PDA

View Full Version : Urine Drug Testing: Q & A



Dr. Joel Nathan
04-01-2009, 12:52 AM
If you have questions on what shows up on urine testing, length of time drugs stay in the system, etc. Ask them. I want to focus on what you'd like to learn.

As an addiction med doc, if you may be getting monitored, the best way to have a ”clean" urine is to not use.

On the other hand....

Over the last 20 years, I've been asked questions about passing the screens. At first, I was hesitant on answering such questions; however, when I worked at the Haigt Ashbury Clinic in SF, they routinely answered such questions.

By answering these questions in a straight forward manner, those who eventually want to stop using can come to me for solutions on abstinence or harm reduction.

Dr. Joel Nathan
04-02-2009, 08:57 AM
If drug screens are used for legal or job related reasons, chain of custody needs to be observed. Make sure the seal on the cup is not broken before you openi it up to give your sample. In the case of urine, someone needs to observe it (eye to urethra as they say). The cup is then sealed in your presence and has your initials and the urine observers initials on it. It is then placed in a plastic bag and sent to the lab.

At the lab, whoever touches the urine sample must put their name on the processing slip. Half of the urine sample is saved for serveral months in case the client wants to contest the results. They have have the second sample retested or sent to the lab of their choice.

I visited one of these labs when I was a substance abuse fellow in SF. For even visitors, they check your diver's license and have you sign in and out.

Dr. Joel Nathan
04-02-2009, 09:20 AM
We're talking "clinical water sports" in a round about way.

Having someone observe you while you give a urine sample is not an easy feat for some. If this is a problem for you, you could ask if they'd stay behind you so you can't see them.

I knew someone who drank a pint of orange juice an hour before testing to make sure their bladder was full.

In one methadone clinic, I worked in, the person would to in the bathroom alone but there was a one way mirror in there so they could be observed. They knew that they would be observed?

I've heard urine collectors say, "We'll have to catheterize you if you can't give us a sample." This just gets people fearful; however, the fear may lend itself to flow.

Although I was not observed, after a recent hernia operation, they would not let me leave until I could pee. I tireid twice to go. On the third attempt, the nurse, who had been there for 'eons" said " just let your urine go on it's journey." When I went to the bathroom and pictured "this journey," the river flowed " and I was promply discharged!

If anyone has eperience with how to pee more easily when observed (and I'm not talking about "golden showers"), could you lend us a hand?:cool:

Dr Pangloss
04-02-2009, 10:07 AM
Great stuff. In the literature they call this, "shy bladder syndrome," i believe.

Dr Pangloss
04-02-2009, 10:10 AM
Joel, it's not exactly what you're talking about, but i feel pretty confident these people would fall into the group that can't pee when observed...


1: J Anxiety Disord. (javascript:AL_get(this, 'jour', 'J Anxiety Disord.');) 2006;20(3):296-311.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--linkinghub.elsevier.com-ihub-images-PubMedLink.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3048&itool=AbstractPlus-def&uid=16564434&db=pubmed&url=http://linkinghub.elsevier.com/retrieve/pii/S0887-6185(05)00046-0) Links (javascript:PopUpMenu2_Set(Menu16564434);)

Is "shy bladder syndrome" (paruresis) correctly classified as social phobia?

Hammelstein P (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Hammelstein%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Soifer S (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Soifer%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Department of Clinical Psychology, Heinrich-Heine-University, Universitaetsstrasse 1 (Geb.23.03), 40225 Duesseldorf, Germany. [email protected]
Paruresis manifests in an inability to urinate in public restrooms followed by a considerable avoidance behavior. According to DSM-IV TR this disorder is classified as social phobia. A sample of N = 226 subjects completed different questionnaires concerning paruresis, social phobic symptoms, lower urinary tract symptoms and depressive symptoms. These individuals were divided into four groups: no symptoms, suffering primarily from paruresis, non-generalized social phobia and generalized social phobia. The paruretic group differs significantly in all symptom variables from both the non-generalized and the generalized social phobia groups. Regression analysis separated by groups shows that the interference with everyday life can be mainly explained by paruretic symptoms (in the paruretic group) or by social anxiety and depressive symptoms, respectively (in the social phobic groups). These results question the classification of paruresis as simply being a form of social phobia.

Dr Pangloss
04-02-2009, 10:24 AM
one paper on treatment. Doesnt look like an easy solution:

1: Harefuah. (javascript:AL_get(this, 'jour', 'Harefuah.');) 2000 Jun 15;138(12):1021-3, 1087. Links (javascript:PopUpMenu2_Set(Menu10979423);)

[Psychological treatment for paruresis (bashful bladder)]

[Article in Hebrew]


Elitzur B (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Elitzur%20B%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Psychiatric Clinic, Ichilov Hospital, Tel Aviv Medical Center.
Paruresis, or bashful bladder, is a functional disorder that involves inability to urinate in the presence of others. The symptom meets the DSM-IV diagnostic criteria for simple phobia or social phobia. Although the prevalence of paruresis is relatively high (7% in 1 study and 32% in another), there are few reports of its treatment. The treatment of choice presented in the literature is cognitive-behavioral. We describe a multidimensional model used in treating 3 men who suffered from paruresis. Promotion of relaxation, mental imagery, paradox, gestalt, metaphor, cognitive-behavioral and psychodynamic techniques were used. After 5 treatment meetings, 2 younger men, 18- and 24-years old, respectively, were able to overcome the condition, while a 50-year-old got only partial relief.

swingslammer
04-02-2009, 10:55 AM
Had to take a urine test this morning for the Army, having done it soooo many times for that makes it easier to do for drug tested contest. Man when they start calling out names you just stand there saying "Not me, not me"....and then "DOHHHH!!" Just not fun to have all they guys you work with day after day stand there and "Observe" you pee, which is pretty differant than just by chance being there while you pee.

Dr Pangloss
04-02-2009, 10:58 AM
Had to take a urine test this morning for the Army, having done it soooo many times for that makes it easier to do for drug tested contest. Man when they start calling out names you just stand there saying "Not me, not me"....and then "DOHHHH!!" Just not fun to have all they guys you work with day after day stand there and "Observe" you pee, which is pretty differant than just by chance being there while you pee.


I will remind everyone also, this is comming from a bona fide swinger, with pics to prove it.:D

It's not easy to pee in front of people. this is a pretty common problem, from what a few papers have said...