Trying to figure out new Mass prescrip drug law. Urine test?
May 9, 2016 2:32 PM   Subscribe

While out with a friend today she told me about an experience at her regular doctor's office. While picking up her monthly adderall prescription he said there was a new law and she needed to have a urine test. Am I going to have to take a urine test for mine?

I take low dose generic adderall and have for about a year so this has me even MORE curious than I would have been.

She said she had to pick up her scrip and then he said the new law means she had to take the urine test. She had marijuana in her system and she got put on some list for some type of "seeker" and had to sign a contract with her doctor that stated she'd only go to him for prescriptions.

She doesn't use pain killers but the doctor stated people sell adderall to fund their opiate addiction and that's why she needed to be tested. She was pretty shaken up about it and thought about seeing a lawyer. What if she actually has some injury that needs some serious pain meds?

I take or use any drugs (other than the adderall) but it feels like a violation to have to get urine tested for my 10 milligrams of amphetamines.

I tried to google info about the new law but am coming up with nothing.

What can I expect when I go to the doctors for my next prescription? Is what happened to her really ok?
posted by ReluctantViking to Law & Government (15 answers total)
My friend went to the doctor's the other day for tweaking their back and said up-front that they didn't want pain medicine as treatment. First order of business was still a pee test. It seems like it's getting more common.
posted by Marinara at 2:54 PM on May 9, 2016

This happened to me about two years ago in a different state; it's why I decided to write a letter to my local representatives and go off of stimulants. I was on 15 mg of Adderall per day; the practice I was at was enforcing this policy for anyone taking any dose of anything on schedule II.

They wanted me to sign a form saying it was OK and that I didn't mind having to pay for the tests myself because insurance won't cover it. So, I never actually took the test because to heck with that crap.

The letter I wrote was incredibly snippy, BTW.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 2:55 PM on May 9, 2016

There is no such mandatory testing for people prescribed stimulants under the new law. Your friend needs to find a new doctor. Not because testing is inherently and under all circumstances a bad idea, but because he should be up-front with her that he wants it as a compliance measure, not lie to her about its being the law. Basically, your doctor shouldn't be lying to you, period.
posted by praemunire at 2:58 PM on May 9, 2016 [14 favorites]

I'm not familiar with the specifics of the MA law, but I can address this question:

What can I expect when I go to the doctors for my next prescription?

Call your doctor's office and ask. Without a doubt it's the best way to find out. You won't be put on some kind of list just for asking.
posted by telegraph at 2:59 PM on May 9, 2016 [1 favorite]

Unlikely there is any law. Likely it i a clinic policy for routine UA's on persons on controlled / scheduled drugs. Every doctor will manage this differently. For me, I need to see that someone on a routine regularly filled rx has it in their system, and if not , are they diverting it. The issue of cannabis is a huge grey area and falls, not surprisingly, into territory very dependent on the actual doc writing the Rx. Some docs will toe the line either out of fear of reprisal from their State Board or medical director, and others will not give a shit. The obvious hypocrisy is obvious (i.e we can't drug test alcoholics who drink a fifth a night but smoke a bowl a week before your piss-test and you get nailed), and if you want to make a stink about it you can but don't expect any sympathy. Doctors are overwhelmed and these policies are being instituted across the board, whether you are 90 years old and taking a Norco at bedtime for crippling arthritis, or on a steady dose of adderall, or a new patient just in from West Virginia expecting 6 a day Oxycontin at your first visit for "gout". It's a mess. I would suggest speaking candidly in person at an appt. with your doc and sorting this out in person, and be up front. If they aren't candid as well then look for a new doctor.
posted by docpops at 3:32 PM on May 9, 2016 [2 favorites]

An acquaintance recently got screened for ADD and was required to take a drug test, as well. The doctor said that they want to make sure he wasn't self-medicating for it - he said many people use meth for this reason. Sheesh!

No clue about the legality but this seems like it's becoming policy.
posted by destructive cactus at 3:52 PM on May 9, 2016

My PCP's nurse said a piss test for pain med users at least quarterly is now a policy for Veterans Affairs Hospitals in the Southern Heartland Region.
posted by ridgerunner at 5:10 PM on May 9, 2016

I just (last week) got a Adderall script from my Massachusetts dr and I did not have to take a pee test. I had to bring my ID card to pick it up, though.
posted by Biblio at 5:50 PM on May 9, 2016

Before anyone fires anyone, it's worth contemplating whether the doctor in question said that new laws said such-and-such or new regulations require such-and-such; patients can sometimes hear things the doctor didn't actually say.

