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Advanced pain management clean urine test /cut off all pain meds cold turkey

Can a Nurse Practitioner cut you off stating it is the law from the DEA  if your urine test comes back clean showing no opiates  and your consent form you signed for your urine test stated that  meds  were taken the day before.(NOTE attending staff who had taken me back to do my urine test was told i was not taking  meds for many days due to illness,she kept pushing the issue is it at all possible knowing i take sleeping meds  for sleeping problems ,The only answer i could give was its possible, to my understanding when i asked her if there  was a problem  she  said no this form is  just to let us do the urine test,But i have now found out she  put  down i had taken my meds the day before. I was treated like i was a criminal i was not able to explain  and get no answers of who  or what i should do. The nurse practitioner had been my jury , judge, and executioner without letting me talk.All she seemed to care about was her medical license as well as pushing injections and other surgical help. She would not do another urine test, and she made a scean by walking out of the room saying i will not argue  with you  i was  just sitting there like WTF all i kept asking for is another urine test and who do i talk to  what can i do. her reply no and nobody.(this was the first time anything like this has happened .I dont drink, smoke, take street drugs, i stay home and only go food shopping.HOW CAN A HEALTH PROFESSIONAL ACT AS SHE DID AND NEVER TOLD ME OF WITHDRAWALS OR OFFER ANY HELP IN THIS MATTER.
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7721494 tn?1431627964
I just discovered an interesting feature of this website.

If you happen to write: Cover your ***

Three little symbols representing *** holes appear.

See?

Kurt Vonnegut would have laughed out loud!
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7721494 tn?1431627964
WE WHO ARE IN PAIN, some of us for many years, ARE ALL TIRED of this crap.

You don't need me telling you that acting out in your doctor's office may not be the best way of dealing with treatment issues, especially showing anger to a compassionate provider who has treated you for years.

People like us are angry because we're treated like criminals. I know because I've lived it. But it is not our doctor's fault. It is not our pharmacist's fault.

And I'm not trying to hold myself up as an example. Far from it. I've made big mistakes in managing my medication over the many years I've depended on opioid analgesics. But I have learned a few things that I want to share.

One important thing I try to remember is that there are two ways of looking at any conflict. This has been expressed many ways, but the point here is to consider the other fellow's situation. What's his or her perspective? Forget about your own complaint for a minute -- put yourself in their shoes.

What I want everyone to understand are the pressures placed on these compassionate medical providers -- doctors, PAs, NPs, (and even pharmacists) -- the people that allow us to obtain our pain medications every month.

The pressure on them to under-prescribe is enormous. And if they do prescribe, they have to be very, very careful to document everything. Cover their *** -- you bet.

Everything a prescriber does regarding controlled substances is being closely scrutinized at many levels of government.

Last year, over 2,000 physicians were investigated by state medical boards and federal agencies for over prescribing pain medication. Some of those 2000 doctors are today in prison for treating pain.

Let me repeat that -- doctors risk prison for treating pain.

A long-respected authority in pain medicine, Dr. Lynn Webster, MD, warned about the "chilling effect" our government regulatory agencies have on a doctor's ability to treat pain almost 10 years ago. Well, that chill is ice cold today. Some doctors refuse to write for controlled medications. Others who do are very careful about how they write -- they have a formula that they believe keeps them safe. This is one reason why we all take urine tests, we all have monthly supplies, we all sign controlled substance agreements, etc.

This is the world of living with pain in 2015 America.

The regulators who interfere with the practice of pain medicine are public officials who have failed the job of keeping illegal drugs from our borders. To save their budgets, they have turned inward, against doctors and other prescribers to improve their success rates. Their main interest, like all bureaucratic agencies, is to maintaining their overinflated budgets. I believe the new Obama budget includes $14 billion to deter drug abuse. You can maintain a pretty good-sized empire on $14 billion.

We are the only western nation that regulates at the federal level, doctors with what are essentially policemen who have no medical training. All other western nations regulate their doctors with boards consisting of doctors.

