Do psychiatrists drug test?

Psychiatrists may drug test prior to providing a diagnosis and treatment plan for a patient. But there is no single standard. In fact, drug testing during psychiatric treatment may be mandated by a court or is based on personal doctor choice. More on psychiatrists and drug tests here.

minute read

On occasion.

Patients routinely share private information with an outpatient psychiatrist in exchange for advice and treatment. However, when a patient is asked about illegal drug use, or when a psychiatrist requires drug testing, matters of trust naturally emerge for both parties.  So when do psychiatrists drug test?  What can you expect and do about it?

More here on the questions and concerns you may have when faced with a required drug test for psychiatric treatment. And we invite your questions about drug testing during psychiatric treatment here.

Drug Testing during Psychiatric Treatment is the Doctor’s Choice

Just as hospitals do not have a single standard for drug testing nurses, psychiatrists have no single standard for drug testing patients.  With the exception of inpatient facilities that require drug testing, or when testing is mandated by a court order, patients who elect treatment always retain the right to refuse a drug test.  In most cases, the decision to test a patient for illegal drugs is made at the discretion of the psychiatrist (much like random drug testing pain management doctors order). Some practitioners elect to make drug testing a standard policy, while others make the decision to test on a case-by-case basis. Ultimately, each practitioner has the power to establish and enforce required drug testing prior to providing a diagnosis and treatment plan for a patient.

For those who may be inclined to refuse recommended drug testing, consider the points we make here to ensure your decision is based on factual information rather than common misunderstandings.  There are two main reasons why psychiatrists might order drug tests.

Reasons Psychiatrists order drug tests

1. To provide safe, suitable psychiatric care

The main intent behind a requested drug test is to become properly informed about a patient in order to provide safe, suitable care and support the interest of a patient’s mental and physical health and well-being.

2. To meet medical standards, probation requirements or personal policy

Psychiatrists who enforce mandatory drug testing are taking a “better safe than sorry” approach to ensure their treatment is effective and not exacerbating symptoms or creating new ones for patients who may deny active drug use. This chosen policy is upheld to every patient seeking treatment as a protective measure for the patient and the psychiatrist.

Myths About Drug Testing and Psychiatrists

Some common misconceptions patients have about a psychiatrist’s motives for requiring drug testing can lead to unfounded complaints and concerns. More importantly, a lack of understanding can result in drug treatment being delayed or declined outright.

In some cases, patients who are drug free dislike the insinuation that drug usage is contributing to their symptoms. In these cases, a patient could conclude they are unfairly mistrusted. Furthermore, mandatory drug testing could create resentment for patients who perceive they are being suspected of criminal behavior. Despite common beliefs, psychiatrists do not set out to designate patients as criminals. Instead, a drug test is actually a way that psychiatrists help diagnose potential problems.

More commonly, patients whom may benefit from drug treatment resist the idea of testing due to fears that detection of illegal drug use will get them in trouble with the law or lead to someone like a parent, spouse, or employer finding out. But this is not true. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 protects a patient’s personal health information, keeping it strictly confidential. When drugs are detected, the psychiatrist is under legal obligation to maintain privacy unless the drug test is a legal mandate as result of a court order.

There are some exceptions, however, to the protections provided by HIPAA, such as when the patient is a minor. Parents have the right to access the medical records of a minor child when they give consent for their child’s treatment. If parental consent is not required, psychiatrists typically will not disclose drug use to parents without the minor’s permission. However, most practitioners will encourage minors to talk with their parents when doing so will lead to better management of their drug treatment.

Understanding is key to psychiatric treatment

It’s natural to feel uncomfortable when put on the spot to discuss secret behaviors, and the fears associated with getting in trouble can understandably lead to a protective stance. Patients can choose to protect themselves from trouble or shame, but they should first consider if such a strategy is even necessary. It’s important patients know their rights when it comes to drug testing, and psychiatrists should always encourage and welcome patient questions in cases of uncertainty.

Stay tuned for part two of this series, which will reveal crucial insights into why psychiatrists require drug testing, and why being tested should be the least of a patient’s worries.

Psychiatrists drug test questions

Do you still have questions about drug testing during psychiatric treatment? Please leave your questions here. We will do our best to answer you personally, with a prompt reply.

About the author
Clearview Treatment Programs provides highly individualized treatment programs for people with psychiatric disorders, alcohol and drug addictions, and dual diagnosis. Clearview operates the Clearview Women’s Center, which is specifically designed to address the symptoms of psychiatric disorders, including Borderline Personality Disorder and other disorders related to emotional regulation.


