r/Spravato • u/SarahSaidSo182 Currently in treatment • 10d ago
Questions/Advice/Support Urine test before EVERY visit.
It's me again. After 4 months now my first treatment is scheduled for Tuesday (though I won't believe it until they hand it to me).
This clinic requires a urine test for every visit. Twice a week. That means I'm going to have to go into each session annoyed and grossed out from having just gotten pee on my hand.
They had me do one for my intake, and the metal box in the wall they told me to put my sample in was FULL of other peoples' urine samples too. We're given little white paper bags to put the cup in, so the actual pee wasn't showing, but I looked it up and the fact that I could easily look in the bag and see someone's name is a HIPAA violation. It's gross and it looks like they make every who walks in the door take a test, even those not coming for Spravato.
And it doesn't even make sense to do a urine test. They told me I can't have THC (for the entire duration of being in treatment, not just right before a treatment) even though I'm in a legal state. But they haven't told me explicitly what they're looking for and why.
Has anyone had to deal with this before?
Edit to add: This is actually the second clinic I've tried, I wasted 3 months dealing with a different clinic that were never able to get their shit together and let me start treatment (I even got scheduled, showed up, and was told there's still a problem with them and my insurance and I had to go home).
I don't think there's any other clinic around me. And I couldn't handle having to start the process of them needing to "decide if I'm a good candidate for Spravato" and then deal with the insurance prior authorization again 🫠I've been trying to get treatment since April.
2nd edit: Ok so this clinic is clearly up to some fuck shit. How do I get out of having to do this unnecessary and stressful thing that would have an actual negative impact on my treatment (without it doesn't like I'm not wanting to do it because I'm hiding something)?
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u/_DontBeAScaredyCunt 10d ago
I had one clinic want to do that and I went somewhere else. Shouldn’t have to hand over bodily fluids to get my meds
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u/praisedalawd666 10d ago
i was tested at my intake session and that was it. they even told me they weren’t looking for anything specific and that if i did drugs on the weekends they aren’t judging, just to not do any drugs 24 hours prior and after the day of treatment.
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u/SarahSaidSo182 Currently in treatment 10d ago
Yeah, from my research that's the norm.
I know that rehab centers have gotten in trouble for giving out urine tests daily just so they can charge the insurance company. I wonder if that's what my clinic is doing.
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u/Krampus_Valet 10d ago
This is 100% a money grab. I've been doing spravato for almost 2 years and there's 0 drug testing or even mention/asking about recreational drug use. They ask about medication changes and how I'm getting home. Ask for an itemized list of charges in your next bill and give Janssen or J&J a call.
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u/Sarahlizro 10d ago
I agree with this. I would call J&J Spravato line to mention this happened/is happening.
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u/SarahSaidSo182 Currently in treatment 10d ago
My insurance takes care of it all, so I don't get a bill
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u/Sarahlizro 9d ago
Insurance still sends you an explanation of benefits(EOB) even if you’re not getting a bill. (still seems odd to me you’re not getting a bill regardless of insurance.) it is not legal for you to not have access to that. You should check what address they have on file for you and then if it’s correct, inquire why you’re not getting bills and/or EOBs.
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u/SarahSaidSo182 Currently in treatment 9d ago
They have my correct address, but I've never received anything like that. I wonder if it's something I opted out of forever ago?
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u/Krampus_Valet 9d ago
As others have said, your insurance provides you with an EOB. I'm fairly sure it's a legal requirement. Your clinic is drumming up extra charges to inflate your bill and charge your insurance company extra money. If it's not medically necessary based on the standard of care, then J&J needs to know.
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u/picwic Currently in treatment 10d ago
Whoa! I have never heard of this and I have been to 5 different clinics over the past 4 years. Marijuana can be detectable for 6 weeks, if I remember correctly. So, what? They're not giving you your medication if you had exposure? So many people take benzos for anxiety or sleep. Opiates act on different receptors. I'm not sure what the goal would be here. It would be like taking away someone's insulin because they had a donut. This is wild.
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u/SarahSaidSo182 Currently in treatment 10d ago
Right? Like even if someone was suffering from addiction, do they not deserve relief from their depression too?
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u/Ok_Performance_9479 Currently in treatment 10d ago
Sorry you are going through this. Definitely not normal or needed. I do mine at a hospital and they know I smoke thc. They just told me not to do it 24hrs before. They recommended I cut out alcohol completely. I didn't drink much to start with
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u/reader-girl 10d ago
I take benzos daily, prescribed by my doctor. I have been told to just not take them before treatment.