Here is the big picture: We must change our system, and to do that, each of you must learn how bad things are in America when it comes to the treatment of pain. It's not just happening to you.

The information is within your reach -- right on your computer. Find those sites that provide real information on this scandal. Don't trust the network news -- you won't hear of our plight. Here, try this to start:
http://stopthedrugwar.org/

Back down here on earth, we must do whatever is needed to continue treatments that allows us to function with CP. If this includes acting with a great deal of humility, respect, and affection toward our providers, who have the courage and compassion to treat us with medications that help take some of the pain away, it is a small price to pay.
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Avatar universal
Hello,philnoir, I thank you for all the advice you have given. May I say this to you I did have a trusting relationship with my NP second of all her actions were not as a professional ,Understand that you have seen my anger in my words and  my upsets as well this dose  not show  who I am as  a person I am very submissive ,very old school, I do as I am told I also have values.And one thing I have learned in my life is to be honest and respect .I think in your mind  you are seeing someone  in  a fighting match in a Drs office this is where  you are wrong .As a Treating medical Dr ,NP what ever there is a code  to fallow She did not give me a chance to explain and even till today I still do not know what really happened.I do know the nurse wrote a wrong amount of time I took  my last pain meds, The NP has wrote even a different time  and then you have the manager  that also said a different time , and yes I do have papers that prove this. As any patient or Dr /NP ect we all deserve respect. We all deserve to be fully told of what is going on.Not just left in a chair being told no no no one nothing you can do .
And as far as any other Dr NP ect the damage is done I don't even need to tell any new dr about this situation seems they all know about it already .I do have a right to file agenst anyone I feel has done wrong or has not looked out  for my health and safty in a professional manner. See you have already judged me by words I have written and  my actions I have taken, you have that right but like everyone that is telling me (they wont there) . I do think there is more to this then I will ever know it might  go back to the Chiropractor  that injured me in the first place. Small town Politician as a father who knows. BUT I WILL SAY THIS TO  YOU AND ANYONE ELSE YES I AM YELLING .... I AM TIRED OF THE OF DR,ECT TAKING ADVANTAGE OF MEDICARE/MEDICAID. And deep down I feel there is more money made by pushing injections and other types of surgical procedures'  I may not be perfect , I may not be the smartest, But I will no longer be intimidated by anyone  again. It took me many years to gain the trust back  and I did with my Pain clinic NP this has traumatized me more then you can comprehend .I have been pushed to many times with tears , nightmares,lack of sleep stress ect no one should be put in this situation. You may not see it but there are just to many big headed wanna bes over stepping there ground,This  is no different then being singled out from any other situation, school, work, family ect. There will always be bullies of all kinds and people with power trips that love to feed off of submissive people. I have no problem to say sorry to anyone or admit I was wrong. I can only ask of you to keep a open mind  to all you talk to many of us have had years of issues ect and we sometimes get to that point of being pushed to far and we fight back. Put yourself in my place, your sitting in a chair and just like that you are told  you will no longer get meds ,you are told that your np will not lose her license over you .you say you don't understand , you ask what happened  , your not being answered you ask what do I do who do I talk to what can be done  and  you hear no no no one nothing.and yet  you still are not told anything. Now add in what once was a really respecting and caring np has now become  this angry evil looking person. And you keep trying to find out what is wrong .and then  your told your urine test came back neg  and  your like ok but  you still do not know what has gone wrong. all that is said is  you signed the paper.well yes always.....4 days later you find out from a manager that the nurse/ helper wrote I had taken  pain meds   even being told I did not take them for a few days because I was ill, well as I stated the nurse / the Np/ and the manager all had different days when I took  my meds last and the copy of the orig paper well anyone can see it has been doctored up ,by the way it many times to get this paper.
I understand things  can happen wrongs and rights and you can forgive  and let things be. But 1 lie leads to many lies .I never want to see anyone lose there job.But I do have  the right to file a complaint ,I did say I was sorry for any misunderstanding to the manager and I also had told the manager to thank the main dr of that clinic for his help .As far as with my np she needed to step up. So if you think so bad of me that is fine .But I was as humble  and respectful as any human can be. And yes it truly hurts I have lost someone I respected and cared for who was treating me.
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7721494 tn?1431627964



You are going to continue to have problems with any doctor because of this attitude of outrage and belligerence medical staff. Continuing to argue with doctors, nurses, or advanced practice nurses will make matters worse.

