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.

5 Responses to Doctors Concerned About Pain Medication Overdose Deaths Require Drug Tests

  1. Roxanne Baker | July 22, 2013 at 12:27 pm

    As a pain patient who receives schedule 2 meds I do not mind giving an UA to my Dr. Told him I would do it monthly if it helped to keep the DEA off his butt,or any other Org that is trying to play Dr without a license. I also sign an agreement to not get my pain meds any place else,why would I need them from anyone else? I don’t mind signing the agreement that says I will only use the same Pharmacy. Again,why would I need a 2nd Pharmacy? Pain patients are not idiots,we are just in pain and need a Dr to treat us with the Government stepping in to tell us what to do!

  2. Doug | July 22, 2013 at 1:55 pm

    This was standard practice 15 years ago when my Dad was a pain management patient in VA. He was a retired scientist with multiple conditions and complications. If he needed drug testing before the opioid epidemic how can any doctor justify NOT testing at this time?!?

  3. Joe | August 10, 2013 at 7:28 pm

    All this is complete foolishness!!!! I have MS, sciatica, spinal scoliosis, extreme lower back arthritis, hip displasia, muscle spasms that last for hrs if not days, muscle tremors, neuropathy from my neck to my toes, degernerative disc, I’ve been shot in both legs (95 while in high school failed car jacking/attempted murder), trigamalgia, TMJ, unable to lift my legs up, cysts growing in my hip joint, insomnia…and with all this smoking a one hitter helps the most with the muscle spasms-as proven not only here in the US/EU/Israel/India/Canada/south American counties. Yet under these false DEA laws regulations forced by pharmaceutical companies and there bottomless pockets to pay the US govt to force us to take medications that KILL umpteen thousands if not millions of people world wide. To keep what US govt holds the only international patent for…marijuana out of the hands/system of people who benefit from it the most. I’m loosing my job due to not being able to normally function on a daily basis. It’s not due to overdoses of prescription medications it all due to the phamacutical companies. Which allows for the continuation of the LOOSING THE DRUG WAR. All these pain contracts began when states brought it upon themselves to stand up against the tyrannical US policy makers. How dare we as American citizens allow our govt to control even the basic privacy laws written in the constitution to protect entities like a business. Which to my knowledge companies have NO RIGHTS over PEOPLE’s rights. Stand up against these laws that are slipped on the pockets of the lawmakers in the form of money!!!!! We as US citizens criticize other countries, but when the people of those countries say enough is enough they Stand up against their governments. When did we as the so-called greatest country on the planet become scared of 535 people in capital hill and one person in the White House?? Be proactive not reactive if we want the change to make the individual US citizen more powerful then a profit machine.

  4. FMS survivor | August 22, 2013 at 10:10 pm

    This is a complete waste of time and money since drug testing has proven ineffective at deterrence, enforcing patient compliance, and reducing diversion! I believe this damages the doctor patient relationship in a serious way. Let’s call this what it is…a cover-your-butt move by the doctors under pressure from insurance and the government.

  5. Jim Harris | August 28, 2013 at 2:36 pm

    I am not sure why the WSJ author did not mention that a federal court has concluded that urine testing cannot be used to assess compliance. This seems to be relevant to the story. Here is the judge’s summary:

    http://www.divert-x.com/docs/Federal-Court-Decision-Urine-Testing-Cannot-Determine-Compliance.pdf

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