Recently I read an article titled, “Drug-Test Physicians? Docs Say ‘No Way”. I was lost for words. I could do nothing but sit and shake my head. Then, I wanted to scream so loud that all the physicians who were quoted in the article could hear me: “You’ve got to be kidding me!”
The remarks made by these physicians are exactly the same ones made by people living with pain each and every time we are asked to provide a specimen for a urine drug test in order to obtain our prescription for pain medications.
My question for these providers is simple. How can you give these responses when your patients have been pleading for you, their physician, to hear them when they have voiced their concern about being forced to take a drug test for no cause or go without the medication you have recommended in the first place?
Ok, let’s break down the article a little bit so you can understand why my response to this article was one of disbelief, anger and plain ole frustration.
I will start by listing some of the reasons why these providers gave that they should NOT have to be drug tested.
- What ever happened to probable cause?
- You only have 1 in 10 chances of being treated by a provider who is addicted to drugs.
- Damage to the physician who is diagnosed as harboring a drug or alcohol [addiction] when, in fact, it was just a lab error? What is at issue is the problem of sample error and being falsely accused.
- Random drug testing is an invasion of privacy.
- Screening for substance use should be based upon reasonable suspicion and not kneejerk across an entire population.
Now that is has been established why physicians feel that they should not be tested, let’s take a look at the person with pain.
How many of us have been given these same drug tests, not just once, but twice, three times or more in a year and for some they are expected to be tested each time a refill for pain medications is needed?
So for arguments sake, let us break down the five reasons as mentioned above.
- What ever happened to probable cause?
We, as people living with pain, can understand that according to the law, there needs to be probable cause before we can be arrested for a crime. So why is it ok that we are forced to take these drug tests without probable cause?
- You only have 1 in 10 chances of being treated by a provider who is addicted to drugs.
So people with pain only have 1 in 10 chances of being treated by providers who are addicts. Well there are 100 million people living with pain, so that 1 -10 chance is 1 to many. According to the Henry J. Kaiser Family Foundation, there are close to 835,000 practicing physicians in the U.S. (about 397,000 are primary care and the remaining are specialists). This means that approximately 83,500 physicians could be impaired?!?.
- Damage to the physician’ livelihood and reputation for those diagnosed as harboring a drug or alcohol [addiction] when, in fact, it was just a lab error. What is at issue is the problem of sample error and being falsely accused.
People with pain can understand how horrible and devasting it could be to a physician’s career if there were a lab error, we are not heartless. What about those people with pain who are dismissed from a medical practice and essentially abandoned due to a lab error? Frequently, there is no second chance given, access to care is lost and we are labeled a non-compliant patient who is most likely a drug abuser. We are falsely accused and labeled as a substance abuser and our medical files are red flagged and we will not find another provider to take over our care. We are basically kicked to the curb with no pain treatment at all.
- Random drug testing is an invasion of privacy.
DUH! Of course it is an invasion of privacy…. but once again what about the person living with pain? Why is it not an invasion of privacy for us? What makes the physician’s privacy more important than the person living with pain?
- Screening for substance use should be based upon reasonable suspicion and not kneejerk across an entire population.
Oh my, oh my….there are very few physicians who do not require drug testing in order to obtain a prescription by legitimate people living with pain. Once again, why is it ok to kneejerk an entire population of people living with pain without reasonable suspicion but not physicians? It is as simple as that.
I have broken down the reasons why physicians believe that they should not be required to take drug testing. By doing this, I hope that I have also shown that what is good for the goose is not good for the gander. It is sad but this leads me to believe that some or many physicians believe that they rank high above their patients, the person with pain. Simply put, we as people with pain are considered low on the totem pole in our society. We are the ones who are at the bottom of the pile, feeling the weight of physicians, who are standing way up top. Are we living in a caste system here? Just because we live with pain does not mean we are all addicts; it does not mean we are all selling our prescription medications; it does not mean we are low life scum of the earth and the root cause of prescription drug abuse.
We are human just like physicians are human. Bring on the equality that is needed. Stop making excuses and stand up for what is right, if you require your patients to accept drug testing then stand up and show you are not above it, stand up and show the world that as physicians you believe in equal rights for all. “Man up” and be drug tested like others in the healthcare professions (nursing, pharmacists, etc), public safety, aviation and government agencies.
Why is it okay for physicians to insist that their patients who live with pain take these tests but it is not okay to require them to be subject to the exact same tests? Would you want an impaired physician taking your life in their hands? They are doing it now without our knowledge. If it is required of patients to have their privacy invaded then it should be equally okay for physicians to abide by the same minimum standard.
