Why Urinalysis in Pain Management?

[geojag]

I am a 54 year old male that has had several back surgeries as a result of a helicopter accident in the late 80's. I am now fused from S1-T12. I am on social security disablitity, but am not yet eligble for Medicae. I have been seeing the same pain management doctor for 15 years. When we started out he was great, periodic follow-ups, availble for questions, a very caring human, etc.

As time has gone on he has become unavaiable, at one point to get a folow-up appointment the scheduling nurse said "the best bet is to schedule a procedure, then you can ask your questions" at the time it was no big deal I had insurance, and I could always use a hardware injection, or an injection of my hips. To make a long story short we had a big blow up and when I confronted him on this topic, he was amazed and did not believe me. He went and questioned the scheduler and said he could not believe that it had been going on. Several similar type situations have developed over the years, and now I do not believe any thing I am told.

About 8 years ago they installed a pain pump in me. A device that is put under the skin of your stomach with a cathader that goes around to your spine that delivers a small amount or morophine directly to the site of the worst pain.

The current situation is this, after 15 years, the doc has decided to implement  "random" urinalysis. I have no problem with taking my meds of not selling them etc. But the whole experience is just way to invasive of my privacy. My Question is this: why after fifteen years has the Dr. gone to urinalysis, it's not to improve patient care as they claim. Or they would have been doing them all along. With the implanted pain pump and no insurance I have few alternatives. But before I discuss the topic with him I would like to understand his motivation. Is it DEA audits, is it to easily dismiss problem patients, why do they do the Urinalysis. Thanks for your input.

[gottilee]

When I went to a pain management center they made me do a urine everytime I went in. It really aggravated me but I went along with it for a while. It didnt make sense because even though I started taking more than prescribed they never said anything about.I felt it was an invasion of privacy to and went elsewhere. You should also call social security you should automatically get medicare while on disability. You may have to pay something a month for it but they take it right out of your check every month. I was on disability in my 20s after a car accident and was given medicare that also got me a prescription coverage. Later

[SunWorshiper_26]

In the last year or two the DEA has come down hard on drs for Rx pain medications which has led drs to be paranoid. They dont want their license revoked so instead CYA (they cover their @as). Also doing some urine analysis and bloodwork can make sure than the meds you are on are not creating other problems I.e. Liver or kidney failure. Some pain meds can even increase rates of diabetes so urine testing would be a good way to go to check that. But it sounds like you are unhappy w your dr and they are no longer providing the service and care that you need. If so i would suggest if possible research and find a new dr. I know it is hard to leave when you have been there for so long ESP too with no insurance but hopefully you are able to find another dr who is more trusting and willing to provide the care that you need.

Best of luck

[atonicat]

They do UA strictly to keep the DEA off of them. In 2004 I believe, the DEA announced that they were going to focus on prescription drug abuse instead of illegal drugs. Pain management is basically run by the government, because of the fear they put on doctors. Doctors are scared to death of "over prescribing" opiates. It's not that they actually think you're selling your meds (I don't see how you could be if you have pump, maybe you have breakthrough pills) it's that they want their ***** covered if they DEA comes knocking on their door.