds I don't even want to imagine how much pain I will be in without them!! I swore I would never let my kids see me like that again. Where I just laid there crying. Not able to walk or get up to make them dinner, etc.. Let alone be able to make it to the food store to use a cart to buy groceries. I certainly hope it doesn't come to that!
Thank you all so much for your support!!
tying to post my story not good with computer lol anyway i tested negative for pain med that should have been in my system i dont get it now my pcp does not believe me sent me a cert letter refusing any more meds suggested i 30 day to find a new doc on mass health new doc with this ya right , pending ssi disability case i think doc sent negative results to them now what ssress has been trigerng my eplipsey anxiety soon to be out of meds i do have thyroid cond could this be why also took antibiotic week before test yes the same doc could this be if so what are my rights if any lab has been nice they cant treat me or take all this away from my recored
These are some of the drugs known to cause a false negative.
The reactivity of 13 quinolones (levofloxacin, ofloxacin, pefloxacin, enoxacin, moxifloxacin, gatifloxacin, trovafloxacin, sparfloxacin, lomefloxacin, ciprofloxacin, clinafloxacin, norfloxacin, and nalidixic acid) was tested in 5 commercial opiate screening assays from September 1998 to March 1999. In 6 healthy volunteers, we confirmed the cross-reactivity of levofloxacin or ofloxacin with these opiate screening assays. be positive, therefore some will and have failed these test.
I am so sorry this happened to you. it is getting to become common here as new members ask the same question you have, why?
I would suggest trying to find a new doctor and be honest and tell them what happened and that you will gladly take test on a regular basis to prove your taking your medications as prescibed. Do not give up, there are doctors that realize these test are not accurate.
Let us know if we can help and we are here for you:)
WOW! I am so glad that I am not going to a Pain Management clinic, it sounds like they really keep you on a tight leash when it comes to getting meds and stuff!! I see a Neurologist at a regular , what would you call it, an outpatient clinic, where there are lots of different kinds of doctors. Anyway, I do remember having to sign some sort of contract when I first started going there almost 3-4 years ago, I think it just said that I wasn't supposed to get any narcotics from anyone but him. there have been times that I didn't count right and called in for a refill early, and I never had a problem. Maybe you should try getting a Neorologist that's not at a pain clinic, ya know?
Just reading about the people that go to a PMC, I am in shock! I have never been treated this way whenever I had a doctor that was giving me narcotics.
It all depends on the doctor and/or clinic individually how they practice. Most are very strict when it comes to narcotic medications and the guidelines and rules you must follow. It doesn't matter if the doctor is pain management or another specialist there seems to be problems with these urine test.
The doctors needs to realize and understand these test are not infallible.
Its too bad they wont admit that the tests AND the STAFF are not infallible. I have seen the physiatrist again, he tried eliminating my instant released morphine and gave me 1 week of time released and the name of yet another doctor!! I thought that because I was on time released morphine I would not have withdrawal from the instant released morphine........Boy was I wrong!!!
did you eat a poppy bagel? let's see could it be that your morphine was excreted faster than usual? it does leave your urine quickly. when you see a new pain dr. he's going to want to see your prior records so you're looking at a possible problem unless you can prove otherwise. be honest with the new doctor when you see he/she before they get the records and you can be sure there will be a note about this in there always is. how to avoid this from happening again? ask a pharmacist they know the chemical composition of all drugs and could give you a better idea as to what may have happened.
beer has opium in it did you have a beer? sounds funny to me that they tested you for vicodin when you're taking morphine both in the same family basically. fishy very fishy.
find a new dr. fast or start over
completely and get a primary and referrals and do your own research come up with how this happens alot to pain patients to hand to your new pain management doctor.
it's a terrible shame and alot of stress for you to start over again hang in there!
