Pain Clinics Test Patients for Marijuana Use

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.

0 thoughts

  1. I had a very similar experience with my pain management doctor; I was given a surprise piss test and failed because I smoke marijuana for pain relief between doses of Percocet. My doctor released me and I now only have marijuana when I can get it for the extreme pain from several crushed discs. I have been unable to find another pain management clinic that will accept me because now my records contain the fact that I am a regular marijuana user. Medical marijuana isn’t legal in my state and not likely for many years (Georgia).

  2. Ethan Says:
    July 8th, 2009 at 11:47 am
    If you’re using marijuana for medicine, why would you need opioids? (Unless you were being treated for something as serious as cancer, hiv aids or wasting disease.) Doesn’t that undermine the idea of the usefulness of marijuana as medicine for pain relief?
    Isn’t that one of the arguments for medical legalization, that it reduces the need for the other addictive\harmful medications?
    Either way, please don’t blame the doctors. It’s not a personal slam on the marijuana community. -They have to cover their own asses from the ever watchful DEA/GOVERNMENT
    Isn’t that one of the arguments for medical legalization, that it reduces the need for the other addictive\harmful medications?
    REDUCE THE NEED FOR.. That is the point.. Just because ones need for a painkiller is reduced doesnt mean they DONT NEED IT AT ALL. Your ridiculus statement only proves that you are not in any type of pain, dont know anyone suffering in pain, and have no sympathy for those who do.
    Goodday sir,
    And i do hope you burn yourself with your coffee on the way to work tomorrow

  3. Number 43 you sir are a moron, Why are you wasteing your time posting retarded comments like that on the NORML.. go to http://www.change.gov and post that crap noone here is going to listen to that garbage. Anyone in serious pain knows that not even opiods take the pain AWAY unless taken in very high doses. I have a wonderful pain MGT. DR. but my pain isnt totaly treated even with heavy opiod use. If there is a plant.. a non toxic non addicting non lethal plant, that can compliment my legitimate opiod use then who the fuck are you to tell me i cant use it? If these DR’s can hand out perscriptions for heroin like substances why in the hell cant they compliment it with a , and i repeat , non-lethal , non-addicting – non-toxic plant?
    Number 43 i hope you or someone you love has the chance to experience the hopelessness involved with chronic pain without much help in sight.

  4. #43 Cannabis for Pain Says:
    July 9th, 2009 at 1:49 pm
    “So if Cannabis is the wonder pain medication,
    why in the world was she taking an opiod? ”
    RE:
    Cannabis for Pain,
    – Pain-relievers act on varied / different nervous-system
    pathways to provide relief.
    – Opioids provide relief by affecting opiate-receptors and
    cannabinoids provide relief by affecting cannabinoid-receptors.
    – Also, their specific pain-relieving properties
    DIFFER from one another…
    – Cannabis relieves certain types of
    pain-conditions that opioids don’t,
    (and vice-versa).
    – Also mentioned before in #38,
    cannabis relieves opioid-induced nausea
    far more safely and effectively than commonly-prescribed
    and OTC anti-emetics.
    (Which primarily consist of
    anti-muscarinic anti-cholinergics,
    such as diphenhydramine and belladonna-alkaloids,
    a class of compounds FAR MORE dangerous THAN cannabis!)

    “Could it be cannabis realy isn’t a great pain
    medication and she was just taking it to get high?
    RE: A person taking cannabis for pain-relief isn’t
    “getting-high”.
    They’re becoming normal,
    REPLENISHING their body’s endo-cannabinoids,
    (internally-made cannabinoids),
    depleted by pain-condition(s)…

    “There is a reason Drs. screen their patients for substances other than what they are being prescribed…”
    RE:
    They’re scared shirtless of the DEA / Fed-RULL-Gubermint,
    over the presence of technically-outlawed plant-compounds that shouldn’t be illegal in the first place, i.e. cannabinoids…

    “They do not want to prescribe something that is going to cause an adverse reaction if you are self medicating with something else.”
    RE: While this is a perfectly-valid concern,
    the strongest cross-reacting medications / foods are
    ALL on more lenient CSA-schedules,
    (if even scheduled, i.e. ALCOHOL, grapefruit, caffeine),
    than the one medication that produces the FEWEST
    adverse-reactions, CANNABIS.

  5. 20,000,000 aressts? I’m not sure about the rest of you but o-o-o-h…dang it that sure hurts!
    CRP YOU ARE BUSTED…WE ARE DOING AWAY WITH YOU IDOTS’
    DARK AGED DILERIAM TOO! go …..!
    “…NOT TO PLANTS CROPS??????????????” RIGHT NOW?????????? TODAY??????????????? JULY 10 2009.
    I have never in my 54 year-old life heard of this ludicrious thinking until now. Where have these people come from?
    Oh and by the way; if anyone wants to go terra-farm Mars with me jump on board! Please just bring the seeds oh no please DO NOT FORGET THE SEEDS.
    Mary Jane is lost somewhere too within this sea of sanity? or is it insanity?
    I just read about the 1998 ‘Barr Amendment’ passing legislature within administrative laws. Oh Thank God. Amen.
    70% APPROVAL – WAY TO GO CONGRESSIONAL MEN AND WOMEN OF AMERICA…THANK YOU…ITS ABOUT TIME…we know the tune. Music to our ears ‘Michael Row The Boat Ashore Hallelluah…Michael Row The Boat Ashore … Amen.’

