For decades doctors trusted patients who said they were taking their pain medications as prescribed. Now, he is asking them to prove it. Aa growing number of pain doctors requiring patients to submit urine samples to demonstrate they are taking pain medications such as oxycodone as directed. Individuals also are being asked to sign written agreements promising they won’t sell their drugs on the side and will seek prescription painkillers only while under doctor’s care. If they refuse, a prescription won’t be provided.
Where Chronic Pain Treatment is Headed
Imagine taking urine samples for a disease and then the doctor finding out these tests revealed some were taking opioids that were no prescribed or illicit drugs like marijuana or methamphetamine. There is a growing concern among physicians that they will be held responsible for painkiller-overdose-related deaths and accidents. For years, efforts to stymie the epidemic of abuse had been led by law enforcement and targeted shady operators, called “pill mills,” that supply the black market for oxycodone and hydrocodone. Urine tests can give us a lot of information to understand if somebody is taking the medications properly — or if they’re diverting them. The goal is to limit prescription drug abuse.
The Efforts Have Their Skeptics
There is a tight rope walk since monitoring prescriptions and locking individuals into signed agreements infringe on patient rights and can create a dynamic where patients are afraid to go to their doctor. And it is unknown whether these aggressive screening tactics make any difference in actually decreasing abuse or diversion. Then there is the question of cost. Urine tests, manufactured by Quest Diagnostics Inc., Ameritox Ltd. and other companies, can cost anywhere from $30 to $3,000 to administer, based on how many drugs are screened. Doctors collect urine samples from the patient and send them to a manufacturer’s laboratory for analysis. Results take on average about five days, it said.
Typically, insurers cover much of the cost. But for pain patients, the monthly tests cost extra and can make you feel like a criminal. Some insurers don’t cover the urine test costs at all since it is already known that patients are on pain medications.
Overdose deaths from painkillers surpass those from heroin and cocaine combined, according to federal data. Pain is one of the most common reasons why people visit the doctor’s office. But physicians receive little training in how to treat pain, and even less on how to identify potential addicts. A patient walks in for the first time, tells the doctor his symptoms and gets a prescription for controlled substances. Now imagine this being performed six to ten times a day with different doctors. Addicts know how to game the system. Some hope that the aggressive screening will eventually create an environment in which patients with clean records can avoid scrutiny both at the doctor’s office and the pharmacy counter. But only time will tell.
Have you been asked for a urine test while under pain medication?