Bizzaro World: I'm Under Suspicion By My Doctor Because I PASSED A Urine Drug Screen

[Wiley50]

I'm a pain management patient. Since 2003, I've worn a Fentanyl Transdermal Patch and take Morphine for breakthrough pain.

If I lived in one of the 13 Medical Marijuana states I would probably be getting pot by prescription. But I don't.

I live in Tennessee and, to cover his ass, my doctor has to run a urine drug screen on me, on average, once a year to make sure I'm not smoking pot. Which is the only other drug I'd be prone to use and occaisionally I have played those odds and
won, so far.

So, last week, when he sprang the test on me I felt good because I knew I hadn't smoked any in many months and would show up clean. And I did.

But, the Fentanyl and Morphine didn't show up either. And they are going crazy about it.

That same office visit, I got a Flu shot and the nurse even commented that I was wearing my patch and so she was sure it wouldn't hurt. I pointed this out.

So, I get a call today and they want me to come in for a "Chain Of Custody" drug screen. Whatever that is?

I assume it means that I'll be searched to make sure I'm not slipping them someone else's clean urine, perhaps by way of one of those "Whizzer" devices.

Can anyone give me any other info on this procedure that I should know.

At this point, the only thing I can guess is they bought some defective drug test kits.

Cause I do take my meds. All of them.

[gateley]

1. I think the chain of custody might mean ensuring that your test results don't

get tainted or swapped with another's - something along those lines.

[pepperbear]

2. try this

http://www.docpotter.com/drustes_basics.html

Chain Of Custody
Chain of custody is a monitoring process to prevent tampering with the sample or the results. Chain of custody begins with collection of the urine, and continues through the final reporting of test results to clients. Sealing of sample containers, transport and control of samples, receipt of samples by the laboratory, and supervision of lab tests remain under strict discipline throughout the chain of custody. Authorized signatures are required at each step. Laboratory results can be effectively challenged in court if there are weak links in the chain. Standards regulate the handling, analysis, and collection of samples if they are intended to be admissible in a court of law. Transfer of urine, blood, or saliva from the subject to the container must be witnessed. For example, if a person is taken to a physician for a blood sample, the physician becomes the first link in the chain of custody. Few physicians understand the legal chain of custody procedures. Unless otherwise instructed, they will usually follow clinical laboratory standards, which will not stand up to challenge by a knowledgeable attorney. The person collecting the blood sample must be able to testify regarding the collection procedure. Likewise, the person collecting the sample must be able to testify to the accuracy of the container label, including the subject¹s name and other identifying information, such as date, time of the collection, and type of collection receptacle. The chain of custody must be maintained until the specimen reaches the laboratory‹and through the confirmation of initial results.

[dave29]

3. they are probably worried you are giving your meds to someone else.

That's about it.

[JNelson6563]

8. Or selling them on the black market

The OP should be prepared for an increase in these random urine samples.

Julie

[petronius]

4. Why would your doctor care if you smoked pot - would he be required to

report it (some sort of TN law)? It sounds to me that whether or not you smoke is irrelevant to your doctor - he didn't prescribe it and it doesn't interfere with your treatment (I assume) - so why does he need to insist on a drug test? :shrug:

[Wiley50]

12. Actually, the DEA can get them if they prescribe to a "Drug Addict" The drug doesn't matter, since

pot is illegal, it puts them in jeopardy.

They used stuff like this against Dr William Hurwitz and sentenced him, originally, to more than 25 years.

So being in a MM state is good for the doctor too.

Somebody, help me re-locate to CA, or another sane state

[aquart]

5. Pain management in this nation is criminal.

My sister is in agony every damn they and they will only give her pills she's allergic to.