  6. I only saw one potential prohibitionist/lobbyist (43.) on here…that’s a good sign. It shows that common sense may prevail, hopefully soon. As more Americans learn the facts about medical cannabis, these paid liars will increasingly have to go incognito.
    This pharmaceutical McCarthyism is literally killing people. Physicians are being coerced into violating their hippocratic oaths (first, do no harm!) in favor of hypocritical oaths (we can’t help those that help themselves) that are spewed by big business interests like the other toxic sludge they pour into our environment.
    At least President Obama gave the states the go-ahead to “experiment”. That’s the key; one state at a time, prove the efficacy of a non-toxic herb versus big-pharma’s stranglehold on our health.
    Shame on the governor of Hawaii (vetoing studies!). Censorship at its worst. I’m pretty sure she’ll be overturned on this one, but we all must clamor for this critical reversal of a disastrous decision regardless.
    It’s time for Americans to put their feet down (march) and demand the DEA, FDA, NIDA ad nauseum and misguided, malfeasant governors stop trampling our constitutional rights.

  7. Women in Utah refusing to become a polygamists’ wives’
    wives’ wives’ were run into the desert to be their postitutes under a fictional guise of “Nevada”.
    They love adultery; welcome to good ‘ole Utah and their cult of good ‘ole boys.
    Dear Oprah would you like to hear my story of slavery?
    Oppression? Silenced muffled voices of the meak?
    Tune in everyone.
    S.L.C. Lead in obesity, child abuse, internet child predators, mental illness, cross-breading cousins until no one ever knoes who’s who anymore.
    My God this sickening sperm banks’ shit…somebodies’ are really geeting their DNA gene pools crossed so it’s not just the mormons neither. It’s no wonder they are so damn wierd!
    In is an injustice to everyone. It needs to end and end quickly. Amen.
    I am disgraced today, sorry folks, oh so sorry.
    Wendy ReNae Warr Elorriaga

  8. The concept of any prohibition comes from the definition of a sumptuary law. A sumptuary law attempts to control and divide people into classes by limiting the desires of those considered the lesser class. Generally monarch type governments use sumptuary laws to inflict class separation through prohibiting the lesser class from participating in something reserved strictly by the so called upper class royalty.
    Any 4th grade student understands this country was founded on the principles of individual freedoms.” A Prohibition law strikes a blow at the very principles upon which our government was founded.” -Abraham Lincoln U.S. President. These same people pushing prohibition would be targeted for treason investigation had they been around during the founding of our country! Don’t Be fooled American people any prohibition enforcement against us is as UN-AMERICAN as Hitler!!

  9. Mary Jane is Free…
    ….She Just Got Out!
    – I do hereby request medical marijuana industry to become legal world over and global wide for the safety and resurrection and sanctity of our homes and welfare. Amen. May It Please Be Free!
    – I do hereby request hemp production and the food nutritional substances industry thereof legal world over. Amen. May It Please Be Free!

  10. #43 Cannabis for Pain Says: – I definitely think Winder Says – is right on the money in this instance.
    Would you like to claify yourself? We the people on this blog have a purpose so fuck off and stop stalling our process of redemption – others’ long long overdue redemption. Amen.
    Are you in pain yourself? Are you just a wierdo voyeure? Is something like you designed to confuse the confused merciless sick and hungry fellow human beings on this earth.
    If you have nothing positive to add but just your simple lack of common sense please in the Name of God Fuck Off – Leave Us Alone To Do What Is Righteous. Amen My Friends, Amen.
    #43 whatever you are – You have never walked a mile in anyone elses’ shoes.
    My Dear Sioux Indian Brother In Law Passed Away Last Summer….
    ….Cecil….would say this person …
    ‘has never walked two miles in my mocassions.’
    I love and miss Cecil.

  11. i had my first lumbar surgery at age 22.my second at age 35.my last one in 2005. i am now 56.was referred to pain mngt.dr. from my neurosurgeon.ended up on fentnyl.went for a follow up and he wanted a drug test.told him i lit up because it helped alot with spasms and related pain.he deferred the test till next time, and said if it was legal he would have no problem prescribing it, but if the test would come back positive, it would be considered abuse.went to my internist who couldn’t believe the pain dr. had me on fentnyl.he weened me off the deadly patch and prescribed ms contin.along with MM i have not increased my doseage.my internist says that i am doing well with not having to increase the ms contin doseage that he oringinally prescribed.i have taken urine tests during my yearly physical, and no mention of MM abuse has been brought up.

