Pain Clinics Test Patients for Marijuana Use
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July 7, 2009
By Dale Gieringer, Director, CA NORML
Like many medical marijuana users, Kristin Redeen needed additional prescription medications for her severe chronic pain. For seven years she had been treated at a private pain clinic in the Central Valley, where a doctor maintained her on Percocet, a semi-synthetic opioid. One day Kristin was unexpectedly asked to submit a urine sample.
“They already knew about my medical marijuana use,” says Kristin, who contacted California NORML. “I didn’t think I was doing anything wrong.”
When the test came back, Kristin was informed that the clinic would no longer renew her prescription because she had tested positive for an illegal controlled substance. Her doctor at the clinic cited legal concerns, claiming –falsely– that DEA regulations forbid giving prescription narcotics to users of marijuana or other illegal drugs.
Kristin was cut off from her Percocet and began suffering seizures. She finally found a physician who was willing to prescribe her another opioid, Vicodin, but only at low doses insufficient to relieve her constant pain.
Kristin is one of a growing number of medical marijuana patients discriminated against by pain clinics. “I must have heard of 25 cases this year,” says Doug Hiatt, an attorney in Washington state. “It’s Jim Crow medicine.”
NORML has received a surge of complaints within the last six months. Many medical marijuana users report that they can’t find a clinic willing to take them on. Others, like Kristin, have been abandoned by clinics that suddenly adopted aggressive drug-screening policies.
Clinics say they are legally compelled to drug-test chronic pain patients so as to avoid liability for overdoses and diversion of prescription drugs, particularly opioids such as oxycontin –which have nothing to do with cannabis.
Chronic pain patients have good reason to object to being denied medical access to cannabis. Chronic pain is the leading indication for medical cannabis use, accounting for 90% of the patients in Oregon’s medical marijuana program. More than 60 studies have shown cannabinoids to be effective in pain relief, according to a compilation by the International Association of Cannabis Medicine which includes four controlled studies of smoked marijuana by California’s Center for Medicinal Cannabis Research.
Studies indicate that cannabis interacts synergistically with opioids in such a way as to improve pain relief [1, 2]. California medical cannabis specialists consistently report that patients are able to reduce use of opioids –typically by 50%– when they add cannabis to their regimen. Cannabis can therefore be seen as a gateway drug leading away from opioid addiction. Nevertheless, patients are being pressured to stop using cannabis if they want to get prescription opioids.
To their dismay, patients have to pay for the drug tests at their own (or their insurers’) expense. Carol, a chronic pain patient who had been treated for seven years by the same clinic without any testing, reports that she was billed $325 for a urine screen. The balance of the bill, which totaled $1,601, was paid by her insurer.
Carol says her doctor told her that “the DEA requires him to drug test all his clients, that he has no choice, it is the law.”
In fact, there is no law requiring clinics to drug screen patients for marijuana. “It’s BS,” says Hiatt. Not a single case is known in which pain doctors have been sued or prosecuted for allowing medical marijuana use along with opiates.
Prosecutors have argued that marijuana might be obtained on the illicit market in trade for prescription drugs, though such a scenario seems implausible in medical cannabis states. “It’s unwarranted paranoia,” says Gregory Carter, MD, one of the few practicing pain experts who recommend marijuana in Washington.
Given that cannabis is notably less toxic and addictive than other prescription narcotics, it seems highly ironic that pain clinics are discouraging its use. The prejudice against marijuana has nothing to do with medical science, but rather with political and legal pressures to crack down on prescription drug use. Non-medical use of prescription drugs has recently emerged as the nation’s number-one drug problem du jour.
A new government report, ominously entitled the “National Prescription Drug Threat Assessment,” reported 8,500 deaths in 2005 from prescription pain relievers (mainly opioids), more than double the 2001 total. “Diversion and abuse of prescription drugs are a threat to our public health and safety – similar to the threat posed by illicit drugs such as heroin and cocaine,” warned Drug Czar Gil Kerlikowske.
The Pain Specialists’ Meeting
The 2009 American Pain Society Convention in San Diego included a panel on “Cannabinoids in Pain Management,” chaired by Dr. Mark Ware of McGill University. Dr. Andrea Hohmann, an expert on stress-level analgesia from the University of Georgia, presented evidence from rodent studies which showed that cannabinoids suppress nociceptive processing through both the CB1 and CB2 receptors, and that endocannabinoids, including 2-AG and anandamide, help suppress pain.Donald Abrams, MD, of the University of California at San Francisco, discussed his studies showing that inhaled marijuana significantly reduced neuropathic pain experienced by HIV patients. Cannabinoids and opioids interact synergistically on separate but parallel pain receptors, Abrams said. He is conducting another study on combined use of cannabinoids and opioids, preliminary results of which appear promising.