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  1. If there is too much of the prescribed medication in system will psychiatrist quit prescribing that medication

  2. Hello all….if you are transferring from one psychiatrist to another psychiatrist, and only took medication like wellbutrin and vistaril, non narcotic medication, will you new psych do a drug test on the very first visit..or what they call a intake visit..????? I have been at the old psych for 2 1/2 years with no problem, and no issues….The new place is really just a social worker, and a person that gives you your medication every month…

  3. Hi,
    I was arrested for a DWI misdemeanor. My lawyer suggested I take a urine test to prove to the court that I’m no longer drinking or smoking. He suggested I go to a psychiatrist that will charge me $850 for the test. My question is: Can I go to my normal psychiatrist and get the urine test for my DWI done there? Can only certain psychiatrists perform the test on you? I’m from new York if that helps.

    Thank you

  4. Does a patient go to a psychiatrist, in an outpatient setting, have to give cobsent to taking a drug test? And, or is it allowed to mislead the patient when they ask about they are being tested for to get urine for a drug screening?

  5. Do the doctors lie or tell you that you’re only being tested for a particular test? In other words if I’m being drug tested for cholesterol levels and they also need a urine test will they also test for drugs?

    1. Yes! They told me that they were checking my DEPAKOTE levels (via:drawing my blood) and did a drug screen! Didn’t ask my permission or tell me that I was being tested! I was new to their practice and it was only my 2nd visit there!!

  6. Hi Madison. The drug test may be a requirement that is part of the student health center protocol when someone is seeking help. Likely, students who have reached out for help in the past may have left the clinic with a combination of drugs in the system…and then may have done something drastic. Usually, procedures such as this are a legal precaution. You can consult your health center’s legal department for a more accurate response.

  7. Hi,
    I’m a college student and we have a student health center on campus. I went to see the psychiatrist on campus a few weeks ago for my anxiety and sleep issues. I told her how I had been feeling anxious lately so she prescribed me something to help with that. Before I left she told me to head to the lab waiting room. When I got there they asked for a blood sample and urine sample which I had no problem with. The issue was I had used the restroom right before I went to the doctor so I physically could not go to the restroom to give a urine sample. I tried multiple times I just couldn’t go! And they told me they could not let me leave until I gave a urine sample. They held me there until I gave them one. Why did they do this? I went to the doctor on my own free will because I was feeling anxious and they held me there because I couldn’t give them a urine sample?? I was so confused could you explain why they did this and why they’re allowed to?

  8. I have been seeing a physiatrist for depression for about 5 years. After about 5 urine drug screens the doctor found out that my medicare doesn’t pay for them. So now they are gonna make me pay for the test and they doctor charges me 75.00. I am on social security income I cannot afford the 50 dollar co pay at his office and now about every 6 months they ask me for a urine drug screen. The doctor has has the cup in his office. I notice that that once in awhile he asks everyone at the same time I am thinking he is doing this to get extra income when he needs it. Why doesn’t my medicare pay for the urine drug screen. Can I tell the doctor I cannot afford it? if my medicare doesn’t pay for it. ??

  9. I have a friend who was recently drug tested by her therapist. without parent permission, her therapist was in the room watching her pee into the cup. My friend said it made her uncomfortable and when she asked her therapist to turn around she wouldn’t. My friend is only 13. Is this legal?

  10. CP
    I feel like I just went through this today. I’m so scared if I fail, only marijuana, but.. If I fail I’m thinking my Clonazapan mass my vyvanse. Two weeks them I have to pass. I’m thinking of looking other places

  11. I have changed doctors, today was our first appointment. I talked Clonazapan as well as vyvanse. I told them if not pass because of marijuana. So I probably won’t pass in two weeks either. If I do fail the drug test. Are the results just effecting my Clonazapan. Or is the vyvanse also a matter of passing a drug test. (I cannot get vyvanse filled for me ever? Because that’s so unfair. To up and scare me like this, is really scared. Just to think a great drug that is an incredible must for my everyday life. What should I anticipate

  12. I smoked @2 joints of marijuana total in the last 3 weeks. I’m on Klonopin for bipolarity and just received a “take a urine test within thirty days” order. I’m not habitual but am about to go into a custody battle w/a practicing alcoholic (irony doesn’t escape me)–can his lawyer subpoena my medical records from my psychiatrist should I fail my test in three weeks? I smoked it in DC, where it’s legal. Anecdotally, years ago when I smoked habitually, pot decreased my mania, depression and helped me sleep.

  13. My reg Dr did drug test and failed. I did not have knowledge of test or sign a document. Went in for bladder infection. Then went to shrink and nurse threw document in front of me. Said it said they would not replace my zanax if lost. I signed. The shrink said I signed approving drug test. Failed. Now shrink says says no longer will prescribe zanax ever. No longer trust. Explained to her I no longer trust her. Asked to drop new urine which I would pass and she refused. I went to another shrink. Reg doc now not treating my acute pain because of positive urine. Is this wrong

  14. I am a 62 yr old female who has been diagnosed with a chemical imbalance causing depression. I have never used drugs or alcohol. My psychiatrist has all of a sudden started requiring an urine test from every patient every time they see the nurse practitioner. I see her at least every 2 months. I refuse to give it because I don’t think that Medicare/Aetna should have to pay for something that I don’t need. Am I right in thinking this?

