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Jim's Mailbag
Hey Jim;
When disabled veterans have their yearly lab tests done (blood & urine) for diabetes does the VA...
A. Check to see if you have your prescribed meds in your system?
B. Check for illegal drugs in your system?
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Jim's Mailbag
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Reply;
You may be referencing routine lab work (blood tests and urinalysis) during physicals that may note high blood sugars as well as high cholesterol and many other abnormalities.
You may at that time be checked for illegal drugs. That is almost accidental because sometimes VA does check you for legal drugs. Here is how it works...
That agreement tells your doctor that you will only take the narcotic strictly as prescribed and that you won't share it with anyone else. It will also say that you agree to take a drug test to see if there is a therapeutic level of the drug in your system. These tests may be random or scheduled.
There has been an infrequent problem that patients will use their narcotics to turn a profit...they may sell the pills to others. If you are tested for your particular drug and you do not have any of it in your system, you'll have some explaining to do.
For example, if your prescription says you are to take 3 pills each day for your pain and you have none of the medicine in your blood or urine, that would indicate that you haven't taken the medicine for days and that you probably don't need it.
When you are tested, the most frequent test is by urinalysis. Each test kit has a cost associated with it. There are different types of test kits that detect different types of drugs. The lower cost testing supplies usually test for 4 drugs at the same time. Other kits will test for 6 or 8 or more. As you would guess, the more drugs detected, the higher the cost of the kit.
Beyond all that, to my
knowledge veterans are not routinely tested for illegal drugs. The
expense alone would be huge and in a more or less routine circumstance,
testing of all patients at a given facility may show that hundreds or
even thousands were using marijuana. The question of "What then?"
arises. Once VA identified all these veterans what should they do?
There are instances where mental health patients who are taking
psychotropic drugs will be tested to ensure that they are not taking
illegal drugs. That's a very serious situation as the mental health
patient can negatively affect the treatment plan by mixing their
prescribed medicines with recreational drugs. Patients who are
candidates for organ transplants may also be counseled (and tested)
about using recreational drugs because of the amount of anti-rejection
medicines they are likely to be required to take.
VA has
recently issued a policy about the use of marijuana by patients. State
laws regarding medicinal marijuana are changing across America but
federal laws aren't. VA is a federal institution and must walk a fine
line between condemning the use of marijuana or endorsing it.
What they did in the policy statement was to leave it up the the
individual treating doctor as to how to handle such a thing. VA will not
allow doctors to prescribe medicinal marijuana but your doctor can
pretty much ignore your use of it if he or she doesn't see a problem.
If your doctor believes that you have a conflict with the use of
prescribed medications and smoking marijuana, you may be instructed that
you must make a choice of marijuana or prescribed medications. That is
strictly a therapeutic decision by the provider and little appeal is
available should it happen to you.
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The New York Times Report
http://en.wikipedia.org/wiki/Drug_test
Much of the testing in both civilian and VA and military settings is
done with a standardized 4 drug detection kit. The test of your urine
would show the presence of narcotics (Vicodin, Oxycontin, morphine,
etc.). marijuana, cocaine (or crack) and amphetamines. In some tests
benzodiazepines (Valium and similar) may be detected.
Therefore, if you are tested to ensure that you are taking your
prescribed medication and you have been smoking marijuana, you'll likely
get a call from your doctor.
The Pain Contract
Your VA and many civilian providers today will insist that you sign a "Pain Contract" if you are on any sort of pain medicines for more than a very brief period.
The reasoning behind this is controversial.
There is a common misconception that veterans who receive any sort of pain medicine are likely to resell it at a very high profit. Like most of the rumors that are published about the American "War On Drugs" there is little truth to this.
The majority of veterans who receive pain medicines from VA are just like you and they have no reason to want to sell their medicines. The bulletins would have you believe that every pill is worth an enormously inflated price and that vets can get rich by selling their medicines.
The result of all this is that you are likely to be tested to ensure that you're taking your medicines. Once you sign the pain contract you give VA the authority to test you at any time. They are not required to tell you that you're being tested for drugs.
If you aren't taking your drugs at the time of the test, your provider may not extend any more refills.
If other drugs (such as marijuana) are seen during the test, you may or may not be counseled. That depends on the individual provider.
The Pain Contract
Pain contracts threaten the doctor-patient relationship
Pain contracts can undermine patient trust
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