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need help with questions about random pill count
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need help with questions about random pill count

I have been going to my pain management doctor for almost 3 years now. I signed a pain management contract with him, and I am aware that they can request a UA or do random pill counts at any given time. I went to my doctor today, and was told that I will have to do a random pill count this coming up next friday. I have always taken my medications the way he has prescribed them. But I am curious to know what date does he determine to do a random pill count from... Would it be from the last date you were seen in his office, or the date of you most recent perscriptions? I am curios about this because for all the months and years that I've been going to see him, they have always scheduled my appt's on the 27th or 28th day from my last appt. So with that being said, my insurance company and pharmacy would allow the scripts that he gave me to be filled no sooner than 27 day's from the last script that was filled... So does this mean that I would have to come up with almost 3 years of 2-3 days worth of pills or would he start the count from the date of my last filled scripts? I'm very confused about this, and I would greatly appreciate a honest answer from someone who has had this done to them...
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1331804_tn?1336870958
Hi and welcome to MedHelp.

I have never been subjected to a random UA or pill count (yet!) but I am pretty sure that he just wants to make sure you have the right amount of pills left starting from the last time you had your prescription refilled.  If you are taking your pills as prescribed, you should have no where near 3 years worth of pills.  

For example if you were prescribed a 30 day supply of percocet with a quantity of 150 pills, that would mean you are alotted 5 pills per day for pain.  So if your random pill count is 15 days since your last refill, your physician would expect at least 75 pills left in your pill bottle.  If there is less, that would raise a red flag.  

Many times random UAs and pill counts go hand in hand.  For example, if you get a random UA that shows a low amount of medicine or no medicine in your urine, when they do the pill count, the doctor would want to see more than 75 pills in your pill bottle 15 days after your last refill.  If there is less than that, it means to them that you are selling your pills or giving them to someone.  

Hope that helps.

femmy
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Avatar_m_tn
Thank you for the response.

I have been going to this doctor for many years, and I have several UA's done, and I've never failed any of them.. As a matter of fact, I asked while I was in the office yesterday for my last UA result from the month prior from Ameritox, and we went over it, and it shows the correct amount of oxycodone in my system. I then proceeded to ask why I've been selected to do random pill counts. I was told he's doing it to all his patients... I don't really have a problem with, as I have nothing to hide.. I have done anything wrong, nor have I sold or given away my narcotics. His staff schedules return appts for 27-28 days from the last appt, and he would give you new scripts on those days as well, so I would immediately take them to the pharmacy to have them filled... I have a huge fear of losing a paper script, so I just drop them off at the pharmacy so I don't lose them. He's never put a specific date of those scripts for me to have them filled, like I have to wait 30 days from the last refill. So with that being said, over the years I've had some months where I have a couple days of extra pills. Not 3 years worth of pills...

So my question was, would he start the random pill count from the date of the refill of narcotics he gave me, or would it go back months and months and months... I hope I've clarified this to where you understand it more.. I know it's sounds so confusing, because it is confusing the hell out of me..

I asked yesterday at my appt, what date he would start the pill count from, and the nurse told me, from the date I was last seen, which would have been yesterday, but yet I'm not going to pick up my new scripts that he gave me until monday, which is when the insurance will allow me to get them filled. So I don't see how he could go all the way back to yesterday, when I'm not able to get my scripts filled on that day....

Does this make more sense now? Now can you see why I'm confused about what bottles of my pills to bring... I don't want to bring to many back to him as he will reduce my scripts. I could use those extra 2-3 days I've accumlated in emergencies where I can't get to the doctor before my last script is up, which I've had to do twice now, since I've been seeing him due to vaction schedules..
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Avatar_m_tn
I get random UA but never had a pill count. My always asks how many I have left. I have always had extra left. Not alot but like 5 . One thing I am concerned about is that 1/2 yr ago I tested positive for a small amount of ethanol. I do not drink, nor does my husband. I was taking OTC cough meds like Store brand as I had strep throat and bronchitis. My Primary also gave me cough syrup with codeine. Ii explained this to the PA I saw that day showed her my prescription for the codeine and she said all is fine, that the alcohol was from the cough medicine.

I had another bout of strep and bronchitis last month and did the same thing, took OTC meds till I could see my Dr, them received antibiotics, cough syrup and albuterol    inhaler. My Dr was fine with that as again I showed my scripts but Im afraid I may show for alcohol again from the OTC cough stuff I took. I dont recall ever being told not to drink, but I dont and would not anyway because of the meds I am on.......Oxy...Cymbalta....topamax  plus I have 2 little ones 5& 6 and really dont have the time to go out and party. (My husband and I havent been out to dinner in about 8 months).

Anyone have any thoughts?  Will I get in trouble?  
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Avatar_m_tn
Im so sorry, I guess I went off track........  My dr asks how pills I have left from the last appointment. I dont think they need a count for the last 3 years. Good for you for keeping on track. I know its very difficult some times when we have a very bad day and want to take more. Wishing you a pain free day.......
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1331804_tn?1336870958
To dmoonchild and chronicpainisevil:

I don't think either of you will get in trouble.  I am amazed that they are going into that much detail to be able to detect ethanol in your urine.. Many mouthwashes as well as OTC cough syrups (like you said) contain small amounts of alcohol.  I wouldn't worry about it as you have made him aware of why of you were taking the OTC cough medicine.

I understand more now of your concerns chronicpainisevil.  That your random pill count is on a day when you won't have too many pills to show.  I think that this is okay.  Just show only what you have left from your last script that you filled which will be a day or two worth of pills.  And let him know that you are due for a refill on Monday.  I wouldn't dig out pills from your emergency stash unless you need them to balance out.  This near empty bottle pill count he is doing tells him whether or not you have run out early and are suffering with the withdrawals as you took too many pills than prescribed.  There are many patients out there that take too many and run out 1 to 2 weeks early and tough it out through the withdrawals until they can fill their script.  I think that is what they want to to check.

It sounds to me that you are compliant patient and have been taking your pills as prescribed so you should have no issues with this pill count.  So no need to worry.  :)

femmy
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Avatar_m_tn
Thanks femmy!
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1331804_tn?1336870958
You're very welcome dmoon!  I hope both of you are having a good day!  :)
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