  12. #28 Ethan Says:
    July 8th, 2009 at 11:47 am
    If you’re using marijuana for medicine, why would you need opioids? (Unless you were being treated for something as serious as cancer, hiv aids or wasting disease.) …..
    Isn’t that one of the arguments for medical legalization, that it reduces the need for the other addictive\harmful medications?
    RE:
    Ethan,
    Cannabis potentiates opiates. This means that if you are using cannabis, it helps the opioid/opiate do it’s job.
    So, yes, when using medical marijuana and opiates, one needs fewer opiates.
    Funny how that works, huh?
    Eric

  13. I’m a cronic pain sufferer in Texas and my Dr does drug testing. If you fail you can lose your medicade. I take Oxycodone but it alone just dosn’t do the job. With just a little cannabis I only need about half of the Oxycodone I normally would. I have only once came across any cannabis that worked well by itself, if it were legal that might be different. I know this. If I can’t get treatment for the pain I will seek euthinasia.

  14. I am a chronic pain sufferer in Ohio. During my disability hearing I was asked if I smoked marijuana. I answered them honestly. Yes, I occassionally use. I’d rather smoke a little than take the heavy narcotics which make me stupid, incoherent, lazy and fat.
    I was awarded my disability in 2008. I am in a non MMJ state. I was recently refferred to a pain management clinic where I was subjected to a drug test, which I failed. My family physician had me on a morphine and klonopin cocktail.
    I am recently back in school, studying law. The doctor told me it was illegal to SMOKE marijuana! I told him he was mistaken. It is illegal to cultivate, possess or sell. He kept asking where and how I got it. None of his business. The problem is that, when I originally asked my doctor to give me something less potent than the morphine, he sent me to this “so called” doctor. I told this guy I ABSOLUTELY did NOT want morphine. It is too strong for me. Before I failed the test he told me if I did not take what he felt was best for me, than he could’t help me. When the test came back positive, he told me it was illegal for him to prescribe me anything but mild muscle relaxers and anti-inflammatories(the latter of which I am deathly allergic too!), but he wouldn’t do that either. He did, however, threaten me with the police and children services. (I have an autistic child to care for)My last script was filled at the beginning of June. I still have a couple of days left, because I only take it when I need it, not every day the way they told me too. And now I’m scared shitless because I will be completely cut off, and going through withdrawals.
    Doctors broke my back 10 years ago during a difficult delivery. It took them 7 more years to find it. I now suffer from degenerative disk disease, failed back surgery syndrome, oh yeah the metal is the WORST in winter folks, I have developed scoliosis from these conditions plus spurring throughout the thoracic region and a herniated disk at C-4. There are more injuries to the neck and spine but I think you all feel me.
    I was so glad to find this website! To know I am not alone in suffering. The MJ has taken the edge off the pain without making me stupid, incoherent or lazy. I can still properly care for my child, something I cannot do when they are legally dealing/pushing morphine, especially when you ask for a less potent drug.
    They want us all dummied up so they can do what they want and we wont care!
    The only way to make a change is to force it upon our “Blubberment” I mean government.
    PS. Do any of you know about the WTO and the new codecs going into effect at the end of 2009?

