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Thread: Do all "pain doctors" make you take urnie tests?

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    RealGrapey is offline Banned Reason: Shilling for painmedsonly.com
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    I am very confused here I am seeing a pain doctor but I have been told nothing of urine tests and I am under the impression this is not a pain clinic where they give urine tests. I don't wan to ask either I have just been assuming they don't, and it is not that kind of "pain clinic". I think this forum could benefit greatly from clarification as to what type of pain doctors do urine tests and which do not, and how can you tell which do these tests and pill counts and which do not??? thanks need some help here.

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    P.s. this is a pain doctor or pain specialist but I do not believe he does intrusive urine test analysis, how do I know for sure, there must be an easy way to tell that I am overlooking. I never was concerned about this today until someone said on my thread "watch out for urine tests" and I responded that I don't think I am seeing that kind of doctor, then I realized I want to know for sure that this will not happen. Thanks.
    Last edited by RealGrapey; 05-22-2011 at 08:27 PM.

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    I believe that most do make you take a piss test, at least randomely by most state laws. In SC I know this for sure which is a bunch of crap due to the Mary Jane issue, but thats just my opinion. I believe it is a violation of our civil rights and should be outlawed, but im afraid we are years away from any common sense like that to be applied to our laws.

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    First question would be Did you sign a contract?

    When you were filling out the paperwork on your first visit did you read every single line of every page?

    Some clinics have separate contracts you sign and some of them just have the verbage added in with all the other stuff in the packet of papers you fill out. But you usually have to sign your name 2 or 3 times in the packet of papers and that would cover them for doing UAs even if they didn't hand you a separate sheet and make a big deal out of it.

    I don't know of any current pain management clinic or doctor that doesn't do UAs. Even my doc, who is really laid back and didn't make me sign a contract told me on Day One that I couldn't go to other doctors to get meds for the same condition and that they would UA me that day and every once in a while after that. He said they could do pill counts if they thought you weren't using your medicine appropriately but I haven't had that yet. He said I could get pain meds for other things (like dentists) but to call him immediately and let him know.

    My old pain clinic made you sign a form that had "pain management rules" at the top of the page in about 45 font, it was single spaced and took up the entire page and the rules were so strict that I couldn't get medicine from a dentist or anyone else; THEY would provide all meds. My head was spinning trying to understand the rules and they didn't give you a copy so you never had something to look back on. All I remember was that I couldn't get any medicine from anywhere and even if I ended up in the ER from a car crash they were supposed to call my PM doc before treating! I found it very intrusive but didn't know any better because I thought all clinics were like that.

    Love my doc now, but he'd still kick me to the curb if something showed up in a UA.
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    Quote Originally Posted by Lynx4 View Post
    First question would be Did you sign a contract?

    When you were filling out the paperwork on your first visit did you read every single line of every page?

    Some clinics have separate contracts you sign and some of them just have the verbage added in with all the other stuff in the packet of papers you fill out. But you usually have to sign your name 2 or 3 times in the packet of papers and that would cover them for doing UAs even if they didn't hand you a separate sheet and make a big deal out of it.

    I don't know of any current pain management clinic or doctor that doesn't do UAs. Even my doc, who is really laid back and didn't make me sign a contract told me on Day One that I couldn't go to other doctors to get meds for the same condition and that they would UA me that day and every once in a while after that. He said they could do pill counts if they thought you weren't using your medicine appropriately but I haven't had that yet. He said I could get pain meds for other things (like dentists) but to call him immediately and let him know.

    My old pain clinic made you sign a form that had "pain management rules" at the top of the page in about 45 font, it was single spaced and took up the entire page and the rules were so strict that I couldn't get medicine from a dentist or anyone else; THEY would provide all meds. My head was spinning trying to understand the rules and they didn't give you a copy so you never had something to look back on. All I remember was that I couldn't get any medicine from anywhere and even if I ended up in the ER from a car crash they were supposed to call my PM doc before treating! I found it very intrusive but didn't know any better because I thought all clinics were like that.

    Love my doc now, but he'd still kick me to the curb if something showed up in a UA.
    This is similar to how mine works. I did sign a contract,but it was just not see any other doc for the same condition and no meds for the same condition and that I always have to use the same pharmacy. I have had several surgeries not related to my condition I see him for this year and as long as I called ahead and told them what I was being prescribed and why they have had no issues. I have also changed pharmacies once and told them why and they were fine with that, too.

    They do UA me about every other visit....sometimes every visit...but have never done a pill count.

