Aa
Can a "clean
So I was given a drug test at my pm appt yesterday. I've been in pain management since september of last year for chronic and frequent kidney stones. I sometimes pass 3 or 4 a week, sometimes 1, sometimes none one week and multiple the next, etc. This was the first time I've been drug tested but it isn't surprising because there was a MAJOR raid on 2 pain management clinics the next town over and those dr.'s were brought up on all kinds of charges. So everyone is on high alert right now and I know that a lot of those dr.'s patients have been filtering in to see my doctor. I was told that all pain management dr.'s in my area are going to have to test all patients at every appointment now. My appointment last month was about a week after the raid and my doctor said he wanted me to consider suboxone to detox and he said that would treat my pain as well. But I pretty much said thanks but no thanks because I don't take pain meds round the clock, only as needed so sometimes I go can go days without taking meds and I don't feel any different, so I know Im not physically addicted. Im not sure my doctor really took my particular situation into account. Honestly I just figured it was a knee jerk reaction to everything going on right now. I imagine he's a little on edge. Anyway I just wanted to give all the background. Basically I started thinking about it last night and getting a little concerned because I haven't taken my pain meds in almost a week so I'm not sure theres going to be ANYTHING in my system when they test my sample and Im wondering if that could cause an issue? I know that everything and everyone is under pretty intense scrutiny and Im worried that if my urine comes up completely "clean" that they'll be suspicious that I'm selling my meds or something. Especially since I don't think my dr really grasps that I'm not physically addicted therefore not taking meds round the clock. I get 60 norco 5's a month along with a ******* anti inflammatory. Has anyone run into an issue like this before and had it be a problem? I don't want anything to jeopardize my status as a patient because I don't know if I'm going to get better anytime soon and having access to these meds when needed has been a life saver. Should I be concerned about this? I don't want my dr to think Im doing anything fishy because I'm absolutely not.
I'm so sorry I haven't commented sooner. It's not that I don't care, I most certainly do care. Making this short - I am literally down with a new horrific pain that was DX last night as Brachial Plexus Neuropathy/Neuritis. I wouldn't wish this on my worse enemy - and I'm so sorry I tardy in my reply to you.
You have every right to be angry! I am too! What is wrong with our health care providers - "Do no harm" - is almost laughable. In order to heal effectively and quickly it's a proven research fact that ppl with pain heal slower and are more prone to complications.
Denying major post-op or severe injury patients adequate pain management is barbaric and inhuman. We take better care of our pets. It's more than sad and I don't see any change in these policies any time soon.
You're correct. The government needs to concentrate on the real offenders rather than the ppl in need of acute short term pain management or the legitimate chronic pain patients. There's a town next to me that has a small poverty area where drug sales are happening on most street corners - in broad day light. These small time dealers and users have nothing to fear and they apparently know it. The local law enforcement does not mess with them as long as there are no huge fights or driving infractions. If that were chronic pain patients we'd be busted and in prison. It makes no sense to me. Sadly these "areas" exist in most towns/cities. Chronic Pain patients are easy targets - where It takes a lot of work to catch and prosecute these small time street dealers and users.
I'm so sorry for your sister. I have a very similar situation within my family. We/They have no rights. I'm hoping for that one smart go-getter attorney with high ideas to take up our cause. Waiting for that one right attorney to see the injustice and have the gonads (can I say gonads?) to take on the DEA and the rest of the government involved in these laws that persecute chronic pain patients.
Rant all you want - we're here to support and listen to one another. I rant too! We get it! My heart goes out to your sister!
Waiting,
~Tuck
You have every right to be angry! I am too! What is wrong with our health care providers - "Do no harm" - is almost laughable. In order to heal effectively and quickly it's a proven research fact that ppl with pain heal slower and are more prone to complications.
Denying major post-op or severe injury patients adequate pain management is barbaric and inhuman. We take better care of our pets. It's more than sad and I don't see any change in these policies any time soon.
You're correct. The government needs to concentrate on the real offenders rather than the ppl in need of acute short term pain management or the legitimate chronic pain patients. There's a town next to me that has a small poverty area where drug sales are happening on most street corners - in broad day light. These small time dealers and users have nothing to fear and they apparently know it. The local law enforcement does not mess with them as long as there are no huge fights or driving infractions. If that were chronic pain patients we'd be busted and in prison. It makes no sense to me. Sadly these "areas" exist in most towns/cities. Chronic Pain patients are easy targets - where It takes a lot of work to catch and prosecute these small time street dealers and users.
