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Hi, I am from Pennsylvania and have a question about the legality

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Hi, I am from Pennsylvania and have a question about the legality of random drug-screening for prescription medication. About a month ago, I consulted with my doctor about switching a medication I was prescribed (Ritalin) and my family physician suggested Adderall which I tried for a month. On my second visit, while consulting with the doctor on the new medication, he asked me sign a contract and to provide a urine sample since I was taking the medication.

The contract states: “The purpose of this contract is to prevent misunderstandings about certain medications that you will be taking for pain management or ADHD. This is to help you and your doctor follow the laws regarding such medications.”

Next, the contract lists 18 conditions:

1. I understand this contract is essential to the trust and confidence necessary in doctor/patient relationship.

2. I understand if I break any part of this K, my doctor will stop prescribing these pain control/ADHD medications, and I may be dismissed from the practice.

3. I will not get prescriptions for ADHD, pain medication, sleeping pills . . . from any other physician.

4. If I see any other physicans, I am required to inform them of this contract.

5. I will keep regular appointments with my doctor. I will call at least 24 hours in advance if I am unable to keep a scheduled appointment.

6. I agree to follow all of my doctor’s recommendations for diagnostic testing, and management of my condition.

7. I will communicate fully with doctor about the severity of my pain/symptoms, how my pain/symptom

8. I will not use any illegal drugs, including marijuana

9. I will not share, sell ,or trade, my medication with anyone.

10. I will safeguard my medication from loss or theft. Lost or stolen medications will not be replaced

12. I agree to use only one pharmacy for refilling all my pain and ADHD medicines that are prescribed

13. I will not use my pain/ADHD medicine more frequently than it is prescribed. If current therapy does not provide adequate control I cannot change the dose on my own. I must contact my physician.

14. I agree to always be ready to give blood/urine sample. During the office visit I will come prepared to provide a urine sample. I agree to come into the office when I am called to provide a sample the same day I am called.

15. I understand that it is strongly recommended that I never eat anything containing poppy seeds such as, sociable crackers, because this could give a false positive on a drug screening. From this point forward, anything positive on a drug screen will be presumed to be correct.

16. I understand and agree to follow these guidelines that have been fully explained to me. All of my questions and concerns have been answered. A copy of this document was given to me.

Firstly, the doctor did not explain the full meaning of the contract and told me that it was to ensure that the Adderall was in my system and that I was not selling the medication. I do not sell my medication and this aspect should not be an issue, however, I have used marijuana within the last week and am fairly certain I will test positive for it. Ultimately, I understand that in Pennsylvania, using marijuana is illegal but I am interested in knowing how this condition can be imposed by my physician a month AFTER prescribing the medication (he never asked me about marijuana use or warned me against it while taking the medication) I was notified of this condition after reading the contract. Also, I have friends that are prescribed the same medication in higher dosages who have never been tested for drugs- how can one office be ethically obligated and another not under Pennsylvania law? I would also like to know: 1.) Is this contract is legally enforceable? 2.) Are the results of the drug screening are allowed/required to be included in my medical history (or can I object to the inclusion of such information), and 3.) If I were to switch physicians, would my former doctor be allowed/ obligated to inform my new doctor of the drug test results?

Your insight and guidance would be truly appreciated.

Thank you for your question today, I look forward to assisting you. I bring nearly 20 years of legal experience in various disciplines.


Ok. The law doesn't require doctors to enter into these sorts of contracts. So, there is no legal obligation for a doctor to have this contract. That being said, there is no law stating that they can't have this contract, which is why you will see some doctors with a contract and some without a contract. The doctor may have dealt with a number of individuals that are doctor shoppers. To protect himself, should he decide to cease treatment, the doctor has decided to establish this agreement and nothing in law will stop him from doing so.


Now, the doctor prescribed the medication to you, but for you to continue to receive the medication you would be required to enter into the contract. That makes sense, because before that date, the doctor did not know if you were going to be a long term patient. The medication may have proven ineffective or something else may have needed to be done. However, once the doctor decided that he could move forward with you, he decided that he wanted to move forward on the terms of the contract.


The doctor, who is not a lawyer, has no legal obligation to explain the contract to you. That is for you to do for yourself, asking for time to review the contract and even to have it reviewed by an attorney for you, before you sign it.


So, to your questions.


1. Yes, it is. The doctor can legally choose to not work with you, if he wants to.


2. The drug test can be in your medical history, because it is factually part of your medical history. You submitted to the test and if the test is accurate, it is an accurate reflection of your medical history.


3. If you got a new doctor, that doctor is going to ask about prior medical history and doctors you've worked with before. Now, your current doctor would have no obligation to hunt you down, to see where you are being treated. He wouldn't have any legal purpose for that either. However, if your new doctor finds out about your old one, they can discuss your medical history because it is important in treatment, so HIPAA would not stop the sharing of information. The old doctor isn't obligated to find any new doctors you go do, but your new doctor is ethically obligated to try and figure out your medical history, simply because it matters in terms of your proper medical treatment.





Customer: replied 4 years ago.

Thank you for your thorough answer- it was very informative and helpful. I do have one last question- If I switch physicians and have my medical records transferred from my previous doctor to my "new" doctor, wouldn't it be likely that such results be included in the history because he would need to know information on my current prescription- I guess I don't understand how what one physician may consider relevant to treatment (my doctor will not prescribe to patients using marijuana) while another may have no interest in such matters- if it is left to their discretion- how is this information objectively relevant? And my final question (I promise) is: Was I mistaken in thinking that patients had some type of authority in deciding what information a doctor is allowed to include in their personal history? I have had friends claim that they have asked their physician not to include certain personal information and the doctor obliged their request.

Yes, if you transfer to a new doctor, your medical records will get obtained by your new doctor...but only for doctors that you inform him of. There isn't a centralized repository where your doctors are listed, such that any future doctor will know about any past doctor.


They will only know what you tell them, though failing to tell them everything can effect your treatment and if your doctors find out that you are withholding information, they can release you too.


Each doctor has their own license. They are entrusted to make decisions concerning the prescription of drugs. It is not illegal for a doctor to not want to prescribe medications to someone that uses illegal drugs. Nothing against you, but statistics show that those that use illegal drugs are most likely to abuse or sell prescription medication. This doctor may simply not like that statistic and can choose to refuse to work with people that use illegal drugs, even one as common and accepted as marijuana.


Your medical history is a combination of two things....stuff about you and stuff about your doctor. The doctor can include in their records everything they did related to your treatment. That is your medical history, but you are not in control of what goes in it. You can certainly remove a document from it, for your own purposes, but you can't change the medical history that the doctor retains or provides if they are asked for a complete medical history.


Your friends mentioned that their doctors obliged their request. Your doctor may to, but there isn't any legal obligation to scrub your records at your request.

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