Healthcare providers can decide that they're uncomfortable prescribing abusable medications for all sorts of reasons, and can institute all sorts of protocols to address those concerns.
posted by lazuli at 6:17 PM on May 9, 2016 [1 favorite]

Regarding praemunire's point, it's entirely possible that the person administering the test had no idea whether the new policy was due to a new law or not, and just assumed it. I've found that in general the nurses and PAs in my doctor's offices blame "the law" for basically every clinic policy change, even when it makes no sense. I mean, HIPAA gets blamed for all sorts of goofy stuff. I don't think this is "find a new doctor" territory in and of itself. I don't expect medical professionals to be legal experts. It's a little more egregious coming from a doctor... but honestly I think a lot of the time medical practices just get updated advice from their lawyers and say "sounds good" and that's about as far as they go to understand relevant laws.
posted by town of cats at 6:19 PM on May 9, 2016 [1 favorite]

Yeah, I meant to expand: "New regulations" may be coming from the insurance company, from the medical group that owns the practice, from the agency that owns the practice, etc. There are plenty of reasonable places where regulations and dictates might pop up that are not state law.
posted by lazuli at 6:22 PM on May 9, 2016 [2 favorites]

I don't know about it being "law" anywhere, but my doctor's office (who gives me stimulants) has a policy that patients take a urine drug screen every six months. I smoke weed (in a state that it's not legal PERIOD) but my doc knows and never says anything when I test positive for THC, in addition to the stimulant she is giving me, every time.
posted by Amalie-Suzette at 7:43 PM on May 9, 2016 [1 favorite]

It's a little more egregious coming from a doctor... but honestly I think a lot of the time medical practices just get updated advice from their lawyers and say "sounds good" and that's about as far as they go to understand relevant laws.

Sorry, your doctor should not be telling anyone that the law requires something as invasive as urinalysis when it's just not true. Note that the OP represents this (admittedly second-hand) not just as a throwaway comment but as a several-exchange conversation where the doctor went into some weird rigamarole about trading Adderall for painkillers. A professional should have a competent working knowledge of the law governing his practice; at the very least, he shouldn't be actively, positively misrepresenting the law to his clients to scare them into compliance with his preferences. Not only is it paternalistic BS, it also destroys therapeutic trust--as we can see in this very post.
posted by praemunire at 9:15 PM on May 9, 2016 [3 favorites]

I don't think it's actually a law, but I think this is becoming quite usual. My doctor, in Ohio, said something about it being a new law to make sure I wasn't diverting my meds, and I'm like--you know full well I don't even fill it as often as I can because I halve my doses when I get heartburn, and even if I was selling it then I'd only have to keep *one* to still have it in my system? Even more so because he said he didn't care at all when I went to have it done as long as I did it before my next appointment.

I'm still working out how I feel about this; I haven't yet determined if my insurance will cover it. But I did enough research to determine that no, my state did not actually pass any new laws or institute any new regulations between visits. Given that I don't appreciate either how invasive it is or being lied to about the reasoning, I'm exploring other treatment options, which is really irritating given how well this has worked for me over the past few years. I was just telling a friend earlier that it feels like they're trying to make it impossible for adults to get stimulants for ADD, period, and that I no longer feel like I can rely on this as a long-term plan. I've already gone through artificial shortages, through having to pay for office visits every three months at the specialist rate just to get the exact same prescriptions I've always had, and so on, but at some point there's a bridge too far.
posted by Sequence at 11:03 PM on May 9, 2016 [2 favorites]

In the end it's an even simpler calculus - your doctor isn't going to risk his practice and mortgage and kids' educations on a single person's pharmaceutical need. If the medical board 'suggests' screening urinalyses in patients on controlled substances, then expect that they will happen. I don't know what individual doctors are telling their patients but I'm quite candid about why 90% of my patients waste time and money on them in order to keep our practice from getting into trouble over the 5-10 % who may be diverting, or quite often have multiple opiates in their system when they should only be using a single drug (i.e. they're obtaining other opiates, putting us at risk). We do get to exercise judgement from time to time on this issue, but for the most part medical practice is so busy and overwhelmed with non-medical things that doctors aren't taking time to explain this properly. And managing schedule 2 narcotics (stimulants and opiates) is a massive time-suck for staff. So if you have a place that you can obtain your medication from and the biggest hurdle is a UA, it is understandably maddening, amongst other things, but nothing would make the practice happier than for you to go elsewhere for your medication, assuming you can even find a doctor who wants the hassle.
posted by docpops at 5:34 AM on May 10, 2016 [2 favorites]

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