  15. So a while back I used to take Vyvanse and Klonopin for my ADHD and anxiety. One weekend I ended up doing coke in moment (stupid stupid mistake I know I regretted it immediately please don’t judge me for something I did on impulse) and the following week my psychiatrist asked for a drug test. It did come back positive for cocaine and ever since then she took me off both vyvanse and klonopin. I’ve gained 40 pounds and my grades have gone from As to Fs because of how hard it has become to focus in classes with 100+ students everyday. If I were to go to a different psychiatrist and ask for them to put me back on at least vyvanse would they be allowed to do that or would my other psychiatrist tell them about my positive drug test?? I feel like they wouldn’t because of Doctor-patient confidentiality but I don’t know. All I know is my grades have just been getting worse and being unmedicated is becoming a big problem health-wise for me and is starting to affect my personal relationships as well.

  16. Regarding the privacy issue: Can psychiatrists share the results of a drug test with the Social Security Administration or lawyers working for a client attempting to obtain SSI/Disability on the basis of mental illness? Or is this private information between the patient & doctor? (Assuming the patient has no legal issues & is over 21).

    Drug tests often provide false positives & I would hate for this to interfere with my ongoing SSI case. I attend a state-funded clinic and am likely going to be put on (Schedule II) ADHD medication soon, so there’s the possibility of a drug test. I take a lot of supplements & legal OTC meds that are known to cause false positives (Benzedrex inhalers, CBD, ibuprofen, etc). Not sure whether to agree to a drug test or refuse on the basis of my Disability case. My appointment is next week so this is kinda urgent!

    THANK YOU in advance!

  17. I am a minor my doctor hasn’t for the past few times but I’m always safe than sorry but what is the likely hood I will be tested by them for marajuana

  18. Do psychiatrist test or have the right to test for illegal substances including marijuana in wi if u r not on controlled substances?

  19. UDT baseline testing is strongly suggested or required prior to drug initiation therapy or for medication adherence or non-adherence for safety and efficacy.

    Medicare guidelines for testing are based on medical necessity for low risk, medium risk or high risk patients.
    The challenge for Providers is to overcome patient fears and reprisals and confidentiality. Discussion with patients regarding UDT should be done in a sensitive manner and that UDT is a tool for providers or BMHS to initiate appropriate drug therapy for a good patient outcome (efficacy), and possibly to mitigate overdose or death from drug to drug interaction.

  20. Im just curious if substances like amphetamines whether licit or not affect levels of the metabolic panel tests for example causing certain levels such as blood glucose to read much higher than normal

  21. I’ve been with my psychiatrists office for 10+ yrs and on the 3 meds at high doses for at least the last 5yrs. The meds I take are dangerous to stop cold. I was recently drug tested, 2nd time ever. I got a certified letter saying 1 of my prescribed meds were not in my system and that marijuana was. I went where I had my blood test done and got a copy of the results which showed the marijuana in my system and it showed my prescribed med was indeed in my system. I took the copy of results I was given which showed my med positive 1st, and the marijuana positive further down the page, to my doctor office in an attempt to fix this. When I showed them I had the results they then said they were actually terminating me over the marijuana. Can they really do this? Just drop me with no warning, my next appointment is in 7 days and my meds are dangerous to stop. They didn’t send me to another doctor. They wouldn’t even give me a chance to fix the issue & be re-tested. After all these yrs. I live in WV and have WV medicaid/medicare their office is in Ohio I can’t help but believe this has something to do with it. I do not know what to do I’m terrified and so anxious right now.. Please tell me if theres something I can do.

  22. I have recently sought help from a psychiatrist and I was open and honest with her about everything. I am 55 years old and took up smoking a little bit of marijuana before bed – at home, in the last 6 months or so. It helps me sleep and I like the thoughts that come to my mind. For an hour we had a long discussion about how difficult my life has been and I felt she and I connected. Then 5 minutes before I left she said she wouldn’t be comfortable treating me as long as I continued to smoke marijuana. I am super conflicted by this. I have my 2nd appointment in 6 weeks. I haven’t stopped my minimal marijuana use. Maybe after I run out I won’t get more but since I don’t use much at all it may last another month or two. Should I even bother going to my next appointment? I almost feel betrayed that she used this against me – already. It’s really hard for me to reach out for help and trust someone and this just has me twisted up.

  23. If you absolutely can not pee with a stranger right beside you and you are being drug tested where it was causing you several anxiety and embarrassment what can do to get the doctor to agree to get them to test you in any other way but through urine!?