I'm so sorry for your sister. I have a very similar situation within my family. We/They have no rights. I'm hoping for that one smart go-getter attorney with high ideas to take up our cause. Waiting for that one right attorney to see the injustice and have the gonads (can I say gonads?) to take on the DEA and the rest of the government involved in these laws that persecute chronic pain patients.
Rant all you want - we're here to support and listen to one another. I rant too! We get it! My heart goes out to your sister!
Waiting,
~Tuck
Hi my friend. Thank you. After I typed this out I wish I could have deleted it but I read it again and thought no, we all need to stand up for our rights as pain patients. It's so wrong that many of us are being treated the way we are. I know your situation very well and it breaks my heart to know what you're going through. There is no need for any chronic pain patient to live with unbearable pain.
Yes, I was shocked and so upset that my sisters Dr refused more medication for a couple of weeks. Apparently he's never had open heart surgery or he would never let one of his patients be in that much pain.
I couldn't agree with you more. This is an insane war on drugs. If they would put this much time in to illegal street drugs I know it would make this country a better place.
Sorry for another rant.
Yes, I was shocked and so upset that my sisters Dr refused more medication for a couple of weeks. Apparently he's never had open heart surgery or he would never let one of his patients be in that much pain.
I couldn't agree with you more. This is an insane war on drugs. If they would put this much time in to illegal street drugs I know it would make this country a better place.
Sorry for another rant.
You are not ranting and this is well said, from the heart too given your recent battle with your sister. Absolutely our pain treatments are being impeded by this insane war on drugs, we are simply collateral damage. But the powers that be are not concerned, so long as they can score their pontification points.
I don't think you're being hostile at all. You're being honest. I was thinking about all of this last night, the new laws. We pay our Drs, they work for us. We have little say so on our own health care. Many of us fear our Drs.and feel like we can't tell them what we think is right for our own health. And then we have the government who is in control of everything. How is that right? Our health care is a personal thing.
I had to take my sister in to see the NP yesterday because she just had open heart surgery 10 days ago. She;'s had so much pain that it's over whelming. They sent her home with a few 5 mgs Percocets. She does have Severe RA so she takes a long acting and a short acting med. This is to help with her RA pain. When you have open heart that pain is unimaginable. We asked the NP for more Percocet, she asked the Dr and he refused. How can he not understand that her other meds barely take the edge off the RA pain and now she's had open heart surgery. How can he deny her more medication for a couple more weeks? I was so mad when we left there!
I'm sorry for the rant and I know I got completely off subject. Well, kind of. It has to do with our rights to have pain control when we need it.
To the original poster. You have been given great advice. You're doing everything your Dr is telling you to do. I truly hope everything works out for you. Please keep us up to date.
I had to take my sister in to see the NP yesterday because she just had open heart surgery 10 days ago. She;'s had so much pain that it's over whelming. They sent her home with a few 5 mgs Percocets. She does have Severe RA so she takes a long acting and a short acting med. This is to help with her RA pain. When you have open heart that pain is unimaginable. We asked the NP for more Percocet, she asked the Dr and he refused. How can he not understand that her other meds barely take the edge off the RA pain and now she's had open heart surgery. How can he deny her more medication for a couple more weeks? I was so mad when we left there!
I'm sorry for the rant and I know I got completely off subject. Well, kind of. It has to do with our rights to have pain control when we need it.
To the original poster. You have been given great advice. You're doing everything your Dr is telling you to do. I truly hope everything works out for you. Please keep us up to date.
I meant to comment on the fact your Doc spends only about 5 minutes with you per visit. The new opiate prescription laws actually state that every quarter the patient should have a physical exam of sorts - and it needs to be documented.
PMP (or PCP that prescribes opiates) is not required to see you monthly. Most PMP have decided to see their pain patients monthly. In truth it pads their pockets. Five minutes and an RX and they can charge you that $160 office call - and you get to pay a co-pay. I think it stinks but sadly it's become more of the rule than the exception.
If we are seeing a physician every month they truly should know us well - that's no longer the case. Here's your RX, now I'll collect my money. Yes Imay be a bit hostile and disillusioned when it comes to the new "climate" and changes in pain management.
~Tuck
PMP (or PCP that prescribes opiates) is not required to see you monthly. Most PMP have decided to see their pain patients monthly. In truth it pads their pockets. Five minutes and an RX and they can charge you that $160 office call - and you get to pay a co-pay. I think it stinks but sadly it's become more of the rule than the exception.