Dr. Ware discussed studies involving the variety of cannabinoid medicines available in Canada, which include dronabinol, Sativex, Nabilone, and herbal THC. All of them have demonstrated efficacy in pain relief. Cannabis is now recognized as a “third line” agent for neuropathic pain in Canada. Noting that that its adverse effects are mild to moderate, Ware concluded that “cannabinoid analgesia is the real thing.”
During the question session, your correspondent asked why it was that, in light of evidence that cannabis was so useful in pain therapy, there appeared to be an upsurge in drug testing to prevent its use. The panelists could offer no explanation.
We moved on to the exhibition hall, where drug testing companies were conspicuously displaying their wares. Their exhibits showed how well their products could monitor usage of opiates. The exhibitors seemed surprised when we told them that their products were being used against medical marijuana.
One of the more sophisticated exhibitors was Ameritox, which boasted panels for distinguishing a dozen different opioids plus numerous sedatives, tricyclic anti-depressants, barbiturates, and stimulants as well as “drugs of abuse,” among them marijuana. Their saleswoman seemed surprised to hear that the Ameritox test was being used to screen out medical marijuana patients. She said that clinics could easily order the screens without the marijuana if they wanted.
Another company boasted how their test could be administered at the doctor’s office, thereby allowing the doctor rather than the lab to collect the bill.Finally, we spoke to a legal expert on pain medication, Ms. Jennifer Bolen, a former prosecutor turned defense attorney, who has a useful website devoted to the subject:
www.legalsideofpain.com.Ms Bolen pointed to three recent developments that have increased the pressure to conduct drug screening of pain patients. First, pain doctors have suffered a string of stinging legal judgments for over-prescribing opioids to patients who subsequently overdosed. One notable example involved Dr. Thomas Merrill of Florida, whose life sentence was sustained by the Eleventh Circuit Court of Appeals last year.
This February, a prestigious panel of the American Pain Society issued “New Guidelines for Prescribing Opioid Pain Drugs” which counsels that “diligent monitoring of patients is essential. “ The report specifically recommends periodic drug screens for chronic opioid patients at risk for aberrant drug behavior, though it doesn’t mention cannabis.
Lastly, under legislation that took effect this year, the FDA has new authority to require pharmaceutical companies to implement “risk management” programs to prevent consumer drug misuse.
Medical cannabis patients have no easy remedy to the current drug testing onslaught. In the absence of dire bodily harm, malpractice suits are of no avail. In general, pain clinics have no legal obligation to treat anyone. They commonly require patients to sign contracts allowing them to conduct drug screening at will. Nonetheless, patients may have good grounds to complain to their state medical boards. This is particularly the case where they have been abandoned by their doctors after being made dependent on prescription narcotics.
The ultimate recourse is to educate doctors, many of whom remain woefully ignorant of the literature on medical marijuana and chronic pain. At the APS convention we encountered a distinguished pain specialist from San Diego, who joked about having enjoyed the marijuana muchies with his son, but averred that he wouldn’t let his patients use it, on the grounds that it wouldn’t be useful, and anyway smoked medicine is bad for the lungs. Like most convention attendees, he had missed the panel on medical cannabis, where Dr. Abrams had discussed the use of smokeless vaporizers.
Still, good physicians should be open to persuasion from patients. Cynthia, a severe chronic pain patient. had frequented the same clinic for 10 years when she was confronted with a surprise urine test. In addition to prescription opiates, she had been using medical marijuana, though her recommendation was four years out of date. The test cost her $100 and her insurer $500 more.
On finding her positive for marijuana, her doctor informed her that she would have to reduce her cannabinoid level to zero. After a heart-to-heart talk, in which she explained to him how she had been able to reduce her opiate use to minimal levels thanks to medical cannabis, her doctor relented. “I feel really lucky,’ says Cynthia, “You have to feel out the doctor. We have a special relationship. I don’t think he plans to do this with all his patients.”
REFERENCES
[1] Lynch and Clark, “Cannabis reduces opioid dose in the treatment of chronic non-cancer pain,” Journal Pain Symptom Management, (2003) 25(6) 496-8.[2[ Narang et al., 2008 Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy, J Pain. Mar;9(3):254-64.
