Wednesday, November 16, 2011

Pain Management Drug Testing: Demoralizing Mistrust

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As someone who is being cared for by the pain management department at my local hospital, I have to agree to periodic drug testing to receive prescription pain medications. On one level I've accepted this is the way things have to be so I can get access to the pain meds I need to maintain my sanity and a slightly better quality of life despite living with chronic migraine and occipital neuralgia. But I still resent it, and I was really upset this week when I learned I'd have to go in for retesting because the results of my last test indicated I didn't have the medication in my system. Never mind the fact that I am always wearing that patch and change it once a week as directed.

I was lying there on my back resting after my occipital nerve blocks when the doctor asked if I could take another urine test before I left. I said I didn't think I'd be able to that day because I hadn't had anything to drink since I got up and used the restroom, but that I could come back the next day and plan accordingly. I can't pee on command, sorry. Can anyone? After he ducked out I threw my arm over my eyes and started crying. It's just so demoralizing. Must I be untrustworthy and suspect because I have a disabling chronic condition that can be somewhat helped with pain medication, among other options? What have I ever done to deserve this kind of mistrust and scrutiny? It really sucks. I kept thinking, "Who would come in for injections into the back of their head if they were drug seekers and diverting their pain medication for sale to junkies?" If you've ever had those injections you know they are absolutely no fun and rather painful. It just doesn't make sense.

(Thank god for my husband who kept telling me how much the doctor looks like the actor Mike White, creator, executive producer and actor on the HBO show Enlightened, which made me laugh and forget my pity party for a while.)

The worst part to me was that it was as though it was no big deal to them to inconvenience me, and I felt that my word that I'm constantly wearing my pain patch means nothing if the test doesn't reflect that. How can I prove to them this is true? It's simply my word against the test, right?

When I went in for my retest I decided to ask a nurse to look at my back and verify that I was in fact wearing the patch. She declined to do so, but was receptive to my concerns and very understanding. She instructed the person who processes the urine tests to look into the paperwork a bit deeper, which I appreciated. Low and behold, they'd submitted my test to be compared to a different medication than the one I actually take, which is why the test didn't find any evidence of the medication in my urine. It was looking for something I don't take.

Identifying the mistake was a big relief, but why did I have to be the one to bring up that possibility? If I hadn't they'd have submitted the test the exact same way and I'd still be under scrutiny and feel like they consider me a criminal and liar. Even worse I'd be worried they might decide not to treat me anymore. It's just another great example of how important it is to advocate for ourselves. I was polite and respectful, but brought up my honest concerns and actually had my needs met. I guess that's what really matters in the end and what I'd like you to be able to take away from my story.

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DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.