I repeat -- there is no FBI record of people using prescription drugs. If someone tells you there is, they are wrong. There is a state prescription monitoring system. Your doctor and pharmacist both have access to this system and will soon be able to see if you are receiving controlled substances from more than one doctor or pharmacy.

I understand that you are upset, but channeling your frustration against the people from whom you seeking help is counterproductive. Now that you have alienated your PCP's nurse, where are you going to turn next for help?

Building a partnering relationship with any doctor requires trust built over time. Each party has an obligation to the other. Doctor/patient relationships are unique in that they are developed and not bought or sold.

It is totally inappropriate to discuss problems you've had with a former doctors and their staff with any new doctor with whom you would like to establish a new relationship.

Put yourself in the new doctor's position. Would you want a new patient who has just been fired by their previous doctor? Would you want this a patient who argues with your nurse about not receiving medication? If you were that doctor, would you fee comfortable with a patient who has filed a complaint with the state about her PCP's nurse? Why would a new pain doctor want to treat you after hearing all of this about you?

My advice would be to calm down and forget about past injustices. If you no longer have a PCP, you'll need to find a new one. If your PCP is willing to take you back, then you need to humbly apologize for your behavior.

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Avatar universal
Hello,I have asked for a copy of the agreement but have not been given one.My PCP will not give out meds,I am set up to see another Pain clinic but I have already had problems as I stated with the FBI  ect. I went back to my PCP and asked  if there was another place to go I was told no.So we shall see what happens.I have filed agenst my last Pain clinic nurse practitioner with my insurance company and state of Wisconsin Dept of Safety & Professional Services,I will try and find other outlets,.Right now it is hard living with  the pain I feel like what I had  to a somewhat control  to handle has been lost. All I can do is wait till the 17th. I wonder maybe if you know what the law might be to have to bring all your meds with you .I feel this is not right to force me to bring ever med , over the counter, vitamins ect with me.I feel this is going way beyond anything I have ever had to do before and when asked why the nurse said we  want to count them and make sure  your taking your meds and there up to the amount. I don't have any pain meds .I am 1 string short of losing it.Thank you so very much and I will try and check more often .Again thank you be well and safe Pam
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Avatar universal
Are you saying you have rheumatoid arthritis? You said RA so I take it you also have this along with your other medical problems?
I agree with you. No one should be treated badly by medical staff. It's bad enough that we have to deal with pain every minute of everyday. That's stressful enough. And then we have to worry that at any time we could be cut off or dismissed from any kind of pain care.
Do write those letters, do everything you can do to help your situation. If you truly need pain medication you should research pain Drs. There are still some good ones out there who truly do care.
Your sick stomach and headaches are most likely from withdrawal on top of the stress.
Keep us up to date on how things are going and how you're feeling, okay.  
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Avatar universal
Thank you so much ,time to try and  sleep be well and safe
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Avatar universal
Hello And thank you for all the help and concern, I have been slowly cutting down on what meds i had left ,I never abused my meds  and thank god i had some left from past 2 times  of being very ill, I am having very sick tummy and headaches not sleeping well but i dont sleep well to begin with. I also think  my dizapam is somewhat helping me at this point. I never was one to get addicted to anything for me i can stop but this past year things have increased as i knew they would i was told over 20 years ago i would lose the function in my hands as well as RA would take  over within years i have been very lucky i never gave up and kept my hands moving . But it is to a point this  typing is very painful .I have dealt with alot of pain and will continue for  the remainder of my life .But i will not take anymore abuse from anymore medical Drs or staff. I give respect and i  and everyone else being cared for deserves the same.I am old school and what i see for my kids and grand kids and the future holds nothing good. We will lose all our rights there  will be no more freedom,and we the people will no longer be heard. Thank you so much and sorry for taking so long to respond.  
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7721494 tn?1431627964
I believe you.