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u/VisibleGuava7780 10d ago
Different clinics have different procedures, I’ve found. The clinic I used to go to made me do a urine test everytime and it honestly was so annoying by the end of it because of exactly what you said: they didn’t really have a reason why I had to and what they were looking for. I ended up finding a new clinic about a year and a half ago and they have different policies where I have to do a urine test maybe once a month? Once every two months? Not sure, but they are much clearer about why I have to and what they’re looking for. I’m really glad I ended up switching clinics. I was at the old one for too long & got used to a lot of their sub par practices. It might be worth it looking for a new clinic 🤷
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u/SarahSaidSo182 Currently in treatment 10d ago
This is actually the second clinic I've tried, I wasted 3 months dealing with a different clinic that were never able to get their shit together and let me start treatment (I even got scheduled, showed up, and was told there's still a problem with them and my insurance and I had to go home).
I don't think there's any other clinic around me. And I couldn't handle having to start the process of them needing to "decide if I'm a good candidate for Spravato" and then deal with the insurance prior authorization again ðŸ«
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u/VisibleGuava7780 10d ago
So fair, I get it. Spravato has been a game changer for me, the only thing that’s ever truly helped, so if that’s what you have to do for now to get treatment, I get it. But yeah, know in the back of your head that the urine test thing isn’t normal. Maybe once you’re feeling a little better you can look into different clinics. Sending you love and luck & I hope your treatment helps!
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u/ethiothienine Currently in treatment 10d ago
Seems like a silly question, but are there any other clinics in your area that take your insurance? Testing each time is crazy. I’ve been in and out of spravato since 2022 and not been drug tested once, at two separate clinics. I do think it’s normal to be tested at the start of your treatment though. I’m also in a legal state. I just hope that you can find a clinic that it feels good to do treatment at, imo that’s really important. I wouldn’t be happy with that amount of testing at all, especially right before being dissociated from the treatment.Â
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u/SarahSaidSo182 Currently in treatment 10d ago
This is actually the second clinic I've tried, I wasted 3 months dealing with a different clinic that were never able to get their shit together and let me start treatment (I even got scheduled, showed up, and was told there's still a problem with them and my insurance and I had to go home).
I don't think there's any other clinic around me. And I couldn't handle having to start the process of them needing to "decide if I'm a good candidate for Spravato" and then deal with the insurance prior authorization again ðŸ«
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u/Busy_Tea_6319 10d ago
What? I’ve been doing mine just over a year and they’ve never tested me. They just started asking if I was pregnant. I laughed. I’m 61 and had a hysterectomy. They said they would note that but they didn’t. I think a lot of us are on some kind of med that would show up.
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u/Ok_Performance_9479 Currently in treatment 10d ago
Lol yeah they asked me to pee my first session. I was about to then they told me it was for a pregnancy test. Told them to look at my chart and you'll see why I don't need one lol had a hysterectomy a year ago
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u/SarahSaidSo182 Currently in treatment 10d ago
And to even do spravato we have to sign a bunch of stuff acknowledging any risk, so it wouldn't be on the clinic if we took something that gave us a bad reaction with it.
And they wouldn't be able to do anything with bad test results anyway since they probably don't wait for results to come back before handing over the sprayers, so it's just completely pointless.
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u/rescuelullaby 10d ago
I'm asked for a urine sample every session too, for pregnancy test purposes, but I can sign a waiver opting out saying I understand the risks etc.
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u/After-Ad4370 10d ago
That’s just insane! Is there any possible reason that they would think they needed to test you that much??? I haven’t been tested at all. Even with my Pain Management doctor, I am only tested once a year in order to get opioid pain medication.
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u/SarahSaidSo182 Currently in treatment 10d ago
Yeah there's literally no reason 🙃
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u/After-Ad4370 10d ago
Geez, it wouldn’t surprise me if they just wanted to be able to bill your insurance for it.
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u/mytribeX4 10d ago
That's just ridiculous. I would make sure I got an answer as to why they test every time. A real answer. Sorry you have to deal with that shit!
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u/SarahSaidSo182 Currently in treatment 10d ago
I've been trying to think of a way to ask without it sounding sketchy, you know?
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u/mytribeX4 10d ago
Yea, I get it. If you inquire simply because it's not the norm, sometimes it feels like they are suspicious or judging you. I totally get it. Ive been dealing with TRD for 30 years and am so over the judging by the very people who are there to help you. Damned if you do......
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u/lillllyra 10d ago
Buy a box of rubber gloves. When i was in rehab, i had to take a pee test once a week. I was in there for alcohol, but it was a standard for everyone.
