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Why Do I Have To Do A Drug Test?

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We hear this question a lot. Anyone who is prescribed opioid (“narcotic”) pain medications, and certain non-opioid pain medications, has to provide a urine or saliva sample for drug testing at random intervals, sometimes with every visit, sometimes less often. Why is this done?

The urine sample is sent to a lab certified for urine drug testing, and tested to determine levels of several different drugs. It provides objective evidence and documentation that you are taking what you are prescribed, and not taking what you are not prescribed. It’s a tool that prescribers use to keep you safe, other patients safe, and themselves safe. It’s similar to having your blood pressure checked if you are on blood pressure medications, or your blood sugars measured if you are on diabetes medications. We would be neglectful if we did not do drug testing!

Abuse or misuse of drugs can be accidental or intentional – unfortunately, it can also be fatal. Taking drugs that are not prescribed for you can also be fatal, depending on the drugs involved. If potentially fatal drugs are prescribed, we need to do what we can to minimize the risk, and there is no way of telling by looking at a person what the risk for that person is. I’ve had patients who were cookie-baking grandmother types, or successful business owners, who were also using cocaine or heroin, or were addicted to prescription opioids. I’ve had patients who were scruffy, homeless, with tattoos and tongue-piercings, who never had a problem at all. Because the potential consequences of medication abuse or misuse are so serious, i.e. death, we are obligated to test for it in any patient who is prescribed this type of medication.

Urine drug testing is not the whole answer, but it is an important part. It is sometimes possible to “game” the system, and avoid being detected, for a while – although who are you really helping with that strategy? If you have trouble managing your medications or your pain, or you are using illegal or non-prescribed drugs, talk to your provider and get help! You don’t have to go it alone.


At North Shore Pain Management we provide advanced, evidence based, multidisciplinary and cost effective pain management. Our goal is to improve your ability to return to the activities you have been missing as well as provide a meaningful reduction in pain.

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