[BellaB]

19. Tell me about it

A few years back I tore my knee up (for the 4th time) simply getting up off of the bed. Since it is service connected my gf at the time (now wife) said lets go to the VA hospital, since its service connected they will take care of you. I tried to talk her out of it since she was under the delusion that the VA actually helps vets. Let me clarify that last statement before I get flamed, I have been to 2 different VA hospitals, 1 in my home state, and 1 in Tennessee. The one in Tennessee was AWESOME, they took care of everything that was going on from my knee AND they also did a scope to find out why I had so much acid in my stomach. So, I guess I should say SOME VA hospitals.

Ok, back to my original point, I tried to tell my wife that the VA in this state is worthless, so we dont need to waste the time or gas. Well she would not listen so we went down. The er doc said your not having a heart attack so I am not doing anything for you. I finally got in to see the ortho doc a month later and he said there was nothing wrong, and I asked him about the pain and he said the following in front of a medical student "I am a surgeon, I dont do pain management". I have not been back since, I had a civilian doc fix my knee, filed with the VA for temp perm disability because I was off work for a month and surprisingly got that.

My point is, most doctors today are afraid to give out strong pain meds because SOME patients either abuse them (Lush for example)or some sell them instead of using them.

[Rhythm and Blue]

6. Well, that certainly makes sense.

They know that there are opiates in your system. Those didn't show up in the drug test. That would mean that the test has failed--either you're doing drugs and gave a fake sample, you're selling your medication, the testing equipment malfunctioned, there was a clerical error, or something of the sort.

What they're doing now is ordering another test, in which your sample will be very closely followed, to prevent any mishaps. I wouldn't worry about it, as long as you're actually clean.

[Warpy]

7. What it means is that you have to pee in front of someone

and hand the container directly to him/her. They're ASSuming that you brought in somebody else's urine and used it.

My guess is that either the lab fucked up and some other person is being accused of having narcs in his system or the test was defective. I'm betting on the former.

Did I mention how I loathe the drug war?

[Mythsaje]

13. It would be SO tempting to slosh the container

just to aggravate and annoy the person waiting for the hand-off.

I too hate the drug war. Fucking creeps.

[charlie]

15. What's the doctor's liability?

Are there significant pressures brought to bear on doctors if they don't follow up in such cases, in this age of compulsory paranoia in behalf of the Motherland... *cough*... excuse me, Homeland?

[Warpy]

18. The lab might be liable but the person who ended up

being accused of taking opiates when he wasn't would have to sue. He would be able to do that only if he were harmed by the false accusation resulting from their carelessness, if he lost his job over it, for instance.

[charlie]

22. Ah, thank you

So a doctor has some measure of discretion left, without certain worry that our burgeoning security state won't come calling. I really hope that's the case.

[SharonAnn]

31. Tennessee has a serious problem with pain pills on the black market.

There are new monitoring regulations this year for this type of thing. That may be what's happened here.

"Hillbilly heroin" is a very serious problem here. And some get all the pills they can in order to sell them on the black market.

[Mend]

9. opiates often don't show up in routine urine screens...they are the hardest

of all drugs to detect.

[zabet]

14. Mythbusters

just showed how eating poppy seed bread or poppy seed
bagels (normal amounts) can make you test positive for the
opiates that the poppy seeds contain. It showed up relatively
quickly and they still tested positive hours later after the
first positive test.

[slackmaster]

20. Hard to detect and the metabolites don't hang around for long

The doctor sounds like a fucking retard.

[Mz Pip]

10. I can't imagine why

they would be testing you for pot anyway. If you tell your doctor you're not toking up then he should let it go at that. What would they do if it came back positive? Have you arrested?? :crazy:

The only other reason might be benign - they want to be sure their tests are accurate and not coming back positive for the drugs you're taking raised a flag for them.

Mz Pip
:dem:

[Wiley50]

17. What they would do is Discharge me, thereby denying me treatment for pain

It happened once before and it took two years in utter agony every day

to find a doctor who would treat me with opioids.

This time would be "three strikes you're out"

Sucks!

[Mz Pip]

40. That is just wrong

You are doing what you are supposed to be doing. Following your Doctor's instructions. Why you should be penalized because you DON'T have pot in you system is just nuts.