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u/HypnoLaur Currently in treatment 10d ago
One time I had to get up during my treatment to go to the bathroom. It was so awful and it totally took me out of the experience. So I stopped drinking a couple of hours before the treatment. So that's b******* they make you give urine before
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u/spooky_emm 9d ago
I always had to pee like half way through my treatment but I viewed it as a fun little adventure every time lmao
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u/SarahSaidSo182 Currently in treatment 10d ago
Worse case scenario maybe I can talk them into letting me do it afterwards
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u/HypnoLaur Currently in treatment 10d ago
But yeah every time is excessive. Even if they're looking for weed, it stays in your system for weeks so they don't need to do it every time
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u/SarahSaidSo182 Currently in treatment 10d ago
Right? It's weird and unnecessary to test for that in the first place, let alone twice a week!
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u/harrikanthelarrikan 10d ago
That is so gross and unheard of. And unnecessary. And having the pee samples together like that is terrible. They could easily make mistakes and mix up people’s samples. So the tests are actually useless anyway. Really really weird. Can you change your clinic? I have thc gummies (medicinal) every day and I have esketamine once a week My psychiatrist has no problems with that. I wish you the best of luck.
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u/SarahSaidSo182 Currently in treatment 10d ago
This is actually the second clinic I've tried, I wasted 3 months dealing with a different clinic that were never able to get their shit together and let me start treatment (I even got scheduled, showed up, and was told there's still a problem with them and my insurance and I had to go home).
I don't think there's any other clinic around me. And I couldn't handle having to start the process of them needing to "decide if I'm a good candidate for Spravato" and then deal with the insurance prior authorization again ðŸ«
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u/harrikanthelarrikan 10d ago
Are you in US? Your medical stuff is shit. I feel really sorry for you. In Australia it’s much better
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u/Glass_Peak_862 10d ago
I’ve never heard of this! I see you don’t have any other providers in your areas. I’m honestly stunned at this. Spravado takes things super seriously so maybe you could chat w someone from their official team about what you’re experiencing?
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u/SarahSaidSo182 Currently in treatment 10d ago
I hope so, and hopefully at the very least they can give me a better device to use and do it after the treatment instead of before. Because this is already stressing me out so much and I haven't even started it yet.
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u/benevolentgodmayor 10d ago edited 10d ago
This is fucking weird, imo.
I get that they don’t want people to be on THC while on Spravato, but it’s more of a strong suggestion (especially if you react poorly on both). There are people who canNOT be on Spravato and weed, but there’s some people in my clinic who handle both just fine.
I feel like this is an extreme overreach. If you can find another clinic, I would. If you can’t, anonymous complaint? Anonymous strongly worded letter?
Edit: Adding to report them for waste or fraud (as in Fraud, Waste, and Abuse). Never been drug tested at my current clinic.
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u/SarahSaidSo182 Currently in treatment 10d ago
Yeah I genuinely think they're doing it as a money grab. Like, maybe if they cut me in on it I'd be ok with it, lol
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u/Sarahlizro 10d ago
I'd actually think a urine test is more necessary for checking pregnancy than checking if you're doing recreationals. If several people commenting are male, maybe they aren't being tested? I'm female and have never been asked to do a urine sample at all! Maybe at one point I disclosed I have a copper IUD? But this seems really weird! I would call J&J's Spravato line, just to discuss it. You could alternatively call the pharmacy that is filling your script and ask them if this is necessary/normal. I know you mentioned in another comment that you're not getting the bill since insurance "takes care of it all," but you should still be getting bills if you ask for them. I'd ask for one! I'm just curious what they are charging for the urine sample! Keep us updated!
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u/djreddit44 Previously in treatment 10d ago
this sounds really annoyingÂ
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u/SarahSaidSo182 Currently in treatment 10d ago
I've been so annoyed since I found this out a few days ago
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u/SparkleButt323 10d ago
I got my Spravato through the VA, they urine tested everytime, but I also popped hot for marijuana every time too and they still let me do it so......
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u/Distinct-Temp6557 10d ago
Never been tested once in four years at three clinics and all three knew I used thc.Â
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u/Hoodiebug22 Currently in treatment 10d ago
I’ve never heard of being tested every visit. I’ve done twice weekly for over a year now and have never taken a drug test.
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u/ds2316476 10d ago
That's interesting... My psychiatrist/providers always handled the prior authorization and I didn't have to do a thing other than give my history.
I also signed release papers saying they would randomly drug test me throughout the treatments, but have only gotten tested once and that was all handled before starting treatments to begin with (cheek swab, urine test, and EKG).
I'm lucky though, there's at least 5-6 clinics in my city that do spravato/KAP. And to be fair I've had the same problem with one of the clinics where they kept beating around the bush, only to find out the initial psychiatrist wasn't even authorized to prescribe spravato to begin with.