From O’Shaughnessy’s, Summer 2009
To order this 52-page, all-content, no-jive publication, send $5 to p.o. box 490, Alameda, CA 94501. O’S is available in bulk to physicians, collectives, cooperatives and reform groups for $1/copy for free distribution to patients and interested citizens.121 Responses to “Pain Clinics Test Patients for Marijuana Use”
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hi,i was in a bad car accident 10 yrs. ago.so i got on methadone to control the pain then wanted off methadone so i got on suboxone to wean off of methadone.found out after got off suboxone that i was red flagged to receive pain meds.i thought i could deal with my back pain if i was not on methadone or suboxone but couldn’t.please someone help me with any info on how i can get back into pain management.
Since it became legal the combination of medical marijuana for chronic pain in conjunction with opioid medication for acute nerve pain reception has proved highly successful in restoring limited, to fully functional physical movement. A couple of years ago The doctor started issuing a one or the other option in the state of Washington. Because your supposed to work with your doctor for optimum results The advise of the physician was taken. Very soon the required dosage for opiates increased substantially to alleviate the acute pain and residual limiting regional nerve pain, which was severe to the point of dysfunctional ability. Should it be legal for a physician to not prescribe opioid medication, (Hydrocodone, Oxycodone), just because an MD at a medically licensed clinic has prescribed medical cannabis? M.D. licenses are granted by the State therefore shouldn’t state law take precedence when a doctor prescribes opioid medications but is only aware, not actually prescribing medical cannabis. Since The prescribing Physician is not prescribing the cannabis, they are not violating Federal law. At the same time The other doctor at a clinic is not violating State law. If this is the case, shouldn’t not administering opioid therapy just because another physician has prescribed medical cannabis legally be illegal. Would this also be a conflict of the oath to try and ease suffering in patients due to medical conditions.
John Purple
I was unexpectedly tested by my doctor six monthes ago and was referred to a “pain clinic.” I doubt I will be accepted into their program as I have always been treated as a “prescription shopper” and now as a “junkie” all because I use a natural medicine to help with my muscle spasms and nausea and it is not legal in my state. How unfair can life be?
MY SON WAS INJURED IN A MOTORCYCLE ACCIDENT AT 15 ALMOST 16 YRS.OLD. HE WAS PUT ON DILANTIN FOR SEIZURES. THEY WERE GOING HAVE HIS LEG AMPUTATED DUE TO GANGERINE,,HIS PATELLA WAS LOST IN A MASS OF MUSCLES.HE HAD A BROKEN JAW.ORALSURGEON AND NEUROLOGIST,THE ORAL SURGEON ORDERED HIM TO HAVE HIS JAW FOR 30 DAYS. HE WAS IN A COMA FOR A FEW MONTHS.HE HAS SPINAL CORD INJURY,AND HERNIATED DISCS CAUSING HIM NUMBNESS IN HANDS AND FEET. HE IS NOW 40 YRS OLD. HE HAS BEEN TOLD BY DOCTORS TO TAKE XANAX,DILAUDID,AND OPIATES. HE HAS NO APPETITE,IS CONSTIPATED FROM MEDS AND VOMITING ALSO.HE HAD BEEN USING CANNIBIS FOR PAIN AND APPETITE SINCE HIS ACCIDENT TELL ME WHEN WILL FLORIDA REALIZE THESE PAIN CLINICS ARE WRONG PRESCRIBING MEDICATION .THEY SHOULD LEGALIZE CANIBIS IN THE STATE OF FLORIDA.THANK YOU FOR ALLOWING ME TO SPEAK FOR MY SON.WHEN I LEAVE THIS WORLD,I ALREADY HAD STAGE 4 COLON CANCER,ITS A MIRACLE I SURVIVED.I WON’T BE HERE FOREVER TO DEFEND HIS RIGHT”S FROM “PAIN AND ETERNAL SUFFERING” “MOM FROM MIAMI” CRYING FOR HELP FOR MY SON”S SURRIVAL IN THIS FIGHT AGAINEST PAIN. ALSO HIS RIGHT LIEG IS 2 INCHES SHORTER THAN LEFT LEG. PLEASE HELP ME WITH THIS BATTLE IN FLORIDA.