    To the OP, it would be hard to believe any type of pain doc would not UA people. My 14 your old son had to see a nuerologist recently and the did a UA on him. I was shocked! They said that it is their policy to UA every single new patient regardless of issue or age. I told him if it came up bad we had bigger issues!!!

    Maybe you could call you doc....not say you are a patient....just act like you are calling around to find a new doc and ask if they use UA in their treatment and see what they tell you?

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    I brought it up. I don't profess to know everything about every state.

    I will say I never signed a contract with my doctor for the first year of treatment and they did UA during that time. I think they had me sign a contract around January. I didn't read because nit too concerned about details.

    I have referred many clients to pain management doctors and I have had many fail UAs during treatment. Some fail because they come up clean (diversion or not taking as prescribed) and some come up with a lot of different stuff in their system. The docs freak out on this and dump these patients. The doctors licenses are on the line and their charts are reviewed.

    The contract things you will get for like sub on other maintenance therapies. Not all PM doctors require a contract. The lack of a contract does not prevent them from doing UAs. You can refuse, but then they can also refuse treatment. The contract actually gives you a right to be weaned and not cut off all at once so that is kind of a good thing.

    The bottom line is don't do other stuff and comply with pain management if you want scheduled drugs. These docs are CYA as they rather kick a patient out of treatment than risk losing their license and their 300k a year gig. Docs are losing their license all the time relating the scheduled medications so they are a but spooked and rightly so.

    It's not that it us right or wrong. It is just reality and the world we live in today.

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    I was never asked to do a urine test by my pain management doc. I would find that a bit insulting as a way to start a relationship. But, I agree with others that you are sort of at their mercy, and if that is what it takes to get pain relief, I would do it.

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    My mother in law gets random UA's without contract. Way to find out? She found out the hard way (not that she does anything she shouldnt it was just a shock and a personal insult she felt like even though it is for their protection) I took her to a visit and they asked for a sample. There was no contract BUT it was in the new patient paperwork we ALL fill out when seeing a new doctor. So maybe ask for a copy of that, or you could try calling and just asking.. if they want to know why you are asking tell them you are considering becoming a patient and want to know if they require pill count, ua, or a contract. Your best bet? Take your medication as rx'd, take only what your doctor gives you and do not do ANY street drug. Then it will not matter if they pill count and UA you every time you walk through the door. You are golden.
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    Well unfortunately as abuse and diversion increase this is almost guaranteed to become a common practice everywhere....

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    eagleweasel is offline Senior Member
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    I know that a lot of people use pain clinics to try to get drugs they do not need for pain, but, still, is it really necessary to start a doctor-patient relationship on a basis of distrust...it just seems like there has to be a better way, to wait until a patient has done something or is showing symptoms of abuse before piss testing them or whatever. Maybe I'm just naive, but if I were a doctor, I'd do whatever I could to start off with a patient on a good note, one that encourages them to trust me and see me as a teammate, not a gatekeeper.
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    Quote Originally Posted by RealGrapey View Post
    I am very confused here I am seeing a pain doctor but I have been told nothing of urine tests and I am under the impression this is not a pain clinic where they give urine tests. I don't wan to ask either I have just been assuming they don't, and it is not that kind of "pain clinic". I think this forum could benefit greatly from clarification as to what type of pain doctors do urine tests and which do not, and how can you tell which do these tests and pill counts and which do not??? thanks need some help here.

    *This post was auto-merged. The following text was added 2 minutes after the last post:*

    P.s. this is a pain doctor or pain specialist but I do not believe he does intrusive urine test analysis, how do I know for sure, there must be an easy way to tell that I am overlooking. I never was concerned about this today until someone said on my thread "watch out for urine tests" and I responded that I don't think I am seeing that kind of doctor, then I realized I want to know for sure that this will not happen. Thanks.
    Most pain doctors do indeed give urine screens regularly.
    This is to make sure you are taking yor meds and not selling them, and that you are taking all of your medisqua, and definitly to make sure that you are not mixing drugs. TThat can be dangerous. especially mixing benzos and and opiate type drug. I have heard of people taking opiates and then mixingi it with high powered benzos and then dying in thier sleep. it causes you to stop brehing in your sleep. Very dangrous. Also, alot of pain docs o this to get the DEA off thier back so they can actually practice medicine without a bunch of money wasting cops telling them how to treat thier patients, it makes me sick when DEA acts like they went to med school. They should stick to keeping drugs out of the hands of our children and leave adultswho bneed thier meds alone.
    I understand the policy, but it can be annoying taking a drug screen like your going to a probation office or something,
    Last edited by auburnfan123; 05-28-2011 at 12:38 AM.