Best of luck.
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Avatar universal
Thank you for all the information.I did receive a letter from them that they will no longer prescribe narcotic meds. I do not have a copy of what i signed they never gave  me one.I have requested all my records all i signed and all tests. They have not sent me any of the forms i signed. I have already twice had  to call for  my med records then my urine test and forms i signed. I will pick them up tomarrow and see what forms are not there. With all this crazyness of being treated like a street junkie with no respect  and care  from both places I called my Primary care DR again to get in and see her to find out what is the problem and why i was being sent to a nurse practitioner again. Her nurse was the one who made the comment  of FBI ect. Note i am not looking for meds from her but even then when i got a call to set up an appointment to see my Primary care DR again her nurse said  in a rude voice  said just to let you know she will not  fill your meds. Im like what the hell is going on .I have never asked her for any pain meds ever in all these years.This situation has gotten out of control .I have filed a complaint with my insurance as well as the Dept of Safety & Professional Services,I will also file with the AMA and the State of WI medical board.There is no reason for the treatment i have been getting and what i have read many people that live  with so much pain are also having these problems.

In the past few years i have noticed more and more nurses have gotten this power trip of rudeness as well as talking bad about the Dr they work under,Even the lab personal that draw blood. With  my injuries i should be seeing a trained Dr not  a uneducated nurse or nurse Practitioner . In my case a educated Dr from Advanced Pain  Management should have handled what ever issues ect that came up. I AM JUST FED UP WITH BEING TREATED LIKE A LOW CLASS CITIZEN .I miss the time  when we had real Drs.

Again thank you  
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Avatar universal
I do understand about the constipation. My sister is on two medications for severe RA and she has this problem. She also has to take a prescription medication for the constipation.
I'm so glad Philnoir answered your post. He gives great advice.
Hopefully you can get this all sorted out very soon. I would recommend researching pain Drs and clinics in your area. Like Philnoir said, it's best to terminate your contract with this last clinic as soon as possible. This should be done in case your primary Dr prescribes to you or you get in to another clinic right away.
Unfortunately pain clinics do not care what reason you have for not taking your medication.  
Again, I think things are out of control with some of these clinics and pain Drs. I wish things would not have changed and all of us could be treated by our primary Drs who we know and trust. Their hands are tied though because of these laws. Just my opinion and take on what's going on.
Philnoir knows what he's talking about and if he says that you should be alright by now not taking your medication then you should be. How many days was it that you went without it before the urine test? I know you said "days" but I'm wondering how many days. If it was 3 to 5 days you would have already went through withdrawal and the worst part should be over by now.
Please keep us up to date on how you're doing. I know all of this must be so frustrating and scary. I really hope you can get everything straightened out very soon.
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7721494 tn?1431627964
If you were able to manage refraining from pain meds for six days without incident, then you will not experience withdrawal symtpoms. If indeed you were opioid dependent, withdrawal symptoms would have began 12-24 hours after your last dose, and reached maximum intensity within 72-96 hours.

The FBI does not maintain a prescription monitoring programs (PMP). However, almost every state does use them them, and they share information with the DEA. These PMPs track all controlled substance prescriptions and the data is available to your doctor, your pharmacist, and to regulatory agencies. In my state, PMPs went into effect in mid-2011.

As for your initial question, any medical practitioner can choose not to treat you at any time. Likewise, you can choose to stop seeing a doctor at any time. Whether or not this is an ethical decision is still being debated. According to the Harvard Medical School, denying anyone pain treatment is entirely unethical.