I say it’s time to fight back and just shut these PM clinics down by NOT USING THEM! If no one goes because of the bullshit they put you through then they will have no patients and therefore no business and they will have no choice but to shut down! I know I know, easier said than done…BUT…it can be done! There are always more than one way to skin a cat! Do what you have to do to get through the day without giving in to these bastards…it’s the only way people! I’ve decided that if I have to I will suffer a little but by golly I’m NOT giving in to these bastards…that includes the government and the doctors who bend down and kiss the governments ass and agree to it (it (contracts))! I’ll do what I have to to get through the day one way or the other and they can all kiss my lily white ass! Suck it up people and grow a pair and FIGHT back or this is only going to get worse! It’s time for a revolt, don’t just sit by and do nothing…if we don’t do something we will lose all our freedoms and I for one will not stand by and let that happen…I will fight back!
I am so glad someone told me about this page.I am 53,i have seizures due to my x husband shooting me in the head,i have had both breast removed becuase of cancer,i also have melanoma cancers that come up on me all the time,i have had 2 back surgerys.I called today to get my pain meds refilled.And was told that i had tested post. for MJ 2 times,one more time and they will not give me my meds anymore.I told them i only smoke it to not puke,and to help with the pain,i have been on Oxicodone 5mg,and morphine 100mg,valum,and soma for about 10 years.Now they tell me this.Id rahter just do the MJ.They tell me that the reason they test me is to make sure i am taking my meds and not selling them.They have had me on stronger,but i asked to be taken of.What can you do.Im afraid they will turn me in to SS,and then i will lose that.I cant stand the pain and i sleep maybe 3 hours a night without the MJ.With it i may sleep 5 hours.But it feels so good.I am not taking it for the buzz as they say.But it is not as bad on you as some of the meds they have me on now.So i sit here now out of my pain meds because i know how i will test,and they told me i would have to.I am in a wheel chair,and right now i am in the bed and cant even move without sever pain.An i have never tried any harder drugs as they say you will go to when you cant get that feeling from the MJ anymore.It just feels good to be able to come here and talk about it.thank you for listening,and God Bless you All.
So they cut me off my meds,just like that.Now how do i get through the withdrawls?Not fair for them just to cut them out like that,maybe wing you of but this is a way to kill someone.And should be medical mal pratice.
same sad story ;1985 herniated low back now 2012 3 x back surguries require narcotic meds for 27 years and still do 53 years old 2012 new law emergency passed pain mng. laws because of abusive nationwide narcotic useage nothing to do with me. yet i test positve for marijuana. imediatly i cant get my pain releif i despratly need. my back never changed the past 27 years never chang for the good just worse.i,ve smoked since adge 13. go figure …WHAT CAN BE DONE? LOONEY TOON thanks for hearing so many screwed over pain patients i,ve been cut open 3x and medical society gets away with this stuff
Looking for current law in FL regarding liability. Chronic pain patient for 12yrs MJ w/small amount of opiates and xanax for chronic anxiety works. As of 2011 new doc [8months] threating to discharge if I test pos for thc and said “one or the other” well I am about at the “other” point but still need anxiety medication even if I try to go off all opiates. Doc is actually pro pot but afraid. Cannot find current law on doc liability for this issue. He is open to being presented with research. All my searches continue to bring me to this page or others linked to it. Thanks.
I have been on pain meds for 8 years in addition to medical marijuana. Recently the doctor asked me for a drug test, which I gladly took as she already knew I smoked. She then calls me and says I have to choose one or the other.
How is this fair? My pain has only gotten worse over the years. I plan on going to the ER tonight if the pain does not go away.
My Husband is having a terrible time finding a doctor since ours lost his license for engaging in illegal prescription selling. Tell me that’s not a crock. Is there anyone by chance who could help me find a doctor in the Northern Michigan area, I really don’t even care as long as I can get there in a day, he just really needs a doctor. Thank you!
[...] decisions for you — and punish you when your choices don’t measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana [...]
[...] decisions for you — and punish you when your choices don’t measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana [...]
[...] decisions for you — and punish you when your choices don’t measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana [...]
[...] decisions for you — and punish you when your choices don’t measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana [...]
[...] lifestyle decisions for you — and punish you when your choices don't measure up to their ideals? More and more hospitals are making exactly those kinds of decisions when it comes to people who choose to use marijuana — [...]
ABMC has developed a Drug of Abuse Screen without THC. This was developed according to the wishes of our Clinician base.