I would be interested in finding out what became of your situation with the false negative, I started reading your first post to my husband and he says it sounded like i had written it. I have been on Morphine 2x daily as well for 14 months now yet my surprise drug screen test came back as Zero usage and positive for Marijuana. I drive 4 hours to my Dr. I take my morphine 9:30 n 9:30 so i KNOW i had taken it on the way down to Pittsburgh. Yet it came back negative? of course he immediatly gave me 30 days and dropped me. In the process I have been trying to find new Dr. but my Dr. wrote a letter in my file.."patient tested negative on morphine with zero usage even though i have been prescribing it for many months" this letter he typed out as we were sitting there. Both of us in complete shock, my husband telling him he gives me my meds, he KNOWS I take them. I also as you immediatly was on phone with lab, etc. I also called a hair follicle place to find a local clinic that would do one for 109.00 out of my own unemployed pocket. I called the lab back and said this test goes back 90 days, which exceeds your lab testing, will this negate the test and PROVE i have been taking it all along?? She says yes i suppose that it would. So now i am scrambling to get the money together to get this test done so that can be added to my file disproving the lab results. Just blows me away to find out how many people out there are in our shoes.
I hope it has all worked out for you I live in a rural area and finding a new pm is going to be rather difficult as my clock has started ticking.
I wasn to let you know that Precious-woman hasn't posted on here since Jan. 2010. This is an older post would you mind re-posting by clicking the Green Tab at the top of the page that says Post Question and start a new thread? :)
There are LOTS of people that can help you with this on here.
I actually have been on... however briefly.
I had to find a new pain management doctor... my old one just wrote me off and had nothing to do with me since then except to send me a bill! It took me quite some time to find another pain management doctor who WOULD listen to me, run the tests (MRI's and CT's) and verify how severe my condition is and that I was more functional ON morphine than I would be on any other medication.
What I did was the same path that you are taking.. talking to the lab, taking other tests. However, I made sure that I faxed two letters to my prior pain management doctor stating that I was told to "leave the cup in the bathroom" and I did not see that cup after I left it in the box!! I did not see them put my name on the specimen cup. and I was not aware of the "chain" regarding the urinalysis... but I am now! I sent a "letter of rebuttal" informing him of the facts surrounding how my specimen was not handled or labeled properly. They HAVE to put the letters or faxes that you send them in your file also, so this will show any future physician that you disputed the results and why!! So he can have his letter saying why he let you go... but your letter of rebuttal will also be in your file!! I know that every single test that I have taken since then has been positive for morphine, so I know that his "assistant" made the error and mixed up my sample with someone else's sample!!
NOW... I make sure my name and information is on every specimen cup that they give me before I even pee in it!! They test me every month and it has been positive every single time!! It's so sad that we have to go through that type of ignorance! We should be given a second test however they act as if they don't even care!!
I am sorry that I have not been on often.... I no longer have a computer because mine died!! I am using my son's computer. I take care of my 80 year old father who was in a coma last Thanksgiving, he was sent home to die (literally) and he has no short term memory. He has congestive heart failure, sleep apnea, diabetes, dementia, triple by pass and the list goes on. So it's hard for me to find the time to log on. as well as the computer problem!
So, Cporovich, I am sending you a private message!! And for all my other pals out there., thank you for your support in my time of need!! and if anyone has an old computer they don't want I would be more than happy to take it off your hands!! :-)
Hi Precious. I just read your whole thread. I'm so shocked that you went through that. It's awful. I am happy that you have a good PM now. CP patients should not be treated that way. It's just so wrong. My mouth dropped while reading your story! It really made me think about the last time I had a urinalysis. When the girl (she was very young) listed my medications, she didn't write down dosage or frequency. I didn't have to initial the specimen, but I think I had to sign a form.
It's ashame that sometimes some of the people working for doctors aren't kinder, and it's ashame that there are incompetent people working for the urinalysis companies, since the medications that we take help us to live a more normal life.
I'm sorry that your father is so very sick. I will keep him in my prayers.
Thank you so very much!! I believe in prayer, so I am thankful that you will pray for him. Last Thanksgiving he was in a coma and on a respirator, at the age of 80 we never thought he would make it! I truly believe it was the power of prayer that pulled him through, and although he has no short term memory because of damage caused by the coma... he did pull through!