Now, let me take a moment and step down off my soap box. I must confess that I don’t dislike physicians; I respect them as I believe they should be. They hold within their hands the ability to identify and treat diseases, to save lives, to reduce pain and to give us the chance to grow old. Physicians can be healers and have the ability to help change the way people living with pain are treated and viewed in our country. My plea is this: Please stand up for what you know is right. Stop allowing people living with pain to be the bad guys here. Stop it now! We are not the bad apples that spoil the cart. The majority of people living with pain are good folks aka “legitimate patients”; we do not abuse or sell our prescription opioid medication or use illegal narcotics. Honestly, people living with pain are too busy just trying to deal with the pain and not take on any added stress. All people living with pain want is to be able to live our lives with some sort of normalcy. From our health care providers, we wish to be treated no differently than other patients who have persistent medical conditions akin to heart disease, diabetes or cancer.
Come on people living with pain and the physicians who are still willing to treat pain, let us join hands and sing a chorus of:
C’mon people now,
Smile on your brother
Everybody get together
Try and love one another right now.
Sing loud! I want to hear you.
I totally agree. My daughter, was going to a pain clinic, for back spurs and herniated disc in her back. My daughter’s back pain started after the birth of my, first precious grandbaby. My daughter, while giving birth had, 2-epudurals. My grandbaby was born, March 2015. My daughter’s, back gotten so bad, she’d be in tears, could barely move. My daughter, never took any type of medication, until the back pains. A neurologist, wanted her to have back surgery, she said no, she was referred to a pain clinic. The pain clinic, continually prescribed her narco 5mg for 5-years, my daughter kept telling them,it was’nt working. My daughter would try exercising, but the pain in her back, would’nt allow her to continue on a consistant basis. My daughter pain was so bad, she wanted to try one of my Tylenol/ codeine pills, to serve if that would help her pain and get her mobil. Now, mind you, for 5-years, she was taking the required urine test, per pain clinic, just as everyone who goes there, when scheduled, for 5 years always passed. My daughter went for the urine test as usual, last week, this week Monday, they told her, she had traces of codeine, in her urine and they, could no longer treat her, my daughter came in my room crying, she was hurt, that they can put on her medical files, drug user and she may never find help for her back pain. Mind you, she kept telling the clinic, the med, was’nt working, they’d tell her, you are too young (35 years old), we don’t want to up the dose, they should’ve tried a different med. For 5-years, my daughter passed their test, they let her go, just like that. Any advice?. will her file be labeled, negativley?, can see find another pain management Dr. or family Dr. to help?.
I’m singing Teresa can you hear me?
Great Blog! You nailed it! Fair is fair – no matter who or what group you talk about. I can not believe their excuses for not being drug tested. Nurses are randomly tested all the time. Tested on new employment, tested randomly, tested if there is cause to suspect a problem.
I get the reports for MQAC (Medical Quality Assurance Commission of WA State) Each time I get a report there is at least one if not more physicians being sanctioned due to diversion of controlled substances, opioid Abuse, or alcohol abuse that has impaired their ability to practice medicine safely. By the way that report comes monthly. The numbers are staggering to me. So glad that they got caught and are now being helped and monitored carefully through a state sponsored program for rehab of professionals with substance abuse issues. They remain in practice as long as they comply with the stipulations in their plan from the commission. It is so easy for them to access controlled medications.
I also see Nurses who divert and abuse drugs meant for their patients. this is a sad commentary on the compassion and caring that is inherent in nursing. It hurts me heart to see or that this occurring among my colleagues in Nursing.
Personally as a nurse I would submit to a random drug screen is requested by my employer. I have nothing to hide and of course right now it would be positive as I take an opioid medication daily for my pain. So we would have to have a discussion of why and how. Many hospitals and clinics have a policy of random drug testing. (in 48 years of nursing truthfully I have never been randomly tested even though it is a policy to do so. I guess my number never gets picked – no one wonder I never win the lottery) I have been asked to submit to drug screening for new employment (at least once) and I always complied with this request.
As a pain patient, I have already told my prescribing primary Physician that I will always be honest and transparent with him about the medications he prescribes to me – I will bring in my prescription bottles if he wants to do a pill count BUT I will not submit to random drug testing UNLESS he can show me that every other person coming to that clinic is randomly drug tested on a regular basis I.E. show me the proof.
Teresa your Blog just points out once more that we as People in Pain are held to higher standard. Thank you for taking the time to pull this article apart and call it what it is – unfair discrimination and labeling.