The prescription drug abusers and the legislative reaction has made it more difficult for those who suffer with chronic pain and require prescribed pain medication and/or cannabis to improve their quality of life. It is outrageous that those in real need face denial of effective pain meds because of rampant prescription drug abuse.
Don’t see Pain Management doctors. The DEA and the drug abusers have destroyed their efficacy and they add the to the rising costs of health insurance. Ask to work with your PCP on a pain management strategy/program. Make sure that you have a long term relationship with your PCP. If your PCP insists that you see a Pain Specialist, find a new PCP.
I suffer from a major C7 neck herniation. I have occasional severe pain, anxiety and numbness/weakness down my left arm. These are classic symptoms and my MRI doesn’t lie. Nor do my neurological tests. I don’t take any illicit drugs and despise taking Vicodin. But it is, on occasion, a necessary evil. I used to smoke cannabis for anxiety, appetite and pain, but quit cold turkey, after 35 years. I had no withdrawal symptoms whatsoever and don’t miss using cannabis, as it became ineffective for me. Plus, I didn’t like the social stigma that comes with its use.
When my neck condition progressed and worsened, I was forced to see a Pain Management Doctor for 3 useless steroidal cervical injections and was prescribed Neurontin and Tramadol. Both drugs worked poorly. The Tramadol would put me to sleep and cause severe constipation. I was forced to provide a urine sample for opiad screening, which was a total waste of money. If the god damned Pain Doctor had simply contacted my PCP of 17 years and asked him if he suspected drug abuse, the test would have been unnecessary, as my PCP knows me quite well. When I need Vicodin, I rely upon my PCP for the prescription and he trusts that I am not an abuser. This is critical for my proper pain management care. I often take only half a tablet or use a low 8mg dose of codeine/aspirin. Lidocaine pain patches also provide minor relief when the pain is mild to moderate. It really pisses me off that I had to endure working with a Pain doctor, who’s office is extraordinarily busy and rude. They don’t call you back. Worse, my pain doctor was three hours late for each of my epidurals and the person who was willing to drive me to and from the clinic had to wait, as well. There was never an apology from the doctor. I discovered the alternative pain management options from friends/colleagues who also suffer from pain issues and discuss these options with my PCP only!
I am now dealing with Anthem Blue Cross, who have rejected my Spine Surgeons request to perform an artificial disk replacement. The insurer claims that this procedure is investigational/experimental.
America has the best healthcare in the world. Bull sh.t.
Just more proof that a Doctors think they are god. What Drs in the VA don’t realize is they work for the Vet not the federal gov’t., the gov’t signs the checks. Why do new PCPs think that the first thing to do is change the meds you have been stablized on for years? I have seen more than one vet go to what we call the “Flight Deck”> Mental health floor because a Dr thought he knew more than the last one you have seen for a decade. Most of Drs have never had a hang nail let alone a severe injury such as being shot, stabbed, blown up, or dropped on a tree after falling 1300 feet. Really, has anyone seen a truly busted up DR?
The best care I have ever recieved was from a Dr with his arm in a sling. He had a broken clavical, one of the many things I am being treatd for. I said “It hurts doesn’t it?”. His reply “Damn right it does.”I was given pain meds T3s (hard stuff. jk)But there was no argument.
I have never seen my new PCP, not once. His nurse stated “Dr Sarkissian said you have seen him.” I don’t know who the “him”, but proper pronoun followed my a pronoun in the same sentence refers to the proper pronoun. I called him a liar. What can he do shoot me again? No he stops my meds. I was asking for Ritialn that my old PCP, that I saw for 15 years, prescribed for me months ago. This new hack never informed me I was not getting the medication until I called the VA. asking them where it was.I went through a mild withdrawl because of this.
I had to make an appt for mental health to get the medication. More waiting. This new PCP has not filled one request for meds without a battle. Some of these I have taken for over 15 years. He is not a Pain management Dr. yet he is enforcing a pain clinic contract that was void 10 years ago. By the way he was a prison Dr in California. After that worked in a strip mall there. He has practiced 13 years and was a ‘walk in’ to medical school in some Eastern Eurpean country. I believe this taints his veiw of his patients. If he don’t like being called a liar then he should have called and not his nurse that couuld barely speak coherent English. Maybe his English even worse.
I was in a pain clinic and I was released to my old PCP and he was tasked to handle my Pain Management and there was never a problem as long as I had my blood test. Not once have I asked for an increase due to the stigma of asking for more pain meds in the VA system.
