My Story: Drug Tests and Pain Contracts Violate Patient Rights

My Story: Drug Tests and Pain Contracts Violate Patient Rights

My story with chronic pain began in 2010. I sustained two herniated discs in my neck in a tree cutting accident. My injury resulted in severe pain in my neck, with reduced range of motion, weakness and pain in my left arm and hand.

I spent over 3 months sitting upright in a chair because any movement or change in the position of my head or body resulted in excruciating and prolonged agony. At one point I even told the doctor that if things did not improve I would not be able to cope and that they would have to put me into a coma or something until I got better.

Fortunately, that was not necessary and after 18-20 weeks the pain went from unbearable to severe. I declined spinal surgery or epidurals based on my research of the procedures and possible complications from them, which include infections, increased pain, loss of the ability to talk, additional nerve injury, and more.

Arianne Grand Gassaway

Arianne Grand Gassaway

I was able to cope effectively with the pain through the use of opiate drugs and muscle relaxants. I had enough relief to do some of the things I was doing before the accident and I could even lie down again! But, in reality, that injury changed my life forever. We have a small farm and I would never again be able to do anything without the fear of exacerbating the injury again, which has happened several times in the last few years.

In late 2012 I was told by my doctor that I would be required to submit to a random drug screen and sign what was referred to as a “pain contract.” I was told that if I declined, I would no longer receive my medication.

I asked if I was being accused of something (because that is what it felt like) and was told that “there is a drug epidemic in our country” and that I needed to verify that I was using the drugs she prescribed. This contract also stipulated random pill counts and various other restrictions on pharmacies, etc.

I submitted to the drug test and signed the contract under threat of not receiving further treatment if I refused.

In my opinion, these policies and practices amount to coercion and to search and seizure without probable cause or due process. It is to me a very clear violation of patient rights, criminal law, and a violation of the Fourth Amendment.

When I was asked to submit to a second drug screen the following year, I refused and told my doctor that I felt it violated my rights. She said she was sorry I felt that way. I asked her what the results of the first drug test were, and she said it showed I was not using any illicit drugs and that I had levels of the drug she prescribed me.

When I reminded her that I had told her that prior to the test, she just shrugged and told me that people lie. She then referred me to a pain clinic and suggested that I find another primary doctor.

Needless to say, I am no longer receiving treatment for my pain.

I contacted the ACLU and they refused to help. They told me that drug testing is a federal recommendation to combat the drug epidemic in our country and that these practices are now the national standard of care for treating pain patients. Also, as there is no law requiring drug tests in my home state of California, the ACLU will not represent any individual in this matter.

(Editor’s note: the ACLU has filed a class action lawsuit against the Medical Licensing Board of Indiana for requiring physicians to have pain patients submit to mandatory drug testing.)

One ACLU representative suggested I contact a private lawyer, but everyone thus far has refused to take the case.

It is a travesty that patients with chronic pain are being treated like criminals, with the threat of being denied medical care if they refuse to give up their rights. Being forced to take drug tests and submit to random searches of medications only serves to marginalize patients seeking relief from painful illnesses and injuries.

In some instances they even cause patients to stop seeking treatment altogether for fear of the stigma that has been placed on those who use controlled medication. Patients may then turn to self medicating with illegal drugs or alcohol.

Therefore, the current practice of drug testing and pain contracts could actually be viewed as counterproductive at reducing drug abuse in our country and could instead actually increase the incidence of overdose and improper use of medication.

Most people taking controlled pain medication will seldom speak out about their experiences of shaming, discrimination, or being treated with a lack of compassion and dignity. Mostly they fear being targeted and labeled further by those in the medical field and, in some instances, even by close friends or family members.

I have decided not be silent and I am willing to stand up for those who feel that they can’t because I know how hard it is to fight a war when every day is already a struggle.

For those who are unaware, pain is all-consuming and it affects a person’s ability to interface with the world around them. It puts limits on the activities they can or can’t participate in and sometimes even leads to depression and feelings of hopelessness.

There is a saying: “Chronic pain is just that, CHRONIC. It never goes away, it never lets, up and it changes everything.”

It is my hope that by bringing attention to the real face of pain that there might be a shift in perspective in how those who rely on opiates for pain control are viewed. At the very least, maybe those suffering with chronic pain will be able to be treated with the dignity and respect that all patients deserve.

12_7.jpgArianne Grand Gassaway lives in Mariposa, California.

National Pain Report invites other readers to share their stories with us.

Send them to editor@nationalpainreport.com

The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.

There are 42 comments for this article
  1. BL at 7:49 am

    D Raisola, with the exception of the state mentioned in the editors note in the article, drug screens aren’t mandatory by law. Pain drs aren’t the only ones who do them. The majority of drs who prescribe ADD meds for adults do drug screens. It may not seem fair to those who don’t abuse their meds and take them as directed to have to have drug screna and sign pain contracts, but, life isn’t fair. People do lie and just because a patient hasn’t abused drugs before, doesn’t mean they never will. The ones who lie usually don’t look or behave any differently in the drs office than those who don’t. Drug screens and pain contracts offer a litle protection to the drs and without them, no one would be able to receive chronic pain management.