If we are seeing a physician every month they truly should know us well - that's no longer the case. Here's your RX, now I'll collect my money. Yes Imay be a bit hostile and disillusioned when it comes to the new "climate" and changes in pain management.
~Tuck
Well it's good if you have tablets left - be sure to take that bottle with you. The fact you do have tablets left along with the Doc telling you not to take them every day should be in your favor. Be sure to remind him that he instructed you to take them PRN (only when needed). I think you'll be fine.
No I am not prescribed opiates for my kidney stones. I have several other conditions in which I require pain management.
My stones go in streaks - for example I can pass 3-4 in a few weeks time then go a month or two before I pass one again. I actually went close to a year before I passed my last one about a month ago. The few years prior to that it was at least monthly - though most were passed at home and I never "reported" them.
I've even gone as long as 3 months without passing a stone. Usually a test (CT or Ultrasound) reveals 6-8 stones laying in one or both of my kidneys. However the last one I had only showed 4 stones sitting in one kidney and 1 in the other along with lots of "gravel" in both. My urologist said gravel was just smaller stones. I have multiple reasons for stone formation but no true kidney disease.
Have you been evaluated for MSK (Medullary Sponge Kidney)? It will cause you to produce stones. Has the condition called Hyperparathyroidism (a condition that occurs when parathyroid glands produce too much of a hormone) been ruled out? - Or - Cystic kidney diseases? Obviously there are more conditions/diseases of the kidneys that can cause stone - these are just a few that come to mind. I hope you are being followed closely by a Urologist.
Again I'll be interested to hear how your appointment turns out. Sometimes the physician's office will just mail out a letter of dismissal if you fail a drug test. If you don't receive one before your next appointment that's an encouraging sign.
~Tuck
No I am not prescribed opiates for my kidney stones. I have several other conditions in which I require pain management.
My stones go in streaks - for example I can pass 3-4 in a few weeks time then go a month or two before I pass one again. I actually went close to a year before I passed my last one about a month ago. The few years prior to that it was at least monthly - though most were passed at home and I never "reported" them.
I've even gone as long as 3 months without passing a stone. Usually a test (CT or Ultrasound) reveals 6-8 stones laying in one or both of my kidneys. However the last one I had only showed 4 stones sitting in one kidney and 1 in the other along with lots of "gravel" in both. My urologist said gravel was just smaller stones. I have multiple reasons for stone formation but no true kidney disease.
Have you been evaluated for MSK (Medullary Sponge Kidney)? It will cause you to produce stones. Has the condition called Hyperparathyroidism (a condition that occurs when parathyroid glands produce too much of a hormone) been ruled out? - Or - Cystic kidney diseases? Obviously there are more conditions/diseases of the kidneys that can cause stone - these are just a few that come to mind. I hope you are being followed closely by a Urologist.
Again I'll be interested to hear how your appointment turns out. Sometimes the physician's office will just mail out a letter of dismissal if you fail a drug test. If you don't receive one before your next appointment that's an encouraging sign.
~Tuck
I should add that Ive never had a pill count done, I will be sure to bring my pills to my next appt though so I have the proof that I'm not selling or sharing them. Thanks for bringing that up, I don't know why but I hadn't thought about that.
Thanks so much for responding! On my prescription it says to take 2 tablets by mouth per day. At my first appointment my dr strongly urged me to take the pills only as needed so ( common sense to me but he made sure to say it) if I don't need to take them I don't. So I do have extra pills that carry over from month to month. This last time I had quite a few, Ive had an unusually good week so far pain wise, knock on wood :) I usually don't go more than 3 days without needing them. I don't really spend much time with my dr at appointments so I don't feel like theres much of a relationship. He usually spends about 5 minutes with me and asks me a few basic questions and thats it. I think thats another reason Im a little concerned because I wouldn't say he really knows me well enough to know what I would and wouldn't do. Honestly just the fact that he didn't know that i don't take them consistently enough to become dependent surprised me. Just because that was something we discussed from the onset and it wouldn't make sense that someone with kidney stones would be in pain 24/7 for months on end.Although I suppose it could happen. I just don't want to get dropped. Before he took me on I had to rely on the er for pain management and it was really hard. Can I ask, do you see your pmp for kidney stones as well? Do you get them as often as I do? I haven't run into many people who get them so often and am still trying to get some kind of diagnosis (if there is one) for why this is happening. Im only 32 and a woman and although Ive had stones since I was teen this past year and a half its gotten a lot worse. Thanks again for answering my question!
