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pain clinic dismissal
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An_250874 posted:
ok i go to a pain clinic and was recently dismissed because they said i tested positive for methodone(eddp) and gave me a list of area pc to go to.............well i did not know what methodone was until i looked it up on the internet. i have a buldging, herniated, and 2 ruptured disc in my back and need my script to even function. my doctor says he totally believes me when i say i have not knowingly taken any such thing............however it our state law that if you test positive for methodone in my state you are automatically terminated. ive been going there for a yr and never had #1 problem with any drug test which i took every month and there was a very, and i stress VERY "TRACE" amout in my system. i honestly do not know how this happened, i want to know if this will show up like my medication records do? that i was discharged , or dismissed for a positive test for methadone? and when i called the dr.s on the list they put in my letter they will not see me without a repherral and my pm DR will not give me 1, says he only doew the pain clinic and i will have to see my surgeon who is located in the same building, or my pcp can refer me, he also told me i would be unable to get the prescription medication i was taking due to this, is that true? i do not understand how " under due dilligence" my pm DR would not have called me back in immediately and just threw another test in me! if it was negative then there had to be an era somewhere, i know that eras occur all the time, human , test, or lab..........all 3 are viable explanations! i start nursing school in the fall to graduate with a BSRN..........so i know a little just apparently not enough not even my nursing instructors can answer this ? for because they do not know, i do not want to be "labelled" you know........so is this possible? will it show up in the data base for prescribers and pharmacies? if yes will it state specifics? and will another pm Dr. be able to write my scripts as they have been written for me to this point? and is my pcp able to take care of this for me until i can get into see another pm doctor or surgeon? ok so i dont know if i said this but i was under the impression that would no longer be able to recieve the class of narcotics ive been taking any more, is this also correct?
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Peter Abaci, MD responded:
False positive test results can occur with urine drug screening tests. One of the potential causes of a false positive test is when another medication in your system has a component in it that cross-reacts with a medications that is being tested for. For example, with narcotics it may be possible that the metabolite of an antibiotic like levofloxacin could cause the test to show up positive.

Urine drug screening is now becoming widely used in pain practices. Unfortunately, this has caused you a significant amount of distress and has impacted your medical treatment. I think it would be worth it to talk to your doctors about the possibility of a having a false positive result and having them re-evaluate your plan.
 
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lorigibs40734 responded:
Some types of medications can give a false positive for illegal drugs and other prescription drugs.

In some states, (I live in KY and they do this) they report to a data base that doctors access.

Could you ask them to test you again? Tell them everything you've taken in the last month, including any antibiotics and OTC meds.

Since you've been a patient there for a while, they may agree to test you again and see what shows up.

Best of luck to you!
Lori
 
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racknstack replied to Peter Abaci, MD's response:
Would a serum pain management profile be more accurate than a urine profile? At some point, the 'it must be a false positive' argument has to be addressed.

And what are the 'big offenders' for false positives; how do you determine what's a false positive and what's not?
 
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ctbeth replied to racknstack's response:
Hello Racknstack,

Blood serum tests are more sensitive, thus more accurate than urine testing.

I have not experienced the false positive issue as a patient, but as an RN, I'd suggest that a patient's history, length of time the MD is familiar with the patient's situation, if the test in question is the first positive test, would all be factors that may be considered.

Another factor is if the patient gave an honest verbal profile-when the tech or medical assistant asks what meds and at what time the patient has taken his/ her prescribed and OTC meds.

It is imperative to inform pain management MDs or their RNs of any new Rx that one is taking: some antibiotics, cold medicines, and other substances can alter urine drug screens. If this situation occurs, it's a good idea to bring the Rx bottles in to the MD appt, although in most states, but not all, all of the patient's prescription meds can be seen by all of his/ her treating physicians.

Some pain management contracts do not allow for a second chance, false positive or not. In these cases, it would be standard that the specimen is tested with a more sensitive and less ambiguous type of testing.

The ultimate determination is individualized to the MD, contract, history, and whether the specimen is sent for more sensitive testing.

There is a person who posts her upon occasion who is very knowledgeable about drug screen evaluation.

Good luck.

CTB


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