Hi Dr.Mike, question I was going to ask u on live today. My last appointment, I did urine screen. It showed a little bit of alcohol from night before. I'm on oxy IR 20mg 5x per day. They called me a week after the test came back, and they said the doctor wants to reduce 50%. How do I handle that?
To answer your question, I have a few of my own. 1) Are you a diabetic and is your diabetes controlled? - the number one reason for having alcohol in your UDS is actually uncontrolled diabetes as when the body improperly metabolizes sugar, alcohol is part of the by products. 2) How much is a little bit? If you still had residual alcohol from the night before, it speaks to you drinking more than you think if it was still in the system, and this is probably the concern.
But your question asked, how do I handle that? Non-defensively. Meet with your provider, you have your supply for this month, ask for an early appointment to discuss your providers concern. I want you to go into the appointment as the patient who shares the prescribers concern. The number one thing you DO NOT want to do is go in there saying, "THERE IS NOTHING IN THE AGREEMENT THAT SAYS I CAN'T HAVE A DRINK NOW AND AGAIN?" - you will add such fuel to the fire that doesn't even have to be a fire.
So, to circle back. Be non-defensive. Ask for guardrails on how much alcohol is acceptable. Remember something I say a lot: ALL help comes with strings, and accepting the help means accepting the strings. Validate that the prescriber is there to keep you safe, and you want to reassure him that you take his concern very seriously. Now right now the provider genuinely is planning on decreasing your levels, so you need to be proactive and say, "I want you to feel as comfortable caring for me as I do having you care for me, so give me more firm guidelines in this area." With the provider having this as the basis for "corrective action plan" to document intervening when he has a concern, he will feel less pressured to follow through with this change.
Praying for you - Good Luck.