  15. howdy folks, to post nmber 28 ethan,I have ankylosing spondilitis and wrighters syndrom with nerve damage from a bad car wreck 27 years ago,you ask why take opioids along with pot for my pain,well for one the opioids dont releive all pain! the muscle pain twisting and pulling on my bad disc makes the pain much worse! with some folks if your messed up enough it takes different kinds of things to help one another to get releife,I’ve hurt for most of my life and without medications to keep me from hurting so bad I would be a tortured misserable soul and just could not live under that much stress,I cant have any operations to help me,so I’m forced to do the best that I can,I live in california where pot is legal if i choose but the moment they find it in my system they will take away my opioids, I can’t live without them because unlike some my nerve damage is not numbness but sharp pains that go right to the center of my brain and cause migrains for days on end,I throw up and wished I was dead just to get out of so much pain, the pot helps me sleep without pills,I have gurd and acid reflux,and a very slow digestive system,the nerves are damaged going to my intestines also which all causes my digestion to slow so bad that food will sour before I can get it through my system,every now and then I will smoke some pot speeding up my digestion so that it will not make me sick,you see I also am missing a key enzym which kills some of the bacteria that cooking want kill so over a month it builds up in me and the pot also helps speed the process up so that it pushes poisons out of my system that otherwise my body could not do on it’s on,also I am a hypoglysemic! when I smoke pot it will run my sugar a bit higher but it don’t drop me like a rock! one a docter tested me when I was 15 and said son do you feel alright to which i said why doc im just a bit light headed but it’s normal for me to feel this ways and he said well your test show your sugar leval at (19) and he said you should be passed out,I never sen anyone be so low and still be able to talk to me muchless make any sense! I was born this ways so I’m use to it, wehn I reached early 20s I started smokeing pot and my sugar levals have not bothered me for over 20 years unless ive had a few reactions to medications(sulfur drugs) that made it go yoyo until I got them out of my system,
    I’ve smoked pot for about 25 years now and without it I would not even still be here,I would have ended it along tme ago with as much pain as i’ve lived with over the years,I have spinal damge from head to toe and thats not figurativly either,i’ve had spinal injections and trigger point injections that made me ick as a dog but never not one time has pot ever mae me sick! if anything it has helped me when othr drugs did make me sick,its calming nerve easing medication! a mirical drug if you will but it can only help so much and in certin ways! but in ways no other drugs can even get close to !!!when you flip a car 9 times, get ejected 176 feet, bounce off the ground,fly another 45 feet into a 4 strand bobbed wired fence takeing out 6 polls to the ground all woven up intwines in the strands and then the cars very lest flip is on top of you with the car upside down beeing mashed to death it will put pain in places you never thought could ever hurt, i thank god I’m alive each and every day,i am god fearing man and I think god put plants on this earth to feed and heal,god done one hell of a job in my book, and in that book it says not to trust (MAN) and thats where it all comes into play,the doctors get kickbacks by the drug companys! and they spend bilions of dollars for lobbyist to keep the government to do there evil bidding! WE THE PEOPLE HAVE NO SAY THESE DAYS! I only wished that I was born with enough money to fight these crooks! the fact that I can get much better releif with a combonation of drugs with pot they dont care about one way or another,I would not use nearly as much pain meds if I could smoke pot regular without worrying about them taken away what I need so I just sneak around when I can for a few days and try to purge the poisons out of me and go back to cleaning up without it so if they test me I want be out of a doctor or the nerve numbing opioids that I also cant live without,it should not be this ways for me or anyone else, the doctors oaths only go so far as to not get in th ways of there kick back moneys,if I was president I would tst all doctors and those that did not apply that oath to help people above all would be tossed out of there cans!! all Ive heard in the last few months is to take away money from doctors and hospitals when the real villan is the pharma companies thats chargeing more money than all others combined times x10…..notice how quick they ws to jump in there saying they would help with all this dealings in the white house?? what it is is they have donated 1% to make it look like there helping and keep them out of the issue when in reality there charging 90% way to dam much and dont want that part to be drug into the whole issue,there plea bargaining basicaly,and keepingthere name out of it and the president knows this,I’ll even bet that he has bought stock in there companies one way or another just like he did with the freddy mea and fany mack deals,it ruined our country but noones talking about him beeing the number two man for the amount of profit that he made from them two which was into the millions of dollars, it’s like letting the wolf guard the hen house! this is the first time to visit this site,I;m going to try my best to join and get involved in whatever ways that I can,I’m damn tired of running around hideing in acountry that I love because of some damn suit somewheres thats never worked a hard day in his life telling me how I feel and how i should feel being forced to take stuff that I know can’t work as good as pot,for with it regular I would not need the acid reflux medications,nor the sleepin pills,not any nerve pills,and I could even cut way down on my opiods although I will always need some of them! but they are costing our government a fortune just by themselves and I feal bad knowing just how much they cost when I know a small bag of pot that only costs 5% or less as much as the opioids do could help me even more and the savings on all the other medications also,over lifetime it’s enough to help many others not just one,I want to be apart of the solution not the cause,and it may put me in jail or loseing my doctor to do the right thing,thats really sad that our government just dont understnd whats right in plain sight!!! sorry for this being so long folks,I just thought I needed to get it out,not many places one an go to be themselves and speak there minds,we must organize stronger and strike while the irons hot,in california the doors been opened so lets all not let them slam it back in our faces this time,get involved in any ways that you can,I know I’m going to….smokenbull

  16. OK, so I am sooooo glad to find this site! I have been seeing a pain doc for 3 years, they have never popped a urine test on me until last night. I live in MD, and have smoked MJ for 25 years, and work for the federal gov’t. Soo yes, I have federal healthcare. I am scared shitless – I am just hoping that HIPPA protects me cus I know I am gonna pop positive. At this point I could really care less about whether the docs are gonna see me again, because I have had sooo many problems with them – there front office is horrible and I was thinking about switching docs anyways. They have me on all sorts of medication for my chronic pain in my back because I don’t want surgery. And all of the hardware in my back – well I am a walking weather detector. So it’s not like I am lying about any of my pain, as I have a well known surgeon that would like to cut me open and redo my surgery. I am just not ready for that yet. Smoking MJ is the ONE THING that relaxes my muscles, which relaxes my back, which then makes me not be in pain. These docs are so eager to PUSH meds – its almost like they are making a profit!!!! Maryland doesn’t have the MMJ card yet, but I am hopeful. I just got back from CA, and I am jealous. What is the harm with MJ. Nothing!!!! Think about how many people it helps, and yet you smoke it and it can stay with you for 3 – 4 weeks. Yet someone can abuse other drugs, get off of it for a few days, and come up clean. Its just not fair – they need to make a different test for MJ users or not one at all!