If you signed a controlled substance agreement, which most pain patients must do these days to receive opioid analgesics, you may have violated one or more of its codicils, causing your dismissal. For instance, your doctor may agree to treat you with opioid analgesics if and only if you pass all your drug screens.

I have no knowledge of the specific agreement you signed. You must refer to your signed agreement for specifics.

These "contracts" are unethical and discriminatory, as only people in pain requiring opioid analgesics are required to sign to receive treatment. Such is the nature of pain management in 2015 America. Some day this will change. For now, that's the way it is.

I suggest that you forget about this, move on and find another pain practitioner. Ask your PCP to write your meds in the mean time, and perhaps refer you to another provider.

Also, send a registered letter to your former pain clinic to terminate your controlled substance agreement effective today, so that you don't get into trouble with any future prescriber. Most agreements stipulate that you can receive these medication from only one prescriber, or that you can only have one agreement in force at a time.

Best wishes.
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Avatar universal
Hello , and thank you for replying .I will explain a bit better for you.I was off my meds for many days due to gastrointestinal problem and as  people know some meds cause constipation ,and yes i also take a prescription for that. Without getting into  more  it is  very personal and embarrassing .

Ok back to that had happened. I was off my pain meds for days due to this issue.And yes i was in pain for them days and then some . I was asked to do a urine test no problem ,when the assistant took me back she also had the consent form for me to sign as always, I was asked if i had taken any  meds for the last day day in half or so, I said  to her no i dont  think so and i explained to her i was sick without telling this woman my full problem. she kept asking me are you sure and is it possible you took any meds. i said to her anything is possible i do take  sleeping meds and  there are times i have awaken and taken meds  so i said is this a problem, she had said no this is just for your consent for us to take  this urine test.( I thought she had noted this on the form ). As always i just signed it .

Just so  you understand my nurse practitioner and I have a open and honest relationship of trust i keep nothing from her ,I have never in over 20 years raised a red flag,I have turned down meds .I have tried to deal with pain in more ways then just pills.Up until this last appointment there has been no problems.

So this last urine test was taken 2 months before  my last appointment. And this  is when  all the trust , care, and understanding was gone. With out giving  me the benefit of a doubt she had changed into a rude uncaring cruel person .my urine test was negative for pain meds but my sleeping meds showed as i honestly stated to the helper that took my urine test and had me sign the form, But the form i signed i have come to learn as well was dated that i did take meds the day before my urine test it did not mention anything  of what i had told her that i didn't.

I tried to explain i wasn't given the chance to get out a sentence. I was just told that i can no longer get meds from her the law from the DEA and FDA states this and she  will lose her license. I had asked her  to retake  the urine test as well as aked her  who i can talk to  she said no and nobody. Not  to go into all of it  again, I had  called to talk to a manager since he was not in that day. I called the next day  and i was sent to his answering machine  3 days later i got a call. I explained to him what went on and there was not much he could  do. Then i brought up to him Why i was not told i could go through withdrawals and why i was not offered any information  on help. He changed up real fast he offered me pills to help get off the meds and pushed injections pain inplants ect . I was told again the same thing of  pain meds  i could not get them refilled,(WHY DID I HAVE TO WAIT 2 MONTHS TO BE TOLD THIS).Well i asked him about the DEA  and the law or if it was there own personal decision. He could not get a word out ,And stated  to talk  to her about this i said  well you should know this right he said  yes. So i said by law  this is correct. I got the run around stating they have other ways to treat my pain ...........

I contacted the DEA and this is B.S. Like i said trust and honesty was lost. The situation was not handled like a professional ,Seems to me all that this place wants is to do expensive procedures, no real money is made in a 2 month office visit at least not to them $389.00 to write out  my prescriptions weight me take blood pressure ,this is a good sign of why health care cost are the way they are medicare and medicaid are being misused by so many clinics and Drs.

