Comments on Pain-Topics.org News/Research UPDATES: Pitfalls of Urine Drug Monitoring in Pain Care

Dr. Leavitt, I applaud your mentioning of this top...

2010-08-21T20:56:20.358-05:00

Dr. Leavitt, I applaud your mentioning of this topic. I will attempt to keep this short. A rookie pain Dr. at the Veterans Hospital in Nashville, TN labeled me a substance abuser after doing a UDT and taking 5 Months to post the results? She turned up Dilaudid, which was really a metabolite from Hydrocodone, and 4 different Benzodiazepines which were really only metabolites from Valium all the

It is heart breaking to read anonymous' comments. ...

2010-06-15T00:32:15.548-05:00

It is heart breaking to read anonymous' comments. The need for pain medications is fraught with shame, humiliation and fear of legal retribution. As good Americans we have been counseled to "just say no", "bite the bullet" or simply to "get over it". These options are cruel unreasonable and without empathy. Many pharmacies won't dispense these drugs. One is

I am 28 years old, female live in Iowa. I have had...

2010-05-18T22:21:41.959-05:00

I am 28 years old, female live in Iowa. I have had serious chronic pain issues since I was 11 years old (due to arthritis, lymphodema, psoriasis, scoliosis, tmj, ibs, fibro, raynoids). I have been put on everything you could imagine, several times over. The most recent one is Morphine 100mg (2 times daily) as well as Morphine Sulfate Imm Rel. 30mg (2 times daily prn for breakthrough pain). I have

I agree with the last comment. UDT is an insult; k...

2010-02-15T11:05:47.849-06:00

I agree with the last comment. UDT is an insult; kind of like you're guilty until provent innocent, right? I also agree with comment #1: Much more can usually be learned by taking the time to truly listen to what our patients say about their medication-taking practices and subsequent pain relief.
In the end, an 'abuser' will always call him/herself out, so there is no need to

Urine testing is nothing more than an insult of th...

2010-02-09T12:32:13.221-06:00

Urine testing is nothing more than an insult of the highest order to the patient. Maybe the doctor thinks that he is covering his wallet by submitting his patients to the insult of a urine test, but the courts have not always found this to be true!
If a doctor has come to feel he must rely on an insulting test in lieu of his own judgement, he is in the wrong profession, because both

at the very least, physicians who endorse urine te...

2010-02-08T16:21:16.634-06:00

at the very least, physicians who endorse urine testing of pain patients should agree to be tested themselves, under identical circumstances (e.g., under direct observation if that is demanded of patients). Precisely the same should be required of all those working with the physician - nurse, secretary, PA, etc. Furthermore, all specimens should be sent to the same laboratory, and coded to hide

Responding to the 1st comment about stopping the u...

2010-02-03T07:33:51.200-06:00

Responding to the 1st comment about stopping the use of UDT except in very select circumstances, it would be great if all patients told the truth all of the time. However, in the real world, UDT has been an invaluable tool in addition to behavioral monitoring and patient assessment, in that it provides added documentation to support chronic opioid therapy and helps support clinical decisions on

As a chronic intractable pain patient, I have no o...

2010-01-25T16:58:13.643-06:00

As a chronic intractable pain patient, I have no objection to urine testing, with the acception of false positives. If you have a good relationship with your pain doctor, such an incident could probably be easily worked through. Honesty is the best policy.

We agree wholeheartedly with the cautions Dr. Leav...

2010-01-22T10:28:42.636-06:00

We agree wholeheartedly with the cautions Dr. Leavitt provides – in our pain practice, we have stopped using urine drug testing except in very select circumstances. UDT can be costly, time-consuming, and often adds little for guiding therapy. In difficult cases, the interpretation of UDT results can be very challenging and prone to error. Much more can usually be learned by taking the time to