    If we want to drive a car, we must obey certain laws and rules. If we don’t we aren’t allowed to drive. There are is nothing that states drs have to treat chronic pain patients with meds to relieve their pain. Unfortunately, having chronic pain managed isn’t a right.

  2. cyndiann at 5:05 am

    Why don’t you try kratom? It’s legal, a natural plant related to the coffee plant and it helps a lot with pain. Since I posted last I’ve given it a try and have had really good results. Because it’s a plant you do need to take it often but that’s no different than oxycodone and it’s a lot easier to get.

    I am planning on going to a good physical therapist, switch totally to kratom and not see pain management anymore if I can help it.

  3. D Raisola at 8:08 pm

    I’m a 68 yr old woman with chronic pain. I have spinal stenosis, bad discs, and a long list of other spinal issues. ( I can’t even remember how many or the medical terminology.) What I do know, is I suffer. I’m not a criminal..not even a driving citation. I obey the law. I am kind. I love my family. What is so wrong with this system that those suffering have to be reduced to begging for relief? My pain clinic seems to be holding my medications for ransom, and I must submit to “procedures” that really don’t work for any length of time. The cost is high, and they continually want “more money”. I don’t know what to do, but I must say, death is a better option that the constant pain. It’s very sad that those suffering are treated like criminals. Shame on this system.

  4. BL at 3:09 pm

    Angela Ruggles, if the medical records state you signed a Pain Contract, a copy if it with your signature should be in your medical records. No drs has to give a patient pain meds. There is no law or anything else that forces them to do so. It is up to the professional judgement of the dr what to prescribe and how much, if anything. A Pain Contract doesn’t guarantee that a patient will receive any particular med or dosage. When you become the patient of a dr, you agree in writting for him to treat you. No where does it say that the dr has to treat you by prescribing certain meds and/or doses. The dr needs to know what other drug are in your system in order to safely treat you. A Pain Contract is an agreement on the patients part that they will go by the rules and that they have read and understand the rules.

    No rights or laws are violated by Pain Contracts. And no rights or laws are violated if a dr doesn’t prescribe pain meds. No rights or laws are violated by laboratory test, which is what drug screens are.

  5. alex at 11:14 pm

    You were under no threat of not being treated. Not receiving narcotics is not failure to treat. There are many other ways to treat pain than with medications. A pain contract is fully legal. Doctors are not obligated to prescribe you anything and are allowed to make stipulations. You need to get off of your soapbox because you trying so hard to not act like an addict is very similar to actually being one. Oh, wait, that’s because you clearly are.

  6. Angela Ruggles at 4:51 am

    My wife had no contract,she has chronic pain disorder,she signed nothing,she went in for a yearly phsyical,Dr.perfomer a drug screen without telling Angela what her urine sample was for.she thought it was part of theexam.needless to say the test was false and she. Left her sample in a public restroom wich a nurse retrieved sometime later.we fired the Dr.Im her husband and we had the same Dr. Niether of us had ever had a cotract with the Dr.yet he reports in the medical record that my wife did,he then refused to fill my meds agian until i came in to see him without explanation,at that point i refused.We dont even know if the urine sample was my wifes as she left in a public restroom as instructed.l wounder when they. Will all get there jr.g.i. badges.what do we do now?what are ethics,?could she have refused if she was informed that she was taking a drug screen?its my belief that our rights were violated as well as a few laws.what say you?HELP!!!!!

  7. notreally at 3:34 pm

    I had a backpain condition. My doctor referred my to a so called specialist. She stuck me with Cortizone which was so painful that I was unable to move. My regular doctor seeing my agony gave me opiods which put me back to normal. Nex thing I know he wants me to sign a pain contract that was more punitive than criminal probation. I told him no. Now I avoid both the specialist and the generalist. I rather die in pain than put up with either their cortizone or contracts. The reason people mistrust doctors is the behavor of doctors. I will never trust an American doctor again.