I don't get the puritanical attitude that our society has regarding pain management. Rushbo did no one any favors by abusing drugs. He became a high profile example of drug abuse. Thing is, he'll always be able to get meds, whether he needs them or not. Everyone else has to suffer, though.

Good luck to you. I hope this all works out for you. It sounds like you're doing what you're supposed to be doing.

Mz Pip
:dem:

[knitter4democracy]

48. It's amazingly wrong.

I tease Hubby and call him Dr. Feelgood. He keeps track of his pain control patients by how often they need refills, and he'll test their urine sometimes if he thinks they're high in the office (he can lose his ability to prescribe if they think he knowingly prescribed a controlled substance to a drug dealer). He's only had a couple of problems yet so far. Most of his patients really need the meds, and he's happy to help them get better.

[junkiebrewster]

37. ALL they test for is pot...

The other stuff gets out of your system too quick.

[TomInTib]

11. Sounds like more CYA on their part.

As long as you're straight-up, you have no worries.

But, considering your situation, I would ask them for reimbursement for your gasoline (I am only barely kidding).

[MrScorpio]

16. I used to conduct Chain of Custody piss tests in the USAF

Basically, there will be someone to witness the Urine leave your body and into a receptacle.

That receptacle should be sealed and everybody witnesses the transaction.

Make sure you wash your hands thoroughly before doing the do.

[aquart]

38. How do they do that with girls?

Or do I really not want to know?

[MrScorpio]

43. The same processes apply

And no, you don't want to know

[skids]

21. In a world where they give the worng patient surgery...

...they really expect some outsourced lab to flawlessly run a drug test? The lab probably pulls your results out of a bingo cage. Not that drug tests are especially reliable even when done honestly.

[baldguy]

23. Docs shouldn't be law enforcement agents - its a conflict of interest.

Your doctor should be concerned with one thing and one thing only - making you better is you're sick, and if you're healthy keeping you that way.

[Whisp]

24. that is outrageous!

I was just telling my husband about your post and we are both floored! unbelievable. what the helllll is going on down there?

so sorry for this, wiley. here you are in pain and have to go through this Ridiculous Nonsense. Gawd!!!!

wishing you well.

(is it possible that your doctors office mixed up the samples? that happens all too frequently.)

[NorthernSpy]

25. fentanyl won't show up on a standard screening anyway, because it doesn't conjugate to morphine...

I believe that fentanyl is a fully synthetic non-morphine-derived opioid, and I don't think your body ever turns it into morphine. (But don't shoot me if I'm wrong...)

They probably just used the standard opiate screening test, which detects anything that conjugates to morphine (morphine, heroin, codeine, some of the semi-synthetics).

If you hadn't had any of your morphine break-through meds recently -- and some people metabolize them very rapidly -- then it's completely understandable that you'd test opiate-free.

Doctors tend to be pretty retarded about the details of this stuff.

[elias7]

26. you should clarify with your MD: I don't think he's testing you yearly for pot,

but rather that ensuring that you're using your narcotics, not selling them. This is becoming more common in the health profession as many people using chronic pain meds are in fact selling them.

[Wiley50]

27. Nope. They Test For Everything that can be "abused"

They use a multi drug test

[NorthernSpy]

29. but in their suspicious little brains, the question is:

Is he trading his opiates for something he likes better? And what might that be?

You see?


Sad. They really should just practice medicine and stop treating you like a criminal.

[knitter4democracy]

49. Most sell around here for ten bucks a pill.

That's what Hubby's patients told him. That's a lot of money for a lot of people who have big medical bills.

[Viva_La_Revolution]

28. You'll have to pee in front of someone.

so you can't slip the fake stuff in.

Don't they know that a large percentage of tests come back with inaccurate results?

I passed a test once that couldn't have come back negative, I'd been flying high for weeks. but it did. :shrug:

[NorthernSpy]

30. not necessarily -- find out what which opiate test was used...