  24. And BTW, Christina, you’re absolutely right, that is not okay. I work with several attorneys and checked with a few to get their take.
    All of them agreed, the doctor could more than likely be sued AND the frequency with which he’s testing is not only excessive,
    he could be reviewed by your state’s medical board. Many physicians are really taking advantage of people who’ve repeatedly tested
    negative and are patients with some history with the doctor. Monthly testing is NOT within the recommend guidelines and because
    some doctors are getting away with excessive testing and excessive fees for testing, the whole system is becoming rampant with abuses.
    Not many people can afford monthly testing and insurance which covers testing is no excuse for excessive testing. It’s very possible
    your doctor is getting kickbacks for every pt they test with the contracted lab. NOT OKAY.
    (Is the lab by any chance Aegis? If so, I’d bet the doctor and lab are profiting at your expense… And the expense of all the other pts. )

  25. I’ve never been tested. That said I’ve seen the same doc for 15 yrs.
    I went to a pain mgmt doc for 17 yrs and the first time he wanted to test me I quit his practice because
    #1 opioids are NOT a part of my treatment Also, I don’t do illegal drugs, divert, or abuse prescriptions.
    And #2 the test was going to be over $2,000.00!
    Doctors, labs, the DEA, and policy makers have their heads up their asses!
    They’re cresting a bigger black market and adding to the much bigger (than opioid) problem of patient suicide.

  26. My psychiatrist drug tests every mth. I am okay with this but what I am NOT okay with is that it is supervised, but only for women. Since it is a female lab worker every mth the men just go into the bathroom unsupervised.This can’t be right! I am a standard patient, with no court order or anything of the sort. When I protested they agreed to a swab but refused the following mth. What would I need to do to change it to unsupervised or to request any other kind of test? This seems so invasive and very much like discrimination.

  27. Yes hi, I was recently given a random drug test at my psychiatrist office. She said that my first speciemen was unclear and could of been tampered with so that they would watch me for my second one. The little nurse girl came into the bathroom with me and stared at my groin the entire time i gave a second sample. I feel that was wrong and need to get some advice if that was legally right.

  28. My psychiatrist currently prescribes me Kolophin for my anxiety. I get a very low dose and most of the time they don’t help at all. So I started smoking pot…now he wants me to come in for a drug test. I’ve passed all my past drug test but this time I won’t. Will he take me off of my kolophins? If so, is that bad to take someone off their medication cold turkey? I’m so worried

  29. I am a recovering addict. I been seeing the same psychiatrist now for about 3 years. My doctor was random drug testing me which was a urine cup test. We didn’t know it but all the tests that I did take medicare would not pay for them. Now I owe the dr for every urine test I had. I wonder why Medicare want pay for it if the doctor ordered. it.

  30. I get flurazepam remeron strattera from my mental health dr in Indiana I was not asked if I wanted to be drug tested and sign a consent that I didn’t get a copy of and whose letters were to small to read in a minute or two if I refuse next time will I be dismissed from treatment lose the dalmane. Or all my medications can they now fire. Me as a patient I am not ok with being drug tested and the reasons you give are ludicrous criminal arrested persons are presumed innocent your house cannot be entered without a warrant and probably cause to obtain warrant they are drug testing for one reason only to see if illegal drugs are in the patient or to see if the patient is selling or abuseing their controlled substance get real……

  31. Does a Psychiatrist have to ask for my permission before drug testing? I found out by accident that she diid.

    Also, is it okay for my psychiatrist to tell my PCP that she won’t see me anymore because I smoke pot? Isn’t that confidential? Btw, I quit months ago.

  32. Is it legal for a prescribe to ask for a drug test to get klonopin or is it a law that u have to take a drug test to keep the klonopin???

    1. Hi William. If you believe that klonopin is the right medication for you, then speak openly with your doctor.

  33. I just had my first visit with a new psychiatrist after 3 yrs of no treatment for adhd. Lack of treatment has exacurbated stress and anxiety, frustration due inability to focus and manage my time and tasks efficiently. Its also an FMLA approved condition with my employer who has access to all condition-related treatments, tests, etc.
    I saw my previous psychiatrist every month for nearly 3 years and was prescribed meds to help with my adhd symptoms. No blood work, no drug tests. Just trust and monitoring monthly and the treatment worked quite well for me.
    The new dr was not interested in 3 years of drs notes on my previously diagnosed adhd. He spent over 90 minutes asking me whether i have certain symptoms only to interrupt and correct me when i would try to explain my similar symptoms.

    “Do you get by with very little sleep and wake up energized, not feeling tired all day?”
    “Yes. For 6 months now I get about 3-4 hrs of sleep and its hard to get up but once i am, im not really tired all day. Maybe a little at night, but….”
    “no, no, no. That is not mania. I mean does this happen all the time for days in a row, [repeats what he asked before]”.
    “Who the hell said anything about manic depression?”, i thought to myself. So i would try to explain my sympoms again and hed interrupt again. It was extremely aggravating.