  8. ginbug at 10:40 pm

    Beth, My info on pain contracts comes from my doc & his lawyer who are both politically active in advocating for pain patients & doctor’s rights. I have an AA degree in psychology & working toward my BA in addiction & chronic pain patient care.
    The problem w/ these contracts, is the interpretation of them. There are too many ways that a patient can innocently violate them. I have no problem w/ following the law & being a responsible patient; but for the majority of fl pain patients, it is nearly impossible to NOT violate them, like only going to 1 pharm. for all meds. Here in fl. there are very few patients that can do that, as we have to go all over just to find a pharm. that has our meds in stock & find one willing to fill them if they do. I would LOVE to be able to go to just 1 as I am not able to run around searching, because they will not tell you anything over the phone!
    Just as dr. shank said above, you can & will be labeled as dr shopping even if you are not getting pain meds from them or if you were referred to a new doc to get your pain meds. & no longer getting them from the old doc! There are many docs that use the contract as a way to threaten their patients into doing useless & even dangerous procedures like epidurals, that have hurt way more than in helps as only about 20% of pain patients get relief! Also about 60% of pain patients are made much worse after an epidural & will suffer for the rest of our lives!
    You also completely missed the point I was making about other meds. I was simply using them to make a point about how wrong it is that chronic pain patients are seen & treated completely different than other chronic illness patients & about how different it would be if those meds & patients had to go through what we do!
    BTW, high bp, & depression are part of many pain management plans as most pain patients have 1 or both that are treated by their pain doc. Chronic pain can raise your bp & even cause high spikes that can & do cause strokes (I have had 6 mini strokes in only 3 years w/ spikes going as high as 235/119! I was put on bp meds by my pain doc & during bad pain flares will be given more, in an effort to control the spikes) Most pain conditions cause depression & most pain docs treat that also! Many people that are diabetics will also suffer from chronic pain & there are pain docs that will treat that also, especially if it is type 2. You are right about one thing, NO doc would hold bp meds or insulin “hostage” (at least not right now anyway) & No pharmacy would turn them away w/o their meds; but why should it be any different with chronic pain patients? Don’t we deserve the same help & compassion as any other chronic patient? Yet, we are NOT as we are ALL assumed & treated like criminals & addicts, even when we are legitimate, verified, & completely compliant!
    So, the next time you want to tell someone that they are wrong & uneducated, you may want to get YOUR facts straight & not just base your info on your opinion & experience w/ your doc.

  9. Johnna Stahl at 9:19 pm

    Cyndiann: Those who need pain relief will also find a way.

    And while some pain patients look down on those who suffer from addictions — like to heroin — I cannot help but empathize. I have no doubt that mental pain can sometimes be worse than physical pain, and the two often go hand-in-hand.

    I know what it feels like to be without pain relief and I would not want that for anyone, addict or not.

  10. cyndiann at 6:43 pm

    “If doctor shopping was so easy, then why have so many pain patients switched to illegal drugs? It seems to me that the “patients” who are “doctor shopping” are really not pain patients at all… and yet pain patients are penalized anyway.”

    Exactly! Especially in my area where pill mills were allowed then shut down there are very few on the streets anymore and because of that heroin use has gone way up. Those who want to get high will find a way.

  11. Johnna Stahl at 2:03 am

    Dr. Shank said: “This includes a board member who is a ‘pain specialist.’ He, of all people, should model a higher standard. Then again, his own credibility is severely compromised by pain practices that are medically, ethically, and legally ‘highly suspect,’ to say the very least, but he is protected by his position.”

    Over the last 25 years, I have seen the “progression” of the pain management industry, and I find “severely compromised” as an accurate description. Besides being in bed with Big Pharma, the overuse of invasive, short-term treatments has resulted in patients suffering more pain (and damage) in the long-term. (See steroid injections.)

    At first, these treatments kept pain patients returning to their doctors, as they didn’t offer much relief. But not many pain patients can afford this unsustainable type of treatment for very long.

    As I look at both the good and bad from the pain management industry, at this point, I’d have to say that the bad far outweighs the good. And at some point in time, consumers (customers) of products being sold by this industry learn to not only distrust them, but also to actively withdraw from the market.

    I describe this issue in terms of economics so that the pain management industry can understand the bottom line — I mean, it’s not like it’s a doctor’s job to put the patient’s interests first, right? But if the pain management industry doesn’t begin to see the writing on the wall, well, I guess the market (and word-of-mouth) will take care of it.

  12. Johnna Stahl at 1:38 am

    RE: Doctor shopping

    I have a hard time believing that there is an epidemic of pain patients going to more than one doctor for medication. I mean, I’m sure it happens, but not too many pain patients can afford to “doctor shop.”

    You would need to have a lot of disposable income to purchase medications this way, as insurance companies won’t pay for it. And since stores like Walgreens and CVS are all electronically connected, you would only be able to go to the smaller pharmacies. (Not too many of them around anymore.)

    If doctor shopping was so easy, then why have so many pain patients switched to illegal drugs? It seems to me that the “patients” who are “doctor shopping” are really not pain patients at all… and yet pain patients are penalized anyway.

  13. BL at 7:27 pm

    Doctor Shopping is when you go to more than one dr to obtain a controlled substance and don’t tell all of your drs about the other ones you see. If you go to several drs & don’t obtain rxs for controlled substances it is not Doctor Shopping.

  14. Myron Shank, M.D., Ph.D. at 4:01 pm

    Johnna Stahl

    Yes, I believe that everyone, including pain patients, should “doctor shop,” in the common sense meaning that you give the expression. In reality, anyone with pain who does that, for any reason, is almost universally and automatically said to “doctor shop,” in the slang sense of deceitfully obtaining controlled substances by concealing the fact that he is seeing more than one physician at a time for pain.