  17. The cowards and sociopaths of the dea would rather thousands suffer pain unnecessarily than one addict deceive a doctor. As one ex agent put it the dea has become a repository for ‘right wing nuts.’ This rogue agency should be abolished.

  18. Those of you who worry about being cut off opiate pain meds because of medical marijuana use should investigate the possibility of growing opium poppies which is legal in most states. You can dry them and save the heads which can be made into a very effective pain relieving tea. There are instructions and recipes all over the internet. The seeds can be bought online and at many health food shops. The dried pods store well and can be saved for future use. Poppy tea is every bit as effective and Oxycontin and the strength can be adjusted to suit individual needs. Poppy tea provides effective pain relief for a very low cost and while it may be illegal it can save many pain sufferers from the vagaries of sadistic drug testing doctors.

  19. Hi there I have been searching online for a few days now trying to find any official legislation that directly prohibits pain management doctors from prescribing narcotic pain medication to patients that are smoking marijuana. I was recently informed by a doctor that she would be unable to prescribe me any narcotic medication due to the fact that on my questionnaire I wrote truthfully that I smoke marijuana. From what I can tell by the literature that I have found there is no official law prohibiting this. It seems as though this doctor is more concerned with law enforcement then with patient care. Gee go figure. It just seems so crazy that you can tell the doctor that you drink alcohol and they will not have any problem with setting up an appropriate treatment for you but if you smoke marijuana you are unacceptable. I tell you what if I were a doctor I would rather my patients be smoking marijuana and typically reducing the opiate consumption then taking these opiates and drinking alcohol along with them and potentially dying due to countless risks that associate with that scenario. So if anyone could be of assistance and not just say yes or no regarding any official legislation directly prohibiting narcotic treatment but please point me in the direction of a web site or phone number if possible. Thank you so much

  20. I have inoperable brain cancer.I am dying. After 1 year with a pain center I tested positive. I didn’t think they would test but they surprised me. Now they are cutting me off. I am dying, how can they do that. It’s like they are asking me to off myself. I need to vape the MJ to keep the meds down. The nausea and vomiting are part of life, and yes, I take 3 meds for that. Talk about putting me into a downward spiral. I don’t have the energy to fight this or find another doctor. The smoke I can find, what do I do about the pain meds.? I take oxycodone and methodone tabs, how can I find and afford those at street value? I will be non-functional when these scripts run out. Will my children have any legal recourse when I am gone? I absolutely feel like I am being pushed out of this world months sooner than I should be leaving. I feel like “they” have figured out a way to save a few health care dollars. Wow. No way out leaves me with only one way out. It’s not a threat, don’t feel like you have to track me down and save me, it’s not like that, I have enough meds to make through the first of the year, that’s how long I have to figure this out, but WTF, this isn’t how I should be spending the end time. The first thing I read about brain cancer was that the type I had wasn’t painful, that was the first lie the doctors told me, no two say the same thing, offer the same treatment…I just want pain relief to spend the time I have with my young children, and even this seems more than anyone can offer me.
    Does anyone know any way I can get the pain relief I need. I am in the state of Massachusetts. Travel is almost impossible but will do what it takes to spend a few more days with my 2 boys. Curled up in the fetal position in too much pain to cry is not time with my children. Can I get scripts from Canada? Can I send my paperwork somewhere like that and get them to send me these types of meds? I don’t know what to do.
    Thank you for giving me a place to say it, for being the one person to hear my plight(I hope), even if nothing becomes of it, because if nothing else, saying it once helps give me a sense a peace, a sense of hope for others in the future.
    Thank you,
    Sandy P.

  21. From everything that I have read, the MMJ laws, even though some states have passed MMJ, each state uses their own discretion. And pain docs are the worst! I had it out with my physician – told her I felt like she was the one that had me hooked on pain meds, when all I needed to leave the spasms was MMJ. With that, she refused to treat me! Even though I live in a state (MD) where MMJ is legal – BUT YOU CANNOT GET A SCRIPT FOR IT! WTF! No doctor in the state of MD is willing to do that, so why even make it legal? I have started an exercise program now – 3 days a week – to help with getting the mobility back in my leg and my back. Been off my meds now for 2 weeks, and wow I can actually think straight now. Still smokin though! It helps at night – but I have realized that I don’t need as much now that I am off the meds – cus one of the reasons I was smoking so much was because of the side effects of the meds. What wicked web that is. Pain docs are in it for the money not to help people. I am a firm believer of that now that the “doc” and I had our words. I was to come back, and get put back on the meds but be tested everytime I went – and to my expense! No thanks!!! They are making a profit off of every pill you swallow!!!!

  22. OK – now I am pretty upset. My doctor actually had the nerve to send me a letter (certified) threatening me about my MMJ use! She stated that I need addiction help, and if I do not respond to her that she will notify my Primary Care Physician and my work!!! She is not allowed to do this per HIPPA – I need a lawyer FAST! Anyone for some suggestions???