    I dont care about definitions of specific disorders, dr. Im here to tell you my symptoms, not to have you tell me what my symptoms would be if i had a certain disorder. It was crazy.
    Finally he stsrts to wrap up and says he wants a full blood panel and urinalysis. What? I had blood work and a urine test just over 12 months ago. I have a family, kids, a good job, etc. I just cant manage my anxiety and idk if it stems from my untreated adhd. He wants to make me wait 6-8 more weeks to see him once i do these tests and a neurological test for adhd. That one im fine with. But after 90 minutes of him telling me my symptoms are wrong for conditions HE brought up, not me, i havent been able to tell him my story- how this has progressed- over the last 6-9 months and is literally destroying both my professional and personal life!

    Is this common for a first interview? Because my last pyschiatrist talked to me. He asked then listened and took notes. Thats it. I trusted him for that and he trusted i was honest. Because i have no reason not to be! I never gave him any indication i was kying, hiding something or abusing meds, nothing!

  34. According to Medicare only medically necessary drug testing will be reimbursed. I visited a new psychiatrist, the only clinic in town and was drug tested. I needed a continuing prescription for Lithium, no general practitioners would prescribe. I have taken Lithuim for 22 years prescribed by excellent psychiatrists. I also take Cloazepam, PRN, about 1 a month. Both drugs clearly required per my former doctors. The new psychiatrist, insists on regular urine drug testing. The initial screening included: Alkaloids, Acetaminphen, Nicotine, Doxepin, Nortriptyline. I don’t smoke, I have never been prescribed antidepressants, have never been treated for pain. I see nothing in this urine drug test that is applicable. The “abuse” clinic does their own urine testing and insists on regular, frequent testing of everyone. And yet proper monitoring of my Lithium level has not been done. I find the drug testing to be degrading and completely inappropriate. In fact I will be reporting to Medicare regarding unnecessary urine drug testing.

  35. Having moved, I am seeing a new psychiatrist for a bipolar disorder. I have been taking lithium for over 20 years, and clonazepam as needed, average intake is 1-2 pills per month. No general practitioner would prescribe lithium. Only one psychiatrist in town in a clinic focused on drug abuse. I was given a urine test before seeing the doctor–tested for Alkaloid, tylenol, nicotine, doxepin and nortriptyline.–none of which I take. Many years of history with a psychiatrist, never an issue of drug abuse, never on anti-depressants. Medicare paid for the urine test, which is supposed to be medically necessary and which I do not believe it was, and the doctor wants to continue urine tests. I stopped taking clonazepam hoping that would stop the testing which I find so insulting and degrading and inappropriate. I see no clinical value in the urine testing that was done. This medical office does their own urine testing?$$$

  36. My name is Kat and I’m 17. I just recently started going to a psychiatrist and I had my second appointment 4 days ago. My psychiatrist informed me that he was going to drug test me during my third appointment, and to be prepared for the test. I’m 4 months away from being 18, but nevertheless, I’m still a minor. My parents will not be attending the third appointment with me, if that matters at all. Is my psychiatrist allowed to tell my parents about my results, especially if I fail? Is he required to put it in my “records” that they can access? Is there anything I can do to prevent him telling them?

  37. My 22 yr old son away at university went to psychiatrist for anxiety and sleeplessness.
    He was prescribed seraquel and zanex.
    He died a week later.
    There were traces of other drugs in system
    Why wasn’t he required to take blood test being that he was so young and possibly experimenting with other drugs.
    Cause of death was from accidental over dose.

    1. Hi Mother. I’m really sorry for your loss… Words fall short of expressing my sorrow… I believe that the psychiatrist asks questions about consuming other medications or drugs before prescribing anything, but psychiatrists have no single standard for drug testing patients.

  38. I have never done drugs but I do promote the medical use of marijuana. My therapist asked me for a test & I gladly pissed in the cup b/c I am always pride ridden to prove myself clean. This time I had confounding results. I haven’t been smoking weed but I stay in a living situation where other people around me do. I came positive for that. Even worse benzo’s which I knew I had been feeling sick. This is a new therapist for me so I’m nervous that she has the wrong idea about me. I disputed the results & demanded a retest but I’m in the same living arrangements for right now & I’m not expecting any different. Also, I fear that someone has poisoned as to sabotage me purposely w/the benzo. I’m deathly allergic to like every thing un natural. She didn’t seem to think it was a big deal & sort of indicated I could get the benzo for my depression & I can’t understand where the logic is that I would use my money to buy benzo on the street when I could get it free with my insurance. I’m not that dumb. She thinks I told her I currently use marijuana but I didn’t say that. I said I tried to get some from my roommates but they wouldn’t. I’m scared. What’s the next step? I don’t want any drugs!

  39. Is drug testing mandatory for a patient with only one self admission for suicidal tendency. Schytsofrenia disorder no drug or alcohol issue?

    Is group therapy mandatory for this outpatient? Three times a week for 4 hours a day?