    Unfortunately, the terminology is being used with both, entirely different, meanings at the one time. By analogy, consider the word “blood,” which can have (among others) the meaning of “kin” or “a vertebrate red bodily fluid.” Now, imagine that every relative of yours was labeled “blood,” and, thus, a biohazardous menace to society. Of course, that would be an absolute absurdity. So are the actual uses of the slang terms, “doctor shopping” and “doctor shopper.” I have never once heard these terms used in any other way by anyone with actual medical experience.

    Contrary to an anonymous poster, these slang terms are applied whenever pain patients openly transfer care with all of their medical records. These slang terms are also applied whenever pain patients’ physicians request consults (recommendations) from other physicians, whenever their physicians refer them (transfer care, in whole or in part) to other physicians, and whenever a group’s scheduling practices results in pain patients being seen by more than one physician within the same practice and sharing the same medical records. These slang terms are even applied to pain patients who neither receive nor request controlled substances.

    I have seen medical personnel label pain patients as “doctor shoppers,” in the accusatory slang sense, for each of these scenarios, as well as for each of the scenarios in my earlier response to cyndiann. I have heard a medical witness testify, under oath, that these scenarios were “doctor shopping,” and, because they were “doctor shopping,” they were illegitimate. I have heard multiple medical regulators apply the slang terms to these scenarios, then, ignoring the documentation, fallaciously use their own slang as proof of the same conclusions. (This includes a board member who is a “pain specialist.” He, of all people, should model a higher standard. Then again, his own credibility is severely compromised by pain practices that are medically, ethically, and legally “highly suspect,” to say the very least, but he is protected by his position.).

    This use of these slang terms conceals double meanings and a logical fallacy. Since this is the norm in the medical professions, rather than an occasional aberration, egregious treatment of pain patients is not only tolerated, but demanded from others. The one saying otherwise conceals her identity, but not her ignorance.

    Rather than being permitted to hide logical fallacies behind slang terminology, anyone who applies “doctor shopper” or “doctor shopping” to any pain patient should be immediately challenged, corrected, and, if he cannot explicitly specify the grounds and evidence for characterizing the behavior as illegitimate, reprimanded.

  15. cyndiann at 3:05 pm

    Myron Shank, M.D., Ph.D. I have found out that it is Medicaid here in Florida that has caused this situation. I called Medicaid and they said I had to complain to my insurance which I did. Each time I called I got a different response. They are totally incompetent. However it seems it’s not the doctor’s fault. They overhauled the Medicaid program starting June 1 and did not provide a code for the doctors to use to bill the insurance companies. So it is legal for Medicaid to pay for the tests but there is no way for the doctors to bill the companies with no code. I had to pay for 2 tests last week but did get a receipt and will be contacting Medicaid for my money back since it is there mistake that caused this. The doctor was nice enough to give me three months of prescriptions so I don’t have to go back until December now and hopefully by then this mistake will have been corrected. That money could have bought me quite a lot of food on my very limited budget.

  16. BL at 2:06 pm

    cyndiann, it is illegal for a Medicaid dr to bill Medicaid & the Medicaid Recipient for services. But, if a service is not covered by Medicaid, it is not illegal for the dr to bill the Medicaid Recipient. Some states don’t pay for the these drug test, some do. You need to check with your state Medicaid office. Don’t call a toll free number, call the main Medicaid office that is located in your states capital. If you have a Medicaid Health Plan you also need to contact them. The Medicaid Health Plans must cover Mandatory Medicaid Benefits, just as every state must. But, they don’t have to cover optional ones.

    Be Thankful your state Medicaid covers Pain Management for Chronic Non Cancer Pain, Louisiana Medicaid does not.

  17. Johnna Stahl at 9:47 am

    As consumers of American health care, aren’t we supposed to “doctor shop”? (Everyone but pain patients, of course.)

  18. Myron Shank, M.D., Ph.D. at 2:09 pm

    cyndiann

    I would be very surprised if Medicaid were uninterested in a physician (who accepted Medicaid) billing Medicaid patients. I am not qualified to give legal advice, but I believe his actions would be Medicaid fraud (and probably a felony). I wonder if you reported it to the right bureaucracy.

    The Center for Medicare and Medicaid Services (CMS) says that your first step should be the Program Integrity contact in your State Medicaid Agency (listed at http://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforConsumers/Downloads/smafraudcontacts-august2014.pdf). It also suggests checking the CMS State Contacts Database, which it says requires entering your state, contact type, and the organization type (http://www.cms.gov/apps/contacts/ I have no idea what that means, either.). Finally, CMS recommends the Office of Inspector General’s National Fraud Hotline 1-800-HHS-TIPS (1-800-447-8477), or its website (https://oig.hhs.gov/fraud/report-fraud/index.asp).

    I would also contact your state’s office of the attorney general, directly.