Standard screenings only detect opiates that conjugate to morphine. That would not include fentanyl, I don't believe. In which case, those bozos simply chose the wrong test, and they have a hell of a nerve questioning their patient's honesty in the first place.

[Viva_La_Revolution]

33. can't disagree with your points. nt

[Raejeanowl]

32. I'd Bring A Trusted Friend

Especially if that friend is an attorney. And request that s/he could witness and sign the receptacle as well. Put the hinkyball back in their court.

But I really do think they just mixed samples up or got a bad batch of testing materials.

[Rex]

34. Make sure you take someone with you as a witness.

Sounds fishy with a capital F.

[cynatnite]

35. They may want to count your pills...

maybe take another drug test. They'll want to make sure you're not selling your pills and all that.

We're in TN and when my husband was hurt he was put on a lot of pain medicine. He was under contract and had to be closely monitored which included drug testing anytime they wanted. They counted his pills, too.

Just do what you've been doing and stay away from the pot. You should be fine.

[Fly by night]

36. I have heard from many TN pain management patients that their docs ...

... do specifically test them for pot. And if they test positive for pot -- a drug which would allow many of them to reduce or eliminate their need for dangerous and expensive opiates -- they are indeed at risk of being discharged from the medical care of the pain management clinic.

What a royally fucked world we live in. That's why we need Al Gore for President and Dennis Kucinich as head of the DEA. My guess is that Dennis would straighten out the priorities of our neo-Nazi drug warriors in a Cleveland minute. And Gore's own experiences with pot (and his sister's experience with med pot) would serve to (finally) get the cops out of our bathrooms.

BTW, Wiley, when they ask for another urine specimen, ask them into which ear they would like your deposit.

Sorry for your troubles, man. Be sure to put November 12 on your calendar. The world premiere of "Uncounted" (based in large part on our National Election Reform Conference) will take place at the Belcourt Theater in Nashville. Hope to see you there.

[Wiley50]

41. Thanks for weighing in, Bernie

If anyone here knows the score, you do.

And, there's nothing much I would rather be able to do
than to be able to get out to the movie premere,
just like I would have loved to make your coming out party

But my car is on it's last legs
and I, usually, only get out to doctor's appts these days.

I did manage to get to the Book Fair at the Capitol last weekend
but only because my best bud, Joe Bageant
was one of the presenters for his book
"Deerhunting with Jesus"
But that was a real exception.

Thursday, I get started on six months of Interferon-Ribovirin Shots
to try and kill my HepC
from what I hear I'm gonna puke my guts out.

Wish TN could be number 14
This madness has to stop

Keep me on your mailing list
I don't often write back
but appreciate knowing how you're doing

[Horse with no Name]

39. It means they are going to actually watch you take a piss

and you both will sign it as it is sealed.

[Quantess]

42. Why are you lying?

Just Kidding!:+

[Wiley50]

44. You'd better be

I've gone without a toke for too long over this shit

and I'm about ready to kick somebody's ass

[Quantess]

46. Sorry, I guess I'd be irritated too, if I were in your situation.

It's just weird that they assume you're lying.

I had to do the kind of pee test where the person watches you, with the door open, and I couldn't do it. I was pee shy. So after 10 minutes or so, they told me to come back tomorrow. Next day, not wanting to disappoint, I drank tons of water, so much water, that the urinalysis came back unreadable, and, "Dilute". Which counted as "Fail".

You're guilty until proven innocent.

[seriousstan]

45. Another test, closer monitored. That is all. Keep off the weed and you'll be fine.

All tests have some failure rate. The false negative has to be examined just like the,more often proclaimed, false positive. These are the nuisances that we must live with in order to protect and develop the technology. I know there are countless people who have taken, and failed, a drug test that would kill to be in your shoes.

You will shine like the innocent.

[HamdenRice]

47. They are afraid you are selling your pain medication to others

not just that you are not taking it, I suspect. That's why they want to see your paid med metabolites in your urine. In other words, it's not about the marijuana.