All patients for whom we prescribe any controlled substances (narcotics, sedatives, certain hormones, etc) are subject to random drug testing. We use an old-fashioned, but generally reliable method for selecting patients who will undergo urine drug testing during their visit to our office - we roll the dice. Actually, we only roll one die, but it has 12 sides. Before the die is cast, 3 numbers in the range of 1-12 are chosen and then the die is cast for each person on the following day's schedule. If one of the three numbers comes up for a particular patient, a drug test is mandatory.
We have found that this is a fair method and, over time, all of our patients will be tested about 25% of the times that they visit.
Why do testing at all?
We test because we need to know if our patients are taking what they are supposed to be taking. We also need to know if they are taking things that they should not be taking, such as controlled substances not prescribed in our clinic or illegal drugs or alcohol. We also need to know that our patients are compliant with what we prescribe.
What happens if I refuse the testing?
Patients who refuse drug testing will no longer be able to receive controlled substances from our clinic. We will still be able to offer other pain management modalities, including interventional pain modalities, physical therapy, psychological referral.
What happens if there are illegal drugs in my urine?
Because there can be significant, sometimes severe and even fatal interactions between illegal drugs and those which we prescribe, we will not be able to continue prescribing controlled substances for you and will refer you for drug and alcohol counselling. If you do not attend, this will be construed to be non-compliant and grounds for dismissal from the practice.
The bottom line - Take your medications exactly as ordered and, unless there is an emergency, do not take any controlled substances from other providers. (An emergency is a threat to life or limb. We do allow patients to take medications for treatment of pain after surgery or other painful procedures. Contact us with specific questions.)
Why can't I go out to my car/out for a smoke/out to lunch?
Sadly, there are people who will go to extreme measures to try to produce a "clean urine" specimen for testing. To avoid these dodges, you must give us a urine specimen before you leave. We will provide you with as much water as you like in order to facilitate your providing us with a urine sample, but you have to "go" in order to go.
Experienced patients generally will avoid urinating before they come to the office. Patients may ask the receptionist whether they are selected for testing. Once you know, however, that you are selected, you may not leave until you provide a urine sample.