  23. I am currently in pain mgm. for cronic back pain,I am currently on embedda 80 mg and oxycodone 15mg.I take them each 2x a day.My doc has insisted on me getting tested for drugs today,I am horrified to go take the test cause I smoke pot once a day if not more.I know if I fail this test it will be the last time I get any pain meds for my back.and it will also put me in jepordy for my social security claim.It may also give workmans comp the chance to drop my claim so they do not have to pay for doctor visits anymore.I am at wits end with this,and do not know what to do 🙁

  24. That’s really horrible what people are going through because of this. If the clinics would chill out about smoking pot for medical reasons, a lot of people would not be stressing out as much. I’m sure that the stress is adding to the pain! People that have the legal medical ability to smoke pot have to worry as well, just because the clinics are against smoking. If they are legally allowed to smoke, they should be able to show the proof that they can smoke and get help, tested, and get their drugs refilled without any worries. But no, people are losing the ability to get their medication because even though they are allowed to smoke, the clinics will hear no word of it. The clinics are basically saying that they don’t care if you’re legally allowed to smoke or not. If they are against it, their way goes and you’re screwed and you don’t get your refill, you have to go live with the pain and they won’t lose any sleep over it because in their heads, pot is bad legal or not. It’s just not right, and I feel so sorry for the ones who are losing their prescriptions because of the thick-headed clinics.

  25. How does Corey Haim* have hundreds of pain killers around and I am dying of cancer and I can’t get enough pain meds to last the month and I am threatened to lose even lose those because when I can afford it I smoke a little for appetite, as an anti-nausea and to help me sleep.
    It makes me angry that someone who wants to die can get pain killers and someone who doesn’t want to die can’t. I just want to enjoy my children but that’s hard when even their voices hurt…
    Dying shouldn’t be this hard for those that value life.
    *I wish no one that end. The point is I want to know how he got them so I can too! F#ck, I DON’T have a death wish!

  26. I really don’t understand after going to my pain clinic for 4 years, and many 5+ spinal surgeries? They want to test me for thc on the next vist. They wanted to test me the previous vist, but I was honest, and told them I had smoked a little marijuana. They had a darn fit! Now I’m trying to get myself clean of thc before July 3rd in order to pass a test. I’m not obese, and have little body fat. I’m 5’5″, and weigh about 125 lbs. What are my chances of passing?
    I have a medtronics electrical simulator inserted in my abdomen with 3 wires running to my spine. I’m on 25mg fental patch every 48 hours, oxycodone 10/325mg every 6 hours, and Ambian 12.5 mg prn sleep, and I get 20 per month of those which are usless since I rarely sleep. I also have blood in my urine according to my last Primary care visit. Will that affect my test?
    Please, help me as I’m terrified. Believe me when I say I really hate taking the narcotics that’s why I had the medtronics inserted to get off all narcotics. They do help, but the MJ helps me more than anything, because of the side effects of the drugs cause much nausea, and the nausea medicine they’ve given me causes many unpleasant side effects causing my pain level to increase. I’m a 61 y/o woman who thought I would never smoke MJ, but it has helped me more than anything else I’ve taken. When I would smoke a little? I had to take less of the oral pain med, and I would sleep an hour, or two more than when taking the Ambian.
    I don’t really like the staff at the clinic, but I do like the Doctor. Also, since I’m not smoking anything it’s been 4 days. I’m so miserable, because of having to take more of the oxycodone which makes me nauseous.
    I’m just about ready to give up all Doctors, and just use the MJ, and forget the pain meds, but that scares me in wondering if that will work. Any suggestions would help, and I believe it’s criminal in the way they treat occassonal users of Mj for medicinal proposes. Why can’t they just test for the narcotics they give you? Also if they’re so worried about the abuse why not have them have the patients bring their meds in to be counted if they’re concerned about abuse, or some selling them? I would have no problem with that at all!

  27. BTW, Sandy are you still with us? If so? I pray you have been getting relief from your pain, and God bless you, and know I feel certain there’s a place we will go, and pain will never be a problem again. I hope to meet you there some day.

  28. I apologize to Mr. Haim, his legacy, his family and friends and admirers. He died of pneumonia. I do not wish do be the one to spread falsehoods or lies about anyone. He did NOT overdose or die of mixing drugs. I am sorry if I was part of perpetuating any myth or untruth.
    I have, for the moment, found a doctor to treat me. I have been Rx’d, and denied, the phentenal (sic) patch. I am appealing. The first appeal was denied. There is no growth of the tumor at this time, but no further treatment available, the only left is pain management-lol.
    As for seeing you on the other side friend- you do what you need to do to get through it all, and I’ll do the same. I find my joy in the here and now, my love in the hearts of those that surround me, and my eternity in those who will never forget me. Peace and joy- Now and forever.

  29. I have had back surgery 3 times.At one time I was taking 120 pain pills each month as well as 2 types of nerve meds to control pain and sleep,marijuana eliminated all of these meds but I have to quit because my company has drug testing.No one can really believe I am better off taking all those pills.How can our government do this.