    Patient has a psychological therapist and goes twice a week also.

    They have a life and responsibilities all this adding to stress not helpful

  40. The TRUTH is I have not used any illicit drugs since 2008. My psych prescribes 3 “scheduled” drugs-including suboxone. I was his patient for 10 years. My December appointment can’t form to me he’s retiring and his associate is taking his patients. I was very fearful of what would happen to me and my medications & there are three other stressful events going on in my life. I guess I just went back to my original coping tool-going numb, I used cocaine with my uncle. 3 days later I met with the new psychiatrist and was given a drug test. My results come in 2 days and I’m scared. I don’t know what to say. My first instinct say the test is false! But I really am OK now that I met the doctor and he’s nice. That anxiety is gone. I have no intention on using again. I did not enjoy it. I don’t meet with my therapist for three days so I’ve been holding this in. Any advice? I don’t want this doctor to banish me from his practice. What do I do?

  41. I would very much appreciate guidance in regards to a recent experience at a doctor’s office that left me feeling humiliated and mistreated. Mainly – does a doctor (psychiatrist’s) right to drug test at their discretion apply to prescribing non-controlled medications – i.e. prescriptions that are not classified in any of the schedule I, II, etc., specially monitored categories? I was – the best way I can describe it- “strong-armed” into taking a supervised urine drug test at the conclusion of my first visit to this office, where I saw the doctor’s nurse practitioner for about 20 minutes. I asked why I needed to take it, but the only explanation they would give is “everybody does.” I conveyed to them my concern over the test potentially being costly, not knowing how much, if any, insurance would cover – especially if there was no medical “reason.” I had just been laid-off after the small business I worked for was sold, and I clearly expressed that something not covered by my insurance could be a significant financial burden. Then things got creepy: I didn’t know the test was “supervised” until I went to close the bathroom door, and the nurse stopped me and told me she had to watch. At this point, I got more than a little uncomfortable and frankly, I was stunned that it was being taken to a level I’d imagine for parolees, not patients. To add to it, the door was open about two feet as I was taking the test, and I saw a man walk right behind the nurse with a clear view right into the bathroom. Oddly, on top of my standard $30 co-pay, I was charged $50 due to my saying my insurance might not cover the test costs. Weeks later, I got the bill in the mail for the drug test, owing the whole cost of $275. What seems especially weird is that the test was not done by the doctor’s office, but a company called Lab Corp. – so, why would I have paid an additional $50 to the doctor for the test? The whole experience was terrible and I left feeling humiliated, and potentially swindled. So, are there any restrictions on drug tests being administered at a psychiatrist’s office? Do they usually test just when giving people controlled or potentially abused medications, or is a patient like me who’s being prescribed non-habit forming, basic Rx’s equally subject to being tested? A little over $350 bucks spent for the visit and the drug test…for $8 of medication. Seems absurd. Any specific advice/guidance? Help would be much appreciated.

  42. My psychiatrist is ordering me to take a drug test. I would be clear for any illegal drug but I do not take my prescribed xanex and adderal. It says in a letter they will be testing for those prescribed to be in my system. When should I start taking them so I can test positive. & can they test my urine to see if I’m taking prescribed amount or can I take less.

  43. hi guys, I am a 53 year old male and I attend a mental health clinic voluntarily. I was recently told that they would be drug testing me after 3 years of treatment. I have a severe appetite problem which for the last 90 days or so, I have been smoking marijuana. when I confessed this to them, they said if I didn’t pass the drug test they would stop writing me clonopin. btw I have lost 120 pounds, unintentionally. I also suffer from debilitating panic attacks. why would a doctor make this threat when he knows the marijuana won’t be out of my system yet. the test is next week , I have agreed to stop smoking but the threat still stands. how can a doctor do this to a person who suffers from ptsd, panic disorder, childhood abuse, and many others. I have always had a good relationship with everyone there, I don’t get it, if he cuts out the clonopin, anything is possible. I’m trying to help myself but am I supposed to starve to death. I know of no other appetite stimulant that works. please help, I am in a very dangerous situation, I feel my life is in danger. also, there will be no weening, this is only for marijuana, I can’t believe this is happening.

  44. Can a psychiatrist or therapist legally monitor (as in watching you pee) without the UA being court ordered?

  45. “Just recently I was drug tested at my doctors office. I tested positive for meth. Now I have no doctor and I am untreated for my mental issues.”