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    boilermaker is offline Senior Member
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    One thing to try and remember is that most physicians incur at least $200k in school loans before ever making a penny, then go into a job market where starting pay is in the $30-40k range for quite a few years (even longer if you are not a specialists or very very good at your job) add your cost of malpractice insurance $100-200k yearly to this figure and you will see that it is no easy road. After you finally make it to this point of success (really??? success??) the last thing you want is a pharmaceutical seeking patient destroying it all for you and losing your license.

    Abbreviated version: Physicians have to look out for their own ass!

    One more stab: I personally don't know anyone with less than $300k in student loans and less than $150k in Insurance right now lol
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    When I went to a pain doctor years back they never pissed tested me. Theres a good chance you won't be tested eithier if it hasn't been brought up.
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    I don't know how many "Years Back" you are talking about ...but things are different Now. I think anyone who goes to Pain Management should expect to have to take a UA sooner or later. Also it would be in your best Interest to Not use any other Meds that you are not scripted and you should not use any Illicit Drugs. The consequences will be that you will be flagged for life and will have a Very hard time getting Meds in the Future...And you will be in Pain!

    So don't even start Pain Management if you are planning on not following the Rules...You will eventually get caught. These Doc's have seen it all and are Very good at catching folks that try to Beat the system! JMHO
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    You may as well plan on having urine screens once you become a patient of a pain clinic/pain dr. As an above poster mentioned, most of the time your pain contract will mention your being subject to random urine screens, pill counts etc... The only people I know who are not required to sign these contracts, or subject to routine urine screens and pill counts, are those who are having their pain managed by their family doctor. But now, even many family doctors who are willing to treat patients with chronic pain are adopting some form of a pain contract to prevent patients from doctor shopping as well as diversion.

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    hey @RealGrapey i just had a urine tox screen/analysis today, im on a sch 2 pain med. Ive been on it for 2 years, I see my doctor about 2-5 times a year. I only get screened when i have to go in for an appointment, otherwise i dont, i just call in refills and dont really have to worry about tox screens unless i failed my last one or havent seen the doc or taken a urine test in a year.

    But i would say it really really depends on your doctor! If you get the vibe your Dr is very strict and conservitive about prescribing then be prepared to take a urine test. Some places you have to go to a seperate facility to take the test and the doctor gives you a document that you present to the lab and they take the test. In this case when the facility is seperate from the office you can try holding off on the tox screen for a few days(time to clense your system!)

    Sometimes being honest is the best play, if your dr tells you you're you have to take the test in the office that moment, the best thing you can do if you think youll fail is to be honest. Doctors hate being lied and will likely have more respect if your straight with them.

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    I live in Houston and this may not apply to some in this topic. However, in Houston there are many pain management clinics here that were unmonitored for the longest time. A couple of years ago the law starting to shut these places down because of abuse by some of these clinics. That ruins it for people that really need these services. Nowadays, you will need a complete eval, all previous records and some even go as far as a blood test to check kidney and liver functions.

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    I am lucky to have a pain dr. who hasn't drug tested me & I've been seeing him for over 7yrs.I didn't have to sign a contract or have any pill counts.I also see a psychiatrist & doesn't test or do pill counts either.
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    I had a urine drug tests a couple of visits ago, very unexpected but and luckily I didn't have any pot in my system. :P

    I did sign some stuff when I was first prescribed my schedule II medication, guess it was my fault for not reading it.
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    Quote Originally Posted by binky1957 View Post
    I am lucky to have a pain dr. who hasn't drug tested me & I've been seeing him for over 7yrs.I didn't have to sign a contract or have any pill counts.I also see a psychiatrist & doesn't test or do pill counts either.
    Wow 7 years, terrific
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    I've never been tested, just working with my PCP, although I did sign the contract. I don't know how serious her office takes it as they didn't even bother to change the date from 2004 and I signed it this year. Probably to cover her ass. For some reason, PMs never prescribed me meds although they agreed I needed them because I was too young to start down that path. REAL HELPFUL! Just suffer in silence bc you're young and supposed to be healthy. TOO BAD!

    I go see my doc today and asking for much more serious meds so watch me curse myself and get tested. The only problem I may have is that I've taken my flexiril even though she warned me not to with the dose of perc I am on. I'm just paranoid bc I am so afraid of being labeled a drug-seeker since I've been criticized for my age.
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