    Contact your state’s medical board. Even if the physician’s actions is within the law (which I doubt), the board could find that his actions constitute “personal enrichment,” which violates medical ethics, and, thus, is less than the minimally acceptable standard of care–especially since there is a coercive element to his actions. I do not know what proof that you can provide, but the standard of “proof” (if it can even be called that) is much laxer than for a criminal investigation. I would be shocked if your state’s board were not extremely interested in your complaint.

    Of course, if your physician finds out that you are filing complaints against him, you will probably find yourself blacklisted in your community. If you attempt to see a physician outside of your community, regardless of the reason, you will be labelled as a “doctor shopper” and blacklisted. If, while your current physician is still in practice, you try to switch physicians, even within your community, you will probably be blacklisted as a “doctor shopper.” (Note: I know full well what the “definition” of this medical SLANG is “supposed” to be. I also know that slang is defined by the person using it. Just as pain patients regularly testify on these sites, the way that this slang terminology is actually used is very different from the “definition” anonymously alleged on these sites.) Worse, if you wait until your physician is disciplined or prosecuted, you will be considered “guilty” by association, because you “must” have been a “party” to his actions! (Is there any chance that you can just move to another community?) The fact that none of this is either fair or rational does not keep it from being reality.

    Good luck to you, and keep us posted.

  19. Johnna Stahl at 3:57 am

    Arianne:

    “I contacted the ACLU and they refused to help. They told me that drug testing is a federal recommendation to combat the drug epidemic in our country and that these practices are now the national standard of care for treating pain patients.”

    Not only is it sad that even the ACLU has given up, but it is frightening that these practices are now our “national standard of care for treating pain patients.” A medical “standard” created by the DEA and the NIDA.

    If you are a pain patient, you must always be closely monitored and tested for signs of addiction — a condition that only affects a small percentage of chronic pain patients. You are being treated for a condition you do not have, and that about 90% of the population doesn’t suffer from — an added stigma and medical expense only forced on pain patients.

    But now, no matter what kind of medical condition you suffer from, if you need pain medication, you will also be treated in the same manner as chronic pain patients.

    Maybe if patients understood how often drug tests are inaccurate, and how you can lose all access to regular health care if you test positive, there would be more outrage.

    Just as an example of how pain patients are discriminated against, for New Mexico’s Medical Cannabis Program, patients suffering from “severe chronic pain” must pay over $300 every year for at least two doctors to re-certify — all other conditions only need one.

    “…it is the job of law enforcement to deal with criminal activity, not our doctors.”

    The drug war has allowed the DEA to influence and interfere in the doctor/patient relationship, and right now, the DEA appears to be the most powerful player. There are many current efforts to change that, but since President Obama appears unwilling, I guess it will be up to the next president. (How scary is that?)

    “Maybe we should sign away our rights and have every car on the road equipped with a breathalyzer in order to be able to start our car.”

    This is a great comparison, but what is concerning is that there are plenty of people who think this would actually be a good idea. (Another scary thought.)

  20. Arianne Grand-Gassaway at 11:29 am

    I have read all the responses to my ‘My Story’ article thus far. Frankly, it doesn’t surprise me at all that many actually portray me as doing something wrong somehow in their responses or view these policies as somehow best for all involved. It just exemplifies how pervasive the stigma of using opiates has become.

    While there are some that do seem to understand the ramifications of the new policies and procedures being enacted, both in regard to the impact on individuals as well as in regard to the violation of constitutional rights, there are many more who just don’t seem to get it.

    While I realize that there are criminals that abuse drugs in our country, it is the job of law enforcement to deal with criminal activity, not our doctors. If a doctor feels a patient is abusing or diverting their medications, then it is time for intervention and action at that point but not before. To begin targeting people ‘just in case’, and to force them to sign away their rights because there are other people in the world engaged in criminal activity, is discriminatory behavior. Our constitution is supposed to protect us from this kind of discrimination and from unlawful an unjust actions by powerful entities.

    I am disheartened to see that not more people are expressing outrage at what the medical community and the government are doing to law abiding citizens. The implications go far beyond just drug testing chronic pain patients.

    Perhaps when the government starts making anyone considered obese sign away their right to privacy, and begins limiting the types of food they can buy at the grocery store or at restaurants by monitoring their ATM cards, some will balk. After all, according to some studies there are an estimated 300,000 deaths per year due to the obesity epidemic in our country.

    Or hey, 31% of total traffic deaths are currently attributed to alcohol. Maybe we should sign away our rights and have every car on the road equipped with a breathalyzer in order to be able to start our car. And while we’re at it, you will need to consent and sign away your rights at the time you get your driver’s license so that law enforcement can pull you over randomly, even if you are doing nothing wrong, and perform random blood alcohol testing and other tests just in case you might be driving under the influence. It might just save lives and net those who are abusing alcohol.