As far as the incompetence goes.... I totally agree!! I know for a fact that it was my old PM doctors assistant who made the mistake! They had tested everyone that day & there was another patient there when I was there!! So., keep an eye on your tests. Now I sit right down with the nurse & I watch her write everything down on the requisition form. I think that the only way for us to keep ourselves safe from these errors is to become more educated about the whole process and to make sure they're done properly! I understand that these doctors are being watched like hawks and cracked down on., however its not a good enough reason for us to be treated like criminals when we have done nothing wrong and the mistake is on their end!! (but they would never, ever admit that the mistake could even remotely be their fault!!)
Thank you so much precious-woman for your updates. So often we never hear the end of the story. I am glad that yours eventually had a happy ending.
There is also a Caregivers Forum on Medhelp that you may find helpful. I am also the Community Leader there.
I truly understand the challenges and rewards of caregiving. For eight years I cared for my father until he passed a few months ago at the age of 81. I know how difficult it is to watch you dad deteriorate. It tears at you heart. Rest assured that you are giving your father a very wonderful gift. You'll never be sorry. Hug him every chance you get...and don't miss an opportunity to tell him how much you love him and what a great father he has been. You'll never regret that either.
Thank you so much Tuckamore,
Your post brought tears to my eyes after yet another long night with dad! I know that I will have no regrets when he does pass... I couldn't have done more for him than I am doing now! Even his own doctor said that he looks better than he has in 10 years! Amazing for someone who was sent home to die!
I will definately check out the caregivers forum!! After his morning meds and insulin shot, my mom cares for him for a few hours while I nap, however she is 79 and I have noticed her slip with things here and there....3 times now I have found 1 of her pills on the floor, her hearing is going and she can barely walk!
I know it took me a while to find another understanding doctor... and although he is also in the process of switching practices I managed to get the new doctor to understand that if I am not functional... then there is no one to care for my father and I am functional on morphine. Now he just asks me how my father is doing! Its a really hard shock to ones system and ego when that false negative comes back and the doctor who you had all your faith in treats you like you have done something wrong!! BUT there is hope.
Have a great day and thanks!
I would sue the doctor. Not on the grounds of dumping you as a pain patient, but on the grounds that he allowed your reputation to be scarred through unclean testing. I would sue just to get his name on the lawsuit and get it said, I would not even care if I won. But while you may not have recourse to get reinstated in his office, you should surely have recourse to false information in your medical file. This information in your file can tarnish every emergency room visit you ever take. Not to mention give you some serious trouble at the pharmacy
If you had a toxicologist backing you up, I would say things would come around pretty fast.
This is beyond ridiculous. This person had no right to not listen to you. I know that you wanted to remain a patient but beyond that there should be human respect for a long standing patient
It's always wonderful to hear of members updates after a long break. I am very happy that you've found new pain management. It is so important for us to have a good support system.
I was able to take a break from opitaes and regain my ability for the meds to actually work at a lower dose. I never thought I could do it but I did. I can now take a 15mg Oxycodone and that alone will work for me.
I doubt that I will ever use the Fentanyl Patch again.
Well, I am glad that you're ok. Nice hearing form you.
I have two degenerative discs and one slipped disc. I have been seeing a pain managment Dr for three and taking morphine sulfate long lasting and quick release for three years and seen every nuero surgeon he recommend mo one will do surgery because of the location . Monday I had my monthly appointment and his new nurse had me take a ua no big deal. The doctor told me he won't see me anymore because no drugs showed up on my ua. What happened I am still in shock and depressed now and I took everything four times a day everyday for three years what happened what do I do now??? Scared..depressed... and in pain
I know just how you feel, I have been seeing my PM doctor for 2 yrs and now I got a letter saying that he could no longer write my pain meds due to fact that I didn't honor the terms of the controlled substance agreement. I love this doctor because he is not only my doc but my kids and wife as well, and he actually made me feel like he cared about my quality of life and not just the dollar signs. Tommorow is my last visit and I will be without my meds and don't know what I am going to do. In my urine analysis it said that my oxycodone didn't show up and I don't understand, although I had ran out early becuase it doesn't seem to work anymore, but I have never had an issue with this before until now. Frustrated and Unsure about the future.
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