Doctors Concerned About Pain Medication Overdose Deaths Require Drug Tests

An increasing number of doctors who treat chronic pain are requiring their patients who take opioids to submit to urine drug tests. The doctors are trying to avoid being held responsible if patients die from painkiller overdoses, The Wall Street Journal reports.

The tests can tell doctors whether patients are taking pain medications as directed, the article notes. Physicians are also asking pain patients to sign agreements stating they will not sell their medications, and will obtain prescriptions only from that doctor.

Dr. William Piechal, a pain doctor in Fayetteville, Arkansas, says when he initiated urine drug tests last year, he was shocked to find some failed tests came from patients he had been treating for more than a decade. The tests showed some patients were taking opioids he had not prescribed, or were taking illegal drugs. “This is where chronic pain treatment is headed,” he said.

The American Society of Interventional Pain Physicians endorses urine tests for all patients, and several other groups, including the American Pain Society, have endorsed drug testing for high-risk patients. At least 10 states recommend some level of urine drug testing for pain patients.

Some critics say drug testing and written agreements violate patient rights. Edward Michna, an anesthesiologist at Brigham and Women’s Hospital in Boston, who has studied urine testing in pain patients, says it is not known whether these tests decrease abuse or diversion.

Many health insurance plans cover much of the cost of the drug tests, which can run between $30 and $3,000, depending on how many drugs are screened. Some insurers do not cover any of the costs.

13 Responses

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    July 14, 2016 at 3:32 PM

    I find it odd that I’ve signed patient contracts, reverted to purchasing brand name medicine (with tamper proof features) rather than generic thus causing my meds to cost more than double, am now on state wide prescription data base (and the DEA seems to think it is allowed to access our private health records on said data base without a warrant ) and yet *still* nothing is easier for the patient or the doctor. If anything it’s much more difficult to receive adequate pain care than it was before these measures were implemented. Do I have a problem with random drug tests? You bet I do!

    It’s the principal of it that bothers me. Man is meant to be free. Without freedom man does not thrive. And yet, people say they have nothing to hide and don’t even bat an eyelash when they hear they’ve given up their personal information in cell-phones, computers, etc. to the NSA.

    I’m glad I won’t be around when the younger generation is older. People don’t realize that the court of public opinion shapes our reality and future.

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    Pain Guy

    February 10, 2016 at 9:05 PM

    Pain management doctors deal in controlled substances that are highly addictive. As we are all aware, addiction can lead people to do things they would have never considered before to feed that addiction. Among these are taking larger doses than recommended, taking other non-Rx’ed controlled drugs, illegal narcotics, etc. All with a potential of damaging the body further (leading to more medical issues and $$’s paid out) and potentially kill the patient.

    Due to the highly addictive nature of opioid therapy provided to chronic pain patients, they have garnered a significant street value for other addicts as well as recreational users. Thus, many patients will sell pills to make ends meet and potentially cause irreparable damage to others. Selling of scripts is also known as “diversion”.

    Many are not aware of highly stringent government mandates these pain specialists are under, as well as the risk they expose their Medical License (livelihood) and themselves to when practicing pain management due to so many cases of drug abuse and fraud- Brought about by non-compliant patients and in some cases the physicians themselves.

    High complexity urine drug screens break down the urine into the smallest segments searching for not only the drug traces, but the metabolites that are created after digestion of the substance. These physicians also know what levels should be in the patient’s body at the time of testing to smallest fraction- Best of luck trying to fool an LC/MS analyzer.

    The necessity of this test is make sure that patients are compliant- Not abusing their scripts, not diverting and not taking other non-scripts or illicit drugs while under their care. This not only protects the patient from potentially harming his/her self and others, but ensures the doctor took the necessary precautions in best care management procedures making sure the patient is compliant upon receiving a new Rx or a refill.

    The Doctor has a life and business to protect as well. Yes, ultimately, the main goal is to help relieve pain in sufferers, but you can’t forget that everyone doesn’t posses the fortitude that many of you obviously have in being a solidly compliant patient.

    Fact is, just about everyone on this forum knows at least one person that abuses or diverts. Imagine if it was your life at risk? Imagine all of the extra costs to tax payers for additional damage patients do to themselves or others by not being compliant. . .

    In other words, try to see the situation from an angle other than yours. It isn’t about restricting rights or infringing on them, it is about protecting all parties involved in an essentially legal drug deal with serious and consequential product.

    I already know that this will be far too logical for many to digest.

    Best regards,

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    joey farison

    March 17, 2015 at 2:56 AM

    I dont know what everyones big issue is with compliance testing? Personally I think its a small price to pay to save lives….to to have effective relief of my pain…to let our government finally get off there butts and work somethings more complicated and important…to save almost everyone $$ …etc etc etc….if your abiding by the law and following the docs rules whats your big problem…what is in your urine that you are so worried about….its urine…wtf? I honestly couldnt care less….I will give anyone my urine that asks…give me your address and I can prove it? Dont we have problems in this world that are soooooo much more serious and important? Or is urine secrets and ability to abuse drugs everyones priority? Without hesitation, I know my priorities….wow

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    June 29, 2014 at 8:09 PM

    I know UT is a good thing for contoling drug abuse, but how do we know that we are being tested for all the charges we occur, what’s stopping them from just reading the colored strip and charging us for 10 different test, after all I think we should get a copy of the results so we know what were paying for. Lord knows there are a lot of doctor, lawyers who pad their pockets at our expense, and I would like to know our leagle rights to this.

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    April 21, 2014 at 12:08 AM

    And not only to cover their buts but to get kickbacks from labs.

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