Dr. Mark Ibsen in Montana has been videotaping stories of some of the pain patients who come to him for help. The video at the link is about a pain patient who took a drug test, the results showing positive for bud. Even though the patient has a medical marijuana card, the doctor’s office was not happy about the positive result. (I think most pain patients can be fired for testing positive for any federally illegal drug.)
But what got this patient fired (after 7 1/2 years with her doctor) is a positive result for methamphetamines, which she denies taking. The nurse called and fired her as a patient, but said she could get another appointment in three months. That doesn’t make much sense to me. Sure, patients get abandoned all the time, but why would a doctor’s office offer another appointment after three months?
Did the doctor terminate you as a patient or is this a trial separation? How desperate do you have to be to return to a doctor who fired you? What kind of relationship can you have after that?
You pay to see a doctor for over 7 years — that’s a long-term relationship. That’s longer than a lot of marriages, including mine. Of course, a marriage contract is a lot different than a patient contract. When two people get married, the law considers them equal partners in the contract. Not so with pain contracts, where the patient has absolutely no power whatsoever. Allegedly break a rule and you’re out the door. You don’t even get the option of arbitration or any kind of dispute resolution.
And if the doctor breaks a rule? That’s funny, as if doctors (and DEA agents) have to follow the rules.
it is estimated that abt 20% of “pee in the cup” drug tests thrown false positive/negatives
All Things Chronic 
Seems inconsistent to deny a patient care for ANY reason. Sounds to me like the doctor had to be looking for a reason to drop her. Don’t you have to specifically look for methamphetamines? I mean, you’ve got to run various tests to get results. I know! The doc takes 3 vials of blood from me every 6 months because they’ve got to run so many different tests. So didn’t the doc need to check a box asking to see if she had those drugs in her system? Wat up wit dat?
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A simple urine test is used to determine illegal drug use in pain clinics, and many are inaccurate. For instance, I’ve read that Claritin-D, an allergy medicine, can show up as a positive for meth in a urine test. And usually, a blood test isn’t performed, I assume because of the cost.
This is an advertisement for a detox product, but I think the information is fairly accurate (and, I thought, interesting):
http://alwaystestclean.com/meth-drug-test/
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Geez. I know eating poppy seeds can throw tests, too. Terrible that this is happening.
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It is very sad when a provider has a test result come back and does not talk to the patient about it. There could be a completely innocent reason why they got a false positive during a urine drug screen. I understand that Pain Management doctors are required to test their patients for compliance and also making sure the patient has not been using any illegal or prescription medication that is not written for them.
If a patient has a positive result on a drug screen panel the doctor should talk to the patient instead of just firing the patient. I know how detailed most Pain Management doctor contracts are and how it lists dismissal, aka firing, the patient for breach of contract. I think that overall the patient should be given the benefit of a discussion with the doctor about what happened and see if something the patient took could create a false positive.
Patients who need a Pain Management Doctor are a the mercy of their doctor and have so few options when it comes to how often they are screened. Now many doctors, including my own Pain Management Doctor, are requiring me to bring all my medications in their bottles to be counted at each appointment on top of the urine test (that I have to pay for each time and insurance does not always cover the frequency of these screening tests.) It is very difficult for me to carry all 14 medications with me, make sure they don’t get exposed to too much heat (I live in Texas so it is hot as hell around her 9 out of the 12 months) and wait for each one to be counted at each appointment. The government is the one to thank for how paranoid Pain Management Doctors are any more about how much of each medication you are on and how many medications they can prescribe for you even if you are still in agonizing pain after taking your medication as prescribed. I could say so much more, but in the end it would just be redundant based on what I have already said.
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Thank you for writing on this and spreading awareness. Once a patient is fired from a Pain Management Doctor for such a thing it takes a miracle to get into a new Pain Management Doctor and also is hard to not go into withdrawal from your normal medications since you don’t have anyone to write for it. It is being kicked when you are down since you are already in pain and then you have withdrawal on top of that which is a very difficult situation to be in.
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Even if a patient fails a drug test because she broke a rule, a mistake shouldn’t be treated like a crime. Especially if the mistake is due, in part, to the doctor’s inability to adequately treat a patient’s pain.
Everyone blames a patient for taking an illegal drug, especially when they have access to prescription medications, calling it addictive behavior. Doctors think patients just want to get high — they never blame themselves for forcing a patient to try alternative options for pain relief. Forcing patients to take risks that could result in a failed drug test and abandonment.
I would not wish cold-turkey withdrawal on my worst enemies. And I find myself unable to forgive the doctors who forced me into it. But I can thank these doctors for helping me to finally break my addiction to the medical industry. Regaining some of my independence was important, especially since the pain has taken so much of it. I’ll never be free from pain, but it feels wonderful to be free of doctors.
Maybe “wonderful” is an understatement… I’m not sure I can adequately describe the kind of freedom I’m talking about — not having to depend on doctors. Perhaps it’s like becoming an adult, turning 18, and finally being able to make your own decisions. 🙂
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I completely agree with you that patients should not be punished for seeking relief from their symptoms that their current medications, or medications their doctor feels comfortable prescribing. I know for personal experience that due to governmental interference and the refusal of states to approve medicinal use of “illegal” drugs. I wish Texas would allow at least medicinal use of marijuana because I have maxed out on all legal medications that the government and my insurance will cover. I used to have insurance coverage for the fentanyl citrate lozenges, also called fentanyl pops, because I don’t have cancer and I am not in a hospice. I am not dying and my chronic pain conditions, Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome (RSD/CRPS) and my Gastroparisis (GP) caused by the RSD/CRPS, but they are grouped in with other chronic pain syndromes that have gained the nickname the “suicide diseases.” I have to live with the unending burning pain that has overtaken my full body and now has started affecting my internal organs, that is what caused the GP, and pray for a new medication or change in legislation to ease the pain and other symptoms I experiance.
You are right, it is not fair that patients are punished just for trying to make their quality of life better in the case of marijuana.
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I tried fentanyl, patches and suckers, but the nausea was so bad, I didn’t get any pain relief out of them. This was in Texas, where I spent most of my life. But I finally gave up on that state passing a medical cannabis law and moved to New Mexico.
I’m not sure how insurance feels about ketamine treatments for chronic pain, but that’s something fairly new you might check into.
Sorry to hear you suffer from CRPS. If you’re interested in hooking up with a fellow sufferer:
https://achronicpainlife.wordpress.com/
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