    Or maybe, if you could have a genetic factor that predisposes you and your offspring to develop cancer, you will be required to have your fetus tested and then not be able to carry that child to term or not have children of your own at all. After all, cancer kills approximately 564,800 people per year in our country. It has become an epidemic and causes needless suffering when we can just prevent those who might develop cancer from ever being born.

    Do you start to see where things might be headed? All because we began to allow the government to start running the show. Because after all, these policies are ultimately in our best interest as individuals and as a society? Right? The scary thing is, that there will be those who think that even that would be a good idea.
    What a circus.

  21. Beth powers at 7:31 am

    If you are following you pain plan and still having that much pain on a everyday basis, clearly you should see your doctor and make some changes in your med.s. That tells me that your plan isn’t working for you. You may need to try a different pain med and or up your dosage. The goalis to be able to live not totally pain free but live a better uality of life. But remember, you have make adjustments in your life too. You can’t medicate yourself so you can have the life you had before RSD. It’s a give and take. But life is what you make it.

  22. BL at 6:58 pm

    Johnna Stahl, being prescribed opioids comes with a great deal of responsibility. The contracts make it plain what those responsibilities are. There are some drs, usually PCP’s who don’t require contracts. If someone does’t want to sign the contract, they can try and find a PCP to manage their chronic severe pain.

  23. Johnna Stahl at 3:28 pm

    Beth: I’m not saying medical cannabis can’t be added to a pain contract, but I’ve never heard of one where that was the case. Since cannabis is illegal on a federal level, and doctors have to comply with federal regulations regarding prescribing drugs, most will not risk their license.

    I guess adding cannabis to pain contracts when (not if) it becomes legal is something the pain management industry is probably looking into (or should be, anyway) for the future.

    And while millions of pain patients wait for cannabis to be rescheduled or legalized so they can have access, the suffering and tragedies continue — patients being harmed by the long-term side effects of Big Pharma products (including abuse and addiction); people in pain forced to seek dangerous, illegal, and less expensive treatments; families of pain patients being torn apart; and suicides.

    That’s what you call American health care.

  24. Johnna Stahl at 3:07 pm

    BL: First of all, how can patients choose cannabis when it is rarely given as an option? Sure, there are that small percentage of doctors who are knowledgeable on the subject, but they are few and far between — even in states with medical cannabis programs.

    Pain patients who choose cannabis may be using it to supplement opioids, not replace them. Or they might be trying to transition from opioids to cannabis. And contracts are all about the potential of patients abusing their prescription medications, or taking “illegal” drugs — both of which are cause for termination of the contract and the relationship with your pain doctor (which are in short supply).

    And when a pain patient signs one of these contracts, it is done while in pain and under duress — if you don’t sign, you don’t get treatment. (Oh, you want my first born? Sure, just give me some relief, please.)

  25. Beth powers at 8:00 am

    If cannabis become legal and you and your doctor agree that this should be part of your pain management plan the it will be added if it is in the same “class” as the other narc. Meds. Just because you are on a contract does not mean you stop looking for other studies or treatment. You should always keep a open mind!!! We need to stop having these what if ideas and deal with the here and now and what is real. If someone feels that hey would rather die then be in pain etc. then the plan they are on isn’t working and they need to revisit it. Or they maybe dealing with some severe depression and need to have that checked out.

  26. BL at 6:20 pm

    Johnna Stahl, if someone finds that the better and healthier treatment choice for them is marijuana, they don’t need a pain contract because they have no need for the pain meds since marijuana is the better and healthier treatment choice for them. Nothing is preventing them from choosing the better and healthier treatment choice.

    Drs do not promise that they will prescribe specific meds, in specific amounts if the conditions of a pain contract are meet. The wording is general. The patient assumes the dr is agreeing to prescribe their specific meds in a certain dosage.A very small percentage of patients that sign these pain contracts take the time to actually read them completely before signing them. Nor do they get a copy of the pain contract to take home with them.

  27. Johnna Stahl at 12:41 am

    I didn’t have a problem with signing a pain contract, but it made me feel like a drug addict and criminal, just the same — before I had even started treatment.

    And the problem with contracts is that chronic pain patients then cannot access cannabis, even in states that have programs. So, for many, the better and healthier treatment choice is unavailable because of contracts.

    In fact, these contracts force pain patients away from the medical industry, as they are all about Big Pharma treatments — not what’s best for the patient.

    Sure, it’s great to follow the law and everything, but when you are in constant pain, laws don’t mean as much. Think about it: Many chronic pain patients would rather die than live without adequate relief — that’s what you call the height of desperation. Daily, minute-by-minute, desperation.

  28. Rainey at 12:33 am

    I personally think these pain contracts are kind of pointless. I guess the leverage comes from the threat of suddenly being discontinued from your pain medicine. If you already are being treated, and are dependent on opiate medication, you cant really say no. Since there is no alternative, the contract probably is not enforceable. So why?