  30. Sandy, I too wish to remain here with loved ones as long as possible, becuase like you I love life. I really don’t believe I could exist at all if I didn’t believe there was something better than this life to look forward too. I lost a precious Son, and I remain faithful that I may see him again. If you don’t believe that? That is certainly your right, however I thought you could have been somewhat kinder in your reponse. I hope you are doing well, and I will respect your request not to believe in seeing each other after this life is through. I respect your beliefs, and I would hope you would do the same with mine. I really do hope, and pray to see my loved ones again, (don’t worry I won’t include you again in any request to meet you in any afterlife, and feel certain that this is not all there is to life. God Bless You.

  31. Franny, I am sorry if you did not like how I feel or that you think I intended to be unkind. I was not trying to be unkind to anyone- simply stated how I felt. I never crossed my mind that it would taken as unkind to someone else. It was a response, not an assault on anyones beliefs in any way. I am sorry if you felt it was directed against anyone or their faith- I was just describing how I find peace- much like you stating that you believe you will be reunited with those you love gives you peace.
    I would never deny anyone anything that brings them hope.
    I truly apologize if you felt I was attacking you or your faith.
    We share in the fact we have physical pain that is not addressed, I hope we can continue to share our sorrows/frustration/sense of isolation in that. I absolutely respect your beliefs and feelings and I am sorry if what I said came across that way.

  32. Pain is the issue. In most of the examples it was the drugs they took away not the patient, to jail.
    We study organic sulfur which has replaced a morphine pump and all of the oral and addicting opiates. Methadone from 130 mg to O in 8 weeks.
    The definition of pain in biology is the lack of intracellular oxygen, sulfur transports oxygen.
    So if you would like to see dispensers in your area so the jail thing does not ruin any more lives, consider
    the pain.
    If medical pot is a good thing? Then something that addresses the cellular pain and repairs the cause for the pain could be part of the program. Our study hates hearing about pain and love hearing when even pot is not necessary for “what pain.”
    I’m 64 and know the needle and damage done, any needle.
    Our ISP “sisna” could mean “sulfur is superior to narcotic addiction.”
    the Director
    Cellular Matrix Study
    Body Human Project.

  33. Sandy, I also apologize if I came off sounding high, and mighty. I have the greatest respect for others opinions especially when it comes to their faith, and beliefs. We all must choose what works best for us, and no body in my opinion has all the right answers.
    Best to you, and no need to apologize, as I was being too sensitive. Thank You, and have a great day!

  34. Sandy, How are you doing? I hope you’re having less pain. I finally got off the patches on my own, and I’m so angry at my pain clinic. I did several different urine tests for thc, and passed everyone of them, and yet they claim at the clinic that I still had thc in my system? How can that be? I believe they are doing this dilibertly, because, I’ve been insistent on getting off the narcotics! It certainly hasn’t been their plan! Too bad, I will refuse any further testing, and I’ve already talked with my Primary Care Doctor, and he’s willing to help me if I need a few percocets for prn pain if the pain management clinc refuses me the pills. I plan to ask for half of the original perscription on my next visit for my percocets. I went through torment in getting this Medtronics unit, and It has always been my plan to be off of all narcotics in the future. Even though I’ve been told I would never be pain free? One can always hope.

  35. Mr. Collins, I feel your pain, and I also cannot believe the cruelty of the FDA, and especially pain management Physicians! They of all people should know better! After all? that’s their expertise, and yet they are slaves to Big Pharma as well!

  36. This story is all too familiar. I WAS a pain clinic patient on 180 mg. a day morphine for the last four years. When my doctor informed me that he could not prescribe my morphine if I continued to use my medically prescribed cannabis. I chose cannabis.. I have been off my pills for three months today and haven’t felt better in years! Not to mention the mental fog has cleared and I’m ready to stand up and join the fight!