Yes i did contact  my primary Dr  and i now am waiting  for release form to sign so i can make an appointment .But today i recieved a call from this place (NOTE this is where i went when i was first injured and returned back there many years later ).But what i can tell is this nurse that talked to me on the phone said i dont have to worrie about withdrawls nothing will happen .....ween off my pills 3/4 i might get flu symptoms  . Also when i asked  her what i should  do be fore she told me  to ween off the pills she commented that my nurse practitioner from where i was just dropped also offered me injections ect. Ok what the hell is  going on here ,i also said i have just  got copies of my medical reports ..I AM TOLD SORRY WE CANT EXCEPT THEM BECAUSE I MIGHT ALTER THEM...Then i said how long will it take to get into your clinic  she had no idea .I had explained to her i never abused my meds  ect. I told her i dont over use my meds and i said my NP knows this as well.THEN SHE SAID WELL THE FBI DATA BASE  WILL LET ME KNOW HOW OFTEN YOU GOT PRESCRIPTIONS  FILLED......... I am like what the hell is  going on here.Then i told her with these meds if you don't  get them filled by a certain time the prescription  is no  good and i been told by my Dr to always fill them.

Sorry so much  to read and so much more added to this but  WHAT THE HELL IS GOING ON HERE, I feel like i am in a prison camp falsely accused  of a crime waiting  for a firing squad due  to a NP helpers neglect or from money hungry Medical so called professionals.

Just  to add this goes beyond the point of  pain meds. It is  the lack  of professional care, respect, trust,but most of all the DR, NP,LPN ect there Big heads  for control and lack of human compassion and the so called big bucks...MONEY MONEY MONEY( IT IS MY BODY, I DO NOT WANT NO MORE INJECTIONS, I DON'T WANT NO MORE SURGERIES  I AM 54 I AM A STAY AT HOME ALONE WOMAN I DO NOT DRINK, I DO NOT SMOKE, I DO NOT TAKE STREET DRUGS, I LEAVE THE HOUSE TO GO FOOD SHOPPING AND HOUSEHOLD AND PERSONAL NEED SHOPPING. AND YES CANT FORGET THE DRS I SEE .

NOW I AM SITTING HEAR IN FEAR TO GO TO THIS NEW PLACE....A CONTROLLING NURSE ON A PHONE TALKING FBI AND ACTING LIKE I HAVE ALSO COMMITED A CRIME...
THANK YOU AGAIN FOR YOUR CONCERN AND CARE..SORRY FOR CAPS
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Avatar universal
Sorry but I'm a little confused. Are you saying your did take your medicine the day of the urine test. Or, are you saying you had not taken it because you were sick because you were sick? If it had been days then nothing would show up in your urine test. It looks to the nurse that maybe you do not need pain medication if you can go with out it for days. I do understand people have different levels of pain and they also have their good and bad days when they need their medications or they may even feel like they need more medication on those really bad days.
If you're in pain management though, from my understanding, they expect you to take your medication as prescribed and not miss any days for any reason. Again, I'm thinking the nurse felt if you can go a few days with no medication then maybe you don't ever need it. It's not fair, I know. Some people have flair ups and only need medication during that time, and others need it every single day.
I think you should be able to talk to the head of the pain clinic and tell them about your situation. I don't think it's right that an NP can make the decision to take you completely off of your medication. Read your contract though. It may say that she is able to do that. In the mean time make another appointment and ask to talk to the head of the pain clinic. I have read about pain specialists and clinics and their contracts can be very harsh, in my opinion.
If you can get no where with this clinic call your primary Dr to tell them what happened and that you can't just go off of your medication cold turkey. Depending on what you're taking this can be dangerous. Maybe your primary Dr will help you until you can find another pain Dr or clinic who will see you.
I'm sorry for the very long post. I just get very upset when I read posts like yours. Because of these new laws we can no longer have a good patient Dr relationship with our primary Drs and we're forced in to pain clinics or seeing pain specialists that have way to much control over our health and pain.
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