    But what if it was enforceable in a court of law? What would happen if your doctor did not hold up his or her end of the contract? If he or she did not count pills, test urine, or make you commit to one pharmacy. I guess you could sue, if you suffered harm (became addicted).

    You may even be able to get away with a lot thanks to this careless doctor. Shame on him. Addicts behave in some pretty crappy ways. Your doctor breached the contract, so you became addicted and found more doctors to write you prescriptions. Not your problem. The doctor let you down. Stealing money from your loved ones? Blame it on the doctor who refused to follow the pain contract to the letter. You are the injured party. That crime spree? Breach of contract. Your defense won’t hold up in criminal court, but civil court? That’s a whole different matter.

    I wonder about pain contracts. If they are not interpreted strictly, then do the doctors open themselves up to liability? These agreements require time to enforce and physician time is valuable. What doctor would want a pain contract in his or her life? Maybe Ms. Gassaway was dropped by her physician because the whole thing was too much of a hassle.

  29. BL at 10:56 am

    If you smoke a joint and it is not legal on your state, that is a crime. We don’t get to pick and choose the laws we like to abide by. Pain meds are Controlled Dangerous Substances, as is Marijuana. The difference is that with a prescription written by your dr, you have the pain meds legally, by federal law. With marijuana, even if you have a card, under federal law, it is not legal. If someone breaks the law for marijuana, they may well break it regarding prescription meds. Drs have to be able to trust their patients to be responsible with the meds they give us.

  30. Beth powers at 10:08 am

    Ginbug, I have no idea where you get your info but you are wrong!!! This contract is only concerning your pain medications meaning no dr. Shopping no pharmacy hopping. No abusing meds. Which a responsible pt. doesn’t have to worry about. You are still in total control of your care. You choose what path you want to go with treatment. First of all BP meds and insulin isn’t part of a pain management plan. Totally different issues and not at all related to the signed contract!! Another thing is if a doctor made any type of decision like you are describing, like with insulin should be fired because NO. Dr. Would ever make a decision as that with a diabetic pt. these contracts do protect us!! It is documentation showing that we are responsible pt. and do not abuse our meds. This is showing that there is people who are really dealing with pain issues and are just trying to live the best quality of life we can. It is showing that doctors are being pro active in their pain pts care and are not just prescribing meds for no real reason. You need to educate yourself on signing contracts before you give out false information. We want this documentation because abusers don’t follow rules and they are not responsible. The people who live with pain diseases have nothing to hide!!!! Bring it on!!! I hope this helps let others know that contracts are for both you and the doctors and you are always in control of your health and if you aren’t then you need to look at yourself and ask why.

  31. trudy myers at 10:52 pm

    well tell me what illness other than pain that a DR has the patients private world at their beck and call. If I choose to smoke a joint or have an alcoholic drink that should be my private business- and I think its wrong to treat us like a criminals. I only want to be treated like any other illness

  32. BL at 7:41 pm

    The lady I’ve been helping that has severe chronic pain that is untreated said she has no problems signing a pain contract. She has done it before with no problems.

    No dr is obligated to prescribe a particular med. Even if the ACLU is succesful with their suit in Indiana, drs will still have the option of having patients sign contracts and do drug tests. Those who object to this can find a dr who doesn’t do, if they can. Life is full of rules and having to do things we don’t llike that aren’t fair. Each chronic pain patient has the right to decide how they want to live their life. And if they want to receive pain meds, they will have to do things they may not like. You don’t hear diabetics complaining about all the tests they have to do through to receive proper treatment. Like it or not, a dr knowing if you’re taking your meds as prescribed and no other meds or illegal substances is what you have to go through to be sure you receive proper treatment for chronic pain. Chronic pain patients are not privlidged.

  33. trudy myers at 6:16 pm

    I also have to test every month-and have to pay for the test even tho Im only on disability, and he wont even give me enough med to make me comfortable. I cant change doctors because I live in a rural area and they all know each other and if you get labeled a doctor hopper you wont ever get a doctor to even take you

  34. trudy myers at 6:03 pm

    I am in exactly the same boat-but I have neck and low back disc issues and I have fibromyagia (a severe case of it) I have bad peripheral nerve damage in my legs. I think we need to find a lawyer that would do a class action suit against the DEA. We are having our rights trampled and we are being treated like felony drug abusers. Its hurtful and wrong. A class action would be the voice of many

  35. ginbug at 5:40 pm

    Hate to break it to you; but many cancer patients are already having it just as hard as anyone else in getting their meds!! My dad died 3 years ago from bone cancer & all his doc would give him was oxycontin 10mg x2 per day w/ percs 5mg. for break through x3 a day! My dad would cry 24/7 & when I talked to his doc about either raising the amount or put him on methadone. This so called doc. told me that he was already on a huge dose & that methadone was way too addictive!! He was end stage bone cancer that had also spread to his brain & this cold hearted monster was worried about addiction?! The only thing he would agree to, was a morphine drip, which if anyone has ever had a loved one dying of cancer that was put on the drip, then you will know exactly why I did not want that yet! We wanted to spend as much time as possible w/ him alert & pain managed! Oxy & methadone would have allowed it; but once the drip started, he hardly woke up & when he did, he was so altered not even knowing who we were!! He died a month later. So whether it is the aclu or someone else, we CANNOT ALLOW this to continue!! Ill pets are treated w/ more dignity, compassion, empathy,& more humanely than people anymore!! It seems the only rights people care about anymore & is enforced, is the right to bare arms!! No one is batting an eye over the fact that the pain patient is having our rights taken away as everyday we are having our 4th & 9th amendments violated!!!