In the VA system you have to call monthly for any pain meds. The new PCP had his new nurse call and started pushing for a CBC chem 7 and UA. I have gotten these evey 6months for 15 years. But she was really pushing for this. I was also supposed to get testtossterone levels along with seizure med levels. The only thing this Dr focused on was the THC levels in my urine. Not one word about the rest of the test. My pain meds were due the day of the test. He didn’t refill them because he decided to be a medication policeman for the gov’t..
They made an attepmt to contact 7 days later well after my script, MORPHINE, had ran out. They had to look at my information to call me yet they missed that I was within 15 feet of his office. If my wife didn’t call I would have had to drive home then back to the clinic. 240 mile round trip costing tax payers 180 dollars for my trouble. When I talked to the nurse she was surprised I was there. REALLY? I was informed that “there was marijuana in my system.”. I am 10 days past runnning out and my spares are gone. I am going through withdrawl as I am writting this.
In the VA system you have to call to order pain meds monthly 2 weeks in advance. I waited for the meds and they never came, there was no phone call. I called again and the clerk told me they had no record of my call, not unusual for the VA system. The clerk happily took the request and I waited. Still no meds. because of the medication policing Dr.Sarkissian. The VA has said repeatedly that their Drs should not stop pain meds if marijuana is legal in the state you are in. It is in both NV and AZ. where I live.
I called the patient rep Friday and never recieved a call back. I will call Monday to find out if there is a resolution. There won’t be. I will then call the hospital administrator after that, let the fun begin. I’ve delt with this system for 30 years. I know where to drill for the nerve .
A Dr has no right to change a thing if he has never seen you. He has never given you a treatment plan. He has not done one thing except make you miserable. If a Dr can’t take the time to find out you are in the same clinic then how can he be trusted to treat you? Answer: He can’t. It is hard to find a competent Dr in the VA. Most go there at the end of their career, or the begining to pay off their student loan. Sometimes you get a good one. Most of the time you get a Dr Sarkissian and the patient will be tortured until he can get away from him or her.
To all vets you may not be able to sue or file a tort, but you can make a complaint to the state medical board for the lack of treatment. That will be my third call. I’m retired becasue of what happened to me while in service of this country. I have nothing but time. I will find that nerve, bet on it.
Having dealt with the VA – system and Medicaid – Medicaid is better. As far as the VA allowing you to smoke, depends on the doc. and there are NOT many that will approve it. In short, the VA sucks.
Enough. What do we have available to clean-out the THC? Sonne #7 at fred myers health food section. It is a clay base liquid, toxins attach to it and is then pissed out. Used by IRON WORKERS in the union for their UA. Start 2 weeks before the test. Lighten up on the smoking the last week. Also I’ve heard the enzymes in an organic lemon works for light weight mj smokers. Plus the “head shoppes” have formulas to clean out THC. At a price. The timing is the hard thing. There should a test to check your system of thc. Do before going in, to guarantee it. Some of the clean outs strip your body. So take a chewable vit c tablet 1-2 hours before the test to give your urine some color. If urine is too clean I imagine that will be a red flag. Don’t tell the doctor anything. It gets written down for the next doctor to read. Avoid getting angry or upset, he’ll note it. I e-mailed my new doctor and told him I need a doctor not a cop. Didn’t do any good. Your doctor is no longer your friend, he is looking after himself only. I haven’t done the ua yet. I did find out that oxycodone goes for $1.00 a gram. that’s $5.00 for one 5gram pill. We can’t afford that either. I love my pot, what it does for me, but it won’t cover my stenosis back pain. Do I bluff and possibly loose my oxy or try to quit something I need. I’ll ask my doctor, because he knows I smoke mj, for lorazapan/tranquilizer to help me adjust to the change. I’ll take melatonin to help me sleep because without pot it will be difficult. I don’t like sleeping pills, its side effects are bad. Get the doctor to work with me over this. Then he’ll trust me more. Then ask him for just 2 tests a year because of the money, One test with all the illegal drugs. The next one only mj the cost will be less. Those tests are standard not necessary to check for herion, etc. on me again. I absolutely hate this just like you. I did read that patients are ending up in emergency rooms getting injected with opiates to calm down their pain. This is expensive too. We can’t get maintenance drugs but if we hurt ourselves bad like a broken wrist, we will be granted pain meds. Is this an option? For you or someone. We need more resources/answers/plans/bluffs.