  37. Re: Catrina
    I have to agree, at the worst I was taking 24 pills a day, just adding a med for everything. It turns out my pain clinic doc had me on a med a almost 6x the normal dose- the doctor, who had done this, the “mistake’, immediately assumed I was doing drugs. After more than a year at the pain clinic I tested at barely detectable levels, with no tests occurring until I started to complain of strange and multiple issues-every single symptom was on the ‘toxic reaction’ list for the med. The doctor would not listen when I said something was really wrong. I lost balance, had double vision, etc. The doctor told me I must be on something else if I tested positive for one other thing, he also repeatedly changed my Rx’s, both in dosage and length of time (# of days it should last) without mentioning it to me. I was so confused when I ran out of pain meds, and when I called saying I did not understand how didn’t have enough, was accused of ‘drug seeking’, it was not until I talked to the pharmacy that it was pointed out that the majority of my meds had been reduced to 3 weeks, when my insurance wanted it all in 30 day rx’s. When I asked why the doctor did not tell me, he said it was my job to know…after being on the same pain meds, that had only been upped in the preceding 12 months. It is now 6 months later and I can no longer drive, it appears the vision problems are perm from the toxicity at being at almost 6x the correct dose for 6-7 months. (BTW-there was no records of anyone every being on that high of dose for so long. We do not know what permanent effects will endure. “Luckily” my blood pressure is slowing going up, but much damage is permanent. I am so saddened that that doctor robbed me of months of life that has an expiration date. He was so sure it was me that never once did it occur to him that he had erred.
    Before this was discovered, I weaned of everything but the Toprimate (headache med) and had cut back on the pain meds. When it was left just to that I was weaned off the med, it was painful and debilitating, the long term effects are not as painful as the short term, but losing the ability to drive with two young kids bite.
    The point of this post is these doctors claim ‘this’ (sites) issues are about the fear of the DEA. Guess what, by law they DO NOT HAVE TO TEST FOR THC UNLESS THEY BELIEVE THERE IS A PROBLEM. THEY ONLY HAVE THE RIGHT TO TEST YOU FOR THE RESTRICTED MEDS YOU ARE ON. You can ask that you are only tested for the meds you are on- which may result in the doctor being suspicious- but a doctor who is so closed minded is not the one you want. The test for the pain killers is NOT the same test as the illegal screen- the doctor MUST order it…
    THC was made illegal by a man named Asselin, who only wanted more money for his Federal department, made up this whole “pot makes you crazy’ crap- no medical studies, no real doctor testimony. If your doctor backs this, then he is closed minded and ignorant. THC does help with nausea, sleep, and appitite, but I can no longer afford it (so my insurance paid for so many Rx’s but wont buy me a cheaper alternative- which surprises me the most. Ins. Co’s want to make money, I would think they would support this.
    Whatever, this wont be fixed in my lifetime, I am more sorry for the rest of you who half to endure for lengthy, perhaps lifetimes, of pain.

  38. The reason why I read this was to see about the consequences of failing a drug test that is positive for THC which was sprung on someone after 7 years of going to a primary MD who was prescribing oxycotin, roxicodone, xanax and klonipin, and gave a suprise test for the first time and cut off the patient cold turkey without a follow up nor a referral, only one month prescription and was unsuccessful in getting another pain doctor prescrible same meds, three pain doctors, just would not give meds at all-blacklisted basically, labeled a “chronic drug abuser”, when that was the very first and only drug test ever even given. So, the patient lived had it not been for help from other users, and suffered severe physical and mental consequences which are still unresolved after one year-still not acquired anything but darvocet and still trying-paying out of own pocket and living on disabilty income for 8 years with two surgeries on spine, prolapsed uterus and total hysterectomy at 23 years old and severe bone disorder which is very painful and often misdiagnosed. Dont have any voice when you are poor and a piece of paper, such as the new agreement you are to sign if you want meds, that you break when you test positive regardless of the outcome and known lethal consequences of opiate withdrawels alone, xanax is just as bad. This system is placing a conract more important than one;’s life-this is my life!!!

  39. HELP! I just went to the pain specialist in Austin Texas who told me he could not prescribe me any medications if I tested positive for marijuana. He said it was a new law that began in September 2010. I have herniated disks in back and neck, excruciating pain. marijuana helps me with anxiety, but not the pain.
    What to do?
    [Editor’s note: Seek a different doctor or move to one of the 14 states with medical cannabis laws (next door neighbor New Mexico for example).]

  40. Re: Darby
    Personally I worked out a plan to taper off my pain meds. and did so over a five month time span, cutting the dose in half each month. But do not do this by splitting any extended release tablets!
    I also got a referral to a physical therapist and a pain therapist who both taught me a lot of techniques to manage my pain myself.
    One piece of information my pain therapist shared with me is that our bodies can produce 60x more opiates than any pill on the market.

  41. I was on Methadone for about 5 years and dealing with a severe spinal cord injury/chronic pain. Lost private insurance in the spring.Had to take Medicare tested tree times positive for marijuana. The pain management NP said she can no longer write me scripts and never even offered an alturnitive. Methadone is synthic herion if you didn’t know. I’m dealing with tremendous pain and withdrawls and The Albany Center for Pain Management of Albany NY won’t even return my calls or offer any help at all. Our medical system is corrupt. These are the ones that are there to help us and throw us to the street. I always tested positive for the exact script of methadone. I could no longer afford the Zanaflex and acidflex for the side effect of the flexerall. I told my NP at my pain management she said do what ever it takes to control your pain. I now know she was setting me up because I was no longer making them big buck with risky proceedures. I only seen them for scripts. I was told I’m at a medical maximum and medical technology will not catch up with my injury in my lifetime.

  42. I have been on narcotics for 15 yrs now. 90mg morphine sulfate contin, and 40-60mg hydrocodone daily. This is down from what it was. I have been hurt badly enough to get social security. I am a full time college student because I do not want to quit working, I’m only 57 yrs old. I want to try medical marijuana for pain. I smoked it back in the 70’s but quit when my son was born. I am asking for free seeds, I don’t have money to buy them, they are high as hell. Please, if you can, send me some seeds, it will come back to you. I am afraid to go out in the street. Thank You, Paul Nash.

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