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Abnormal UDS results

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I did 6 years of Pain management and now just got a job in ENT 3 weeks ago and loving it.


to answer your question , what do you mean by abnormal UDS?  we normally do UDS every 3 months but sometime I like to surprise them specially the ones I suspect not taking their narcotics. some pt are smart enought to know our routine on UDS testing so I like to randomly test them.


I practice in rural Missouri (high meth area) and percentage wise about 10% would show meth in their urine, very low percentage with cocaine like 5%.  the ones that shows low narcotics has the highest percentage like 15-20% and depending on the situation sometimes we give warning letter, sometimes we fire them terminate their pain contract.

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I am in Washington and my chronic pain patients are almost 85% on THC because it is "legal".


The number of folks who don't even have the prescribed med in their system runs around 10%.


My folks have had a lovely tendency to take their kids Adderall because it "gives them energy" and smoke pot and take their hydrocodone and have positive alcohol in their systems. I ask them how attached to life they are because they seem to be skirting with waking up dead.


I am hating any type of pain management at this point in life and have developed a new hatred for Ambien, Lunesta and TCAs like trazodone. I even ran into a patient who has been on fricking Halcion for 23 years.


It has to stop. There is better living through chemistry and then there is stupidity and denial about living life.


Sorry, bitter ass day.....................

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That's actually kind of reassuring, in that the number of "stable" chronic pain patients in the panel I inherited seem to be consistent with those numbers. I was flabbergasted that people whom we are prescribing large daily narcotics dosages for would risk all that by going extracurricular on us.


But, it appears I'm just a bit naive, and our patients are falling in line with expectations.

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