    Hey there Nicholas. I was just moved by what you posted and wanted to say that I hope you’re able to find adequate care. It shouldn’t matter what other drugs you’re using when related to psychiatric medications. Stopping them suddenly could result in extreme side effects and even awful mental thoughts- any psychiatrist that’s adequately trained should know this. I just can’t believe this happened to you…

    Best wishes,
    Jar Jar Binks

  46. I have been taking amphetamine for add for the last 20 years (14 with my last doctor). Just recently I was drug tested at my doctors office. I tested positive for meth. Now I have no doctor and I am untreated for my mental issues. I will not take another drug screen ever again. so it looks like I will not receive treatment for my illness ever again. I will agree to drug screening when its mandatory for doctors, cops, judges, and all forms of political office (including the President) to take drug screens as well. I too can argue the merits of drug screening these people. If they don’t like they can suffer as I am now. Until then I hope I don’t make it in the news like others with untreated mental illness have. I am not a criminal . I should not be treated as one.

  47. Hello Taylor. The price of drug testing varies according to the type of test and the drugs involved, but generally the cost is between $10 and $30 per test, with hair testing somewhat higher. The price for onsite alcohol tests usually ranges from $1 to $10 per test.

  48. If I would like to get a drug test to prove to my parents I’m clean can I request to get them regularly? Also, how much do they cost?

  49. My son was recently told that if he fails a drug test for marijuana the next visit. He will go to jail. This came from a psychiatrist. Can they for this. And does my son have to take the test.

  50. Hi Brenda. Check in with your state attorney general’s office for more on laws in your state that regulate sharing data between doctors.

  51. I need to know if my first visit with a psychiatrist will he drug test me? My dr. Wants me to go to one but my dr. Has been prescribing me xanax and suboxone for about a year. I already filled out the psychiatrist papers n they will know what im currently prescribed but will he drug test??

  52. According to what I am reading, psychiatrists drug test for the benefit of their patients and that it remains confidential. Tat is not true for the Veteran’s Administration. I understand because I was in a drug treatment program that my psychiatrist may have concerns, but over 3 years later when she is testing me routinely testing me, I was getting annoyed. Finally, my test revealed a false positive for opiates due to an antibiotic that is known to cause false positives. This antibiotic was prescribed to me by the VA and the entire VA knew about the results. I had to fight to get them to retest the sample with spectrometry BEFORE tossing it. I was denied access to employment services offered to vets as I was diagnosed as being “opioid dependent.” I did get my spectrometry and the test was negative, but no thanks to anyone but myself for fighting it. So I do question this practice as not being harmful to patients.

  53. As a patient, I can tell you that misunderstandings do take place in where the doctor says everything that is politically correct that sets the tone from the very beginning where everything said is politically correct. If there is a problem, then please schedule an appointment with the therapist. Oh, and by the way, if you run out of meds early… please don’t give me that lame excuse I always hear about meds being stolen. That one was in writing. Well, if you have family and two teenagers… guess what? If doctors are so concerned about that, then maybe you should only prescribe to individuals that live alone. Medications get stolen, that is a fact of life and not lame excuse. This situation happens far more than doctors are willing to admit. Next, there is the “worry” that an addiction has developed. I have been taking Adderall for five years. Of course I am addicted who isn’t after that amount of time? For a doctor to be looking over his shoulder constantly worrying about an addiction is absurd. Duh….Duh…Duh. Next, if a doctor has to do a urine test then maybe he is worrying about his own welfare and covering his behind. This business about it being for our own good, safety and well being is a good example of the kind of politically correct behavior I am talking about. If a doctor has to drug test then maybe its time to stop prescribing certain controlled substances. Now, from a patients point of view, this is an invasion of privacy and if psychiatrist continue to operate in this manner slowly but surely they will lose patients. Last but not least it is appalling how mentally ill people are treated by psychiatrist, staff members and others. It would take me ten years to tell you about the manipulation and intimidation techniques they use to keep patients in line. Last but not least, psychiatrist that worry too much about controlled substances and all that goes with that territory need to remember that they are the drug pusher that gave it to someone whom otherwise would have never thought about it and didn’t have an addiction in the first place. If you cant be honest with your doctor then what is the point?

  54. do they ever test for steroids in their drug tests.. i have adhd and get drug tested.. no im not on steroids im just curious as for if i ever did them would they know about it?

  55. Hi! I am currently 21 years old and am getting re-evaluated for my ADHD. I have had it since i was 9 or 10 and after using ritalin for a year and half, I switched to natural supplements and amino acids. Everything went well, my grades went up and I was able to focus. Yet now in college, I am having trouble organizing everything. I have been researching medications and have come across straterra or adderol yet I do not know the consequences of taking each with the fact that I have THC in my body. I am a heavy smoker of marijuana to help with my appetite and insomnia as well as ADHD. The re-evaluation has finally led to a psychiatrist calling me to try and schedule a drug test. I have already told them that I smoke marijuana. My question is, do drug tests just show the presence of THC, or does it show how heavy of a smoker you are? Also, if there is any information that would be helpful with the coexistence of an ADHD medication and marijuana is great. THANK YOU!