Hi Kitten,
I'll answer your last question first. Sorry, you can't edit your post, including title. You can do another with the title as you want it to read - but I think you'll obtain responses with your title as is. It's your call.
Ouch! I have chronic kidney stones too! It is often extremely painful, obviously depending on the size - but even so called "tiny ones" can bring me to my knees!
Okay, in reply your concern about the "clean urine" - two things should be considered when evaluating your drug screen. First how are the opiates ordered? If reads "PRN", meaning as needed then it's conceivable that you may not require opiates for an extended period of time. Second would be the "pill count", meaning how many tablets do you have in your bottle. Sixty tablets a month would average two a day - so hopefully even though you haven't taken any recently you should have tablets left.
Those two things should be considered. Here's the rub. If you have a "clean" drug screen and no tablets left the first question arises, "Where are the opiates?" It's not usual that someone would use all their pain relief meds in the first part of the month and retain nothing for the end of the month. I know I wouldn't do that. I'm not saying it couldn't happen.
Sadly in this opiate hostile climate where PMPs seem to monitored by the Gestapo - and Chronic Pain Patients are treated like Criminals - one has to be extremely prudent & follow every rule to the T. Today If a PMP has even a hint of suspicion or something doesn't look good on paper they are dismissing patients - with no benefit of the doubt and no second chances.
How well do you know your PMP? Have you developed a good relationship with him? Do you think he trusts you? It's imperative that he understand your condition. If he doesn't, educate him.
I don't mean to frighten you, that's not my goal. I hope all will go well for you. If you've taken an opiate in the last week it should show in the drug screen, it may be in trace levels but it should be there. It's detectable. Much is dependent upon the type of test utilized. The more accurate (98%) and sensitive test, chromatography reveals the amount or level of drug(s) in the system in addition to the type. The immunoassay is not as accurate and has a higher rate of failure. The more common opiates prescribed for pain management stay in the system from 2 to 4 days.
I hope something I've said has been helpful. I wish the best. Please keep in touch and let us know how this concludes and how you are doing. I hope you'll be active in our community. I'll look forward to hearing from you.
Take Care,
~Tuck
I'll answer your last question first. Sorry, you can't edit your post, including title. You can do another with the title as you want it to read - but I think you'll obtain responses with your title as is. It's your call.
Ouch! I have chronic kidney stones too! It is often extremely painful, obviously depending on the size - but even so called "tiny ones" can bring me to my knees!
Okay, in reply your concern about the "clean urine" - two things should be considered when evaluating your drug screen. First how are the opiates ordered? If reads "PRN", meaning as needed then it's conceivable that you may not require opiates for an extended period of time. Second would be the "pill count", meaning how many tablets do you have in your bottle. Sixty tablets a month would average two a day - so hopefully even though you haven't taken any recently you should have tablets left.
Those two things should be considered. Here's the rub. If you have a "clean" drug screen and no tablets left the first question arises, "Where are the opiates?" It's not usual that someone would use all their pain relief meds in the first part of the month and retain nothing for the end of the month. I know I wouldn't do that. I'm not saying it couldn't happen.
Sadly in this opiate hostile climate where PMPs seem to monitored by the Gestapo - and Chronic Pain Patients are treated like Criminals - one has to be extremely prudent & follow every rule to the T. Today If a PMP has even a hint of suspicion or something doesn't look good on paper they are dismissing patients - with no benefit of the doubt and no second chances.
How well do you know your PMP? Have you developed a good relationship with him? Do you think he trusts you? It's imperative that he understand your condition. If he doesn't, educate him.
I don't mean to frighten you, that's not my goal. I hope all will go well for you. If you've taken an opiate in the last week it should show in the drug screen, it may be in trace levels but it should be there. It's detectable. Much is dependent upon the type of test utilized. The more accurate (98%) and sensitive test, chromatography reveals the amount or level of drug(s) in the system in addition to the type. The immunoassay is not as accurate and has a higher rate of failure. The more common opiates prescribed for pain management stay in the system from 2 to 4 days.
I hope something I've said has been helpful. I wish the best. Please keep in touch and let us know how this concludes and how you are doing. I hope you'll be active in our community. I'll look forward to hearing from you.
Take Care,
~Tuck
Clean drug test cause a problem is what I meant to title this lol. Anyone know if I can edit the title?
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