  36. ginbug at 5:03 pm

    Beth, You need to understand that while you have a good doc that cares about you, many of us DO NOT. I really don’t have a problem w/ drug tests; but it is a violation of our rights. However, there are much bigger violations that need to be dealt w/. That pain contract you think is for your protection, is ONLY for the protection of your doc & by signing it, you are giving up your rights to decide what you may or may not want to do as it gives your doc full control over your decisions to treatments! The only power/ protection it gives you, is to quit your meds or find another doc if you do not want to let him do what he wants!
    What other medical conditions require this or allows your doc to hold your meds hostage if you don’t submit to his treatments? What if docs could hold back your blood pressure meds, if you don’t lose 10lbs.? What if docs could hold back your insulin because you don’t want to have a surgery that you know either will not work or make you much worse?
    What makes pain management any different than any other chronic condition management? Bp meds do not cure high blood pressure, insulin does not cure diabetes, anti depression meds do not cure depression! To manage these conditions, the patient will most likely have to take them for the rest of their lives!
    I believe that there should be regulations/rules for opioids & docs have to be careful when prescribing them & that they should be a last resort for docs & patients to choose; but the abuse, humiliation, judgment, & over all mistrust HAS TO STOP!! It is MY BODY & I am the ONLY one that knows what it feels like to be ME!!! MY BODY MY CHOICE!!!!!

  37. Mrs Sandra L Weidner at 3:08 pm

    Forgot to add, that getting the ACLU involved will take us back to the dark ages where even cancer patients won’t be able to get the appropriate pain relief to fight their battle. Post surgical patients once released from outpatient surgery or hospital won’t go home with needed pain meds.

  38. Mrs Sandra L Weidner at 3:05 pm

    The way I look at it, if you have nothing to hide, then why object to signing a contract that you won’t go to any other Dr and request pain medication and take what is prescribed as ordered and won’t take any illicit drugs? By doing this it protects you and your Dr. Counting the medication can also help you keep track and make sure no one in your house is taking your meds without your knowledge. There are way too many that Dr hop for pain meds, thus making it harder and harder for the legit pain patients to get the treatment that they need. It is attitudes like that, that make it almost impossible for people who live in TN to get appropriate pain management. By refusing to take the test, red flags were raised and you can bet your bottom Dollar that every pharmacy and Dr in your area will be made aware of your refusal. If you have nothing to hide, then take the test.

  39. Beth powers at 9:06 am

    I have RSD. I am on a pain med contract. I wouldn’t have it any other way. I protect my doctor and myself. I have nothing to worry about because I never abuse my meds. When I had landed in the hospital for a totally non related issue that was causing me a new type of pain. Endometriosis. I had a lady come in and wanted to take me off all my pain meds. Because she didn’t understand RSD. Without even consulting my doctor first. I was lucky because a OBGYN dr. Looked into my pain, old and new and found that I needed a hysterectomy. Plus that I have NO HISTORY of abusing my meds ever!!! After the surgery my new pain went away completely. My pain doctor was told about what the nurse/whatever wanted to do and take me off all my meds and was SO ANGRY. He said if this ever should happen again to let them know you are under contract and they can not change any of my medication I am on under contract with unless my pain doctor okays it EVER!!! This protects me. Plus when the nosey govt. asks about me and my meds he has proof that I am response able and so is he. So sometimes we need to look at the big picture before we yell “in fair”. Any way I hope this helps others when it comes to being asked to sign a contract for pain meds.

  40. cyndiann at 6:50 am

    Oh, and not only that but primary doctors don’t even prescribe pain meds where I am. My only choice is a pain clinic and you are verbally abused on a regular basis there because they know you have no choice.

    It may not be right but you had it easy. I wish I had had your options. I would have taken a yearly test in a heartbeat.

  41. cyndiann at 6:46 am

    You are upset over one test in a year’s time? I am forced to test every single month and the doctor is forcing to pay cash for the test and won’t bill my insurance even though my insurance pays for this test. I don’t have the money to spare so what am I supposed to do? I cannot go without my medication and it’s cutting into my food money to pay him. I am on Medicaid and it’s against their rules to charge patients but nobody will listen. I called my insurance and Medicaid and neither is helping me resolve this so evidently doctors can do whatever they feel like doing.