  56. I need some advice regarding a bill I received from the lab that processed my drug test, which I was told I was required to have by my Psychiatrist. I hope someone can help me with this. I am extremely upset and angry because the amount they billed me is over $700!! All the information I have read about urinalysis drug testing says the test runs about $100 if a lab does it. The name of this company is VerraLabs in Kentucky and the test was done in March of 2012 and it took them until January to send me this bill. My insurance would not pay on the claim since I had not met my deductible yet. My biggest complaint is about the doctor’s office since they provided no explanation that my insurance would be billed separately for this test. It should have been part of my copay, especially since I did not request it and felt it was unnecessary (I take meds for depression but have never been a drug user other than this). When I showed the office staff the bill they told me the company will write it off; however the company has now turned it over to a collection agency so it could ruin my credit. I feel strongly that I should not have to pay this bill. Does anyone know how I could file a complaint or obtain assistance to help get this taken care of? I would appreciate any help!

  57. Do they urine or blood test and are they testing for opiates or each individual type of opiate or benzo that’s in your system? The reason I ask is because I’m prescribed Valium but I ran out early and I took a lorazapam instead, will they be able to tell this? And if so, will they then give that information to my pain management dr.? If anyone knows anything about this, I would appreciate any knowledge on this issue I have. Thanks very much.

  58. What type of test do they use, and are they just testing for medications your prescribed by another dr, and illegal drugs? I know I don’t use any street drugs but am prescribed pain medication from my pain management dr. I’m just curious if its a blood or urine test and if my pm dr. prescribes me pain medication will that make a difference since I’m going there because I believe I have add or may be bipolar. It runs in my family on both sides. I just don’t know if its even worth going or spending the money as I have no insurance.

  59. If a nurse practioner request a drug test after disclosure of work related issues I find it hard to believe helping the patient to a drug test for evaluation of condition is warranted. Either the practioner is working only with resources accessible or possess poor rational observation of symptoms associated with a diagnosis. I experienced something here recently which baffled me because I was asking for help with a simple letter of my dilemma which may effect my job performance. When I went back to the clinic to get my levels checked I was told by the phlebotomist that a drug test was also requested. The article above merely describes common procedure which does not explain clearly why its not necessary more so than why illicit drug tests are requested. I personaly think that drug tests for any purpose should be mentioned at the onset of offering services or at least during follow-up where the patient is made aware.

  60. Hi Nicole. The type of drug testing depends on the psychiatrist. There is the DOT 5-panel test, which covers marijuana, PCP, cocaine, opiates, and amphetamines. Benzodiazepines, like Valium, are usually detected in a more broad panel screen. You can ask your doctor or their office for more information about which drugs they screen for…this is usually public information.

  61. Drug testing should probably only be administered when court ordered or else suspicion of drug abuse. It’s crucial to diagnosis if there is apparent signs of psychosis and you feel the individual is potentially harming others. Thanks for the great post. I’m sure many will find this useful.

  62. Hi Marc. I checked into your question, and it looks like medical professionals CAN share information related to drug tests with one another, but only as relates to your medical treatment.

    I’d suggest that you call the HHS for more information and to clarify this point, just for your peace of mind. And you’re doing the right thing! Thanks for your question, and we wish you well.

    Does that help?

  63. I have been a pain patient since 2007 and started going to a Chronic Pain Management Clinic in 2008 which was really helpful. I was on methadone since 2008 starting at 40mgs and I pretty much protested but was told “I needed to be on it”. I tapered down to 10mgs last month and my Dr said I could go off it cold turkey and it’s been over a month and I’m still going through the horrible withdrawals. Anyways, about 3 years ago I met with a psychiatrist who put me on 15mgs of Remeron and just last week upped me to 30mgs and asked me for a urine “Tox Screen”. I had used marijuana in the past and my Dr asked me to stop because it might have contributed to my anxiety, so it’s been 3 years since I toked. BUT, I used a THC Salve like ointment for 2 or 3 days prior to my tox screen and have used it many times (it is used for people who have chronic pain but don’t like the effects of the marijuana and it doesn’t get you loaded) but I think it may have showed up in my tox screen test as I have read other people who have used it failed drug tests. I am a very honest person and even told a stress and anxiety counselor that I have used it. My worry is, will my psychiatrist tell my Dr about it, does this fall under HIPAA? I was also honest in telling her that I had used the salve before I took the test and I’m worried because I like my Dr and don’t want her to think of me as a liar and her taking me off the meds she scripted me to help me with the withdrawals (the only other thing she said about MJ was that it was illegal and not good for the lungs but didn’t reprimand my using it even though I used it to help me sleep). Any help will be greatly appreciated! And thanks for this article!

  64. Yes, I think that knowing that patient confidentiality is a legal consideration can help someone with trust issues feel more secure with the results.

  65. Interesting post, looking forward to Part 2.

    I think the problem comes down to communication and developing a relationship of openness.

    For a patient, surely being 100% open is fundamental to the process of using a psychiatrist in the first place – although it’s easier to write than do so in reality where so much pressure and stress may exist.

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