Ambush Drug Test at my Psych Appointment- Wait, What?

I’m still shaking off my first experience with Medication Monitoring. This took place a few days ago, and I was completely bombarded, with no explanation, no warning, no consideration for my personal space.

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My pdoc appointment went quite smoothly. I talked about my grandfather’s funeral, about the baby, about being a temporary stay at home mom. We went through the checklist about side effects, mood fluctuations, and if I have any thoughts of harming myself (I don’t). Pdoc agreed we should keep my medications the same as they’d been, and he wrote up the new scripts. I gathered my wallet and keys, and started for the office door. Just before I hit the front desk, he informs me that everyone is taking a urinalysis for medication monitoring. I was a little confused. He laughed and said it’s to make sure people are taking their meds, and not selling their Adderall. Well since I take my meds and I don’t sell anything, I just agreed that it wasn’t a problem. I was also under the assumption that he would write me a prescription to take to a lab for the test proceedings. Those of you on Lithium know about this all too well. Was that what happened? Nope.

Surprise! As I walked through the second set of doors into the lobby, a woman I’d not seen before was standing there waiting for me with a little piss cup in her hand. She gestured toward the waiting room bathroom. I felt ambushed. No opportunity for questions, no discussion. I’d been at this psychiatric facility for almost ten years and never felt so put off. Honestly, I felt as if I were in trouble.

After I provided my little sample, she had me sign a form, supposedly for them to bill my insurance. This is also when I was given an informational card entitled, “Medication Monitoring Explained”.
Some key points given include:

  • Helps to understand what medications you are currently taking which could interfere with your prescribed medications.
  • Provides essential information for the safe and effective use of your medications.
  • Your doctor will determine how often you will be tested based on your medical needs.

The kicker in my situation is that in all definitions of the term, I failed my drug test. Yes, I had other substances in my system. I had been treating two pinched nerves in my back with a narcotic pain reliever for about three days, and I occasionally self-medicate with marijuana. During my grandfather’s death and funeral days, I smoked pot in the evenings. (For those of you just tuning in, I’ve always been a cannabis advocate.) The biggest clincher here is that I would have absolutely disclosed this information to my doctor had I any idea it would be relevant. (*Note: I do not promote the notion of self-diagnosing or self-medicating. In my instance, I have had much experience with these substances and I know how my body reacts, on prescribed meds and off.)

All in all, I understand and agree with new advances in patient treatment. If urinalysis is a tool in helping doctors help patients, then I support it. I really think, in my case anyway, that there needs to be a much different procedure in collecting the samples. I already feel vulnerable, as it is when working on my mental health, so in some ways I felt my trust had been violated.

Have any of you had experiences with medication monitoring? I’d like to hear your stories.

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