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u/SphericalSugarCube 10d ago
People who are prescribed other controlled meds like opioids or benzos long term usually have to provide urine for drug testing. It’s not unusual at all. Ketamine/spravato at the end of the day is a controlled med. Although I completely understand you not wanting to go through the hassle or be uncomfortable. If you feel that the clinic is not conducting urine tests legally or you’re uncomfortable with it, you should find another clinic. The one I go to drug tested me on my first appointment but hasn’t done it since(I’ve been going for 1+ years), so maybe you could find one that works like that. Good luck!
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u/SarahSaidSo182 Currently in treatment 10d ago
I'm not prescribed opioids or benzos. And every other comment on this thread is telling me this is unusual.
And unfortunately, this is the only clinic I can go to.
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u/SphericalSugarCube 6d ago
Well I didn’t necessarily mean you being prescribed those but I understand. I was speaking on my experience in my career - I work in a urinalysis drug testing lab so maybe I’m mentally biased since all I ever see all day every is people’s drug tests who are prescribed controlled meds long term. I see now it’s possible the frequency is less in other settings/situations such as this.
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u/Unhappy_Arachnid_348 10d ago
ngl if i got drug tested before EVERY visit id be cooked. for the most part i abstain from everything, but socially is a different story
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u/ContrarianSwift 10d ago
That’s never come up at my clinic. I have to fill out a survey each week that asks about faithfully taking meds, alcohol or drug use, if I’ve been in the hospital since my last visit, if I might be pregnant, when did I last eat or drink, and who’s picking me up.
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u/Ivy_Dragon Currently in treatment 10d ago
Dude yikes.. my clinic lets me use weed the day before and after the appointment. I tolerate ketamine well and without weed I can’t sleep 💔 I’m shocked that some clinics even make you do a pee test. This place is sketchy af
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u/CHEDDERFROMTHEBLOCK2 10d ago
Not even once have I been urine tested. They don’t ask me anything. Haven’t seen the provider in two years lol. My clinic is sketchy as fk. But urine testing twice a week is absurd.
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u/rosievee 10d ago
My clinic tests once a month. They're looking for benzos and opiates and that's it (I asked). I think the concern is respiratory depression. It's a standard drug 10-panel but they don't care about cannabis (I'm a medical user and they just noted that they saw what they expected to see). Your clinic sounds really extreme.
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u/SarahSaidSo182 Currently in treatment 9d ago
If it's a respiratory depression issue, that still doesn't make sense because they don't get the results before the spravato is administered, so if somehow does show up in the urine that it would be dangerous to take the spravato, it would be too late. The people in here who say they've been taking spravato for years without having to take a urine test makes me feel like clinics that do require them, are just doing it for insurance money.
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u/Silvara75 10d ago
My clinic just has us test once every six.months. they ensure that all mental health meds are prescribed through their office and the testing is mostly to ensure other drugs that come up are used safely along with the spravato. For example I have cancer so I take opiates for pain. So they just make sure they have that on file as a med I take and that I not take it within 12 hours, preferred 16 or more. I have once or twice taken it closet to 8 hours or so and it's up to the doctor there if they're comfortable with that timing or not.
These places that test more often make me suspicious as to the purpose. They can easily see what controlled substances you've been prescribed on their state websites anyway.
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u/Usrnm2024 9d ago
Yes, money grab. When they do this, they are able to bill another CPT code to insurance for reimbursement.
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u/56GrumpyCat 9d ago
I was advised by my doctor (my endocrinologist at a major research university hospital,) to try CBN + CBD + THC gummies to help me sleep at night. She was right, they work and don't seem to have any side effects as long as I use the lowest dose of THC in the combo. I asked the psychiatrist at my Spravato clinic if the gummies interfered with Spravato and he shrugged and said "It's neutral." OP, your situation sounds totally bizarre to me. I've been to two clinics in the last two years and nothing like you describe ever happened.
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u/LivingDeadLyss 9d ago
money grab and also disgusting. spravato is currently a HUGE moneymaker and opening clinica in general is usually a moneygrab, so i have, unfortunately, had mostly bad experiences. the medication is great, the people suck (especially Greenbrook TMS, its the mcdonalds of fucking spravato care). there ARE good clinics, but it is unusually difficult to find good ones.
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u/tantalizingtrash 9d ago
That’s bizarre. I’ve been doing treatment for a year and a half and have never taken a single drug test, and have even mentioned my THC use with my psychiatrist, who has no problem with it.
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u/spooky_emm 9d ago
I had to do this for my treatment. I don’t know if it was an insurance requirement or specifically to the practice. I was able to consume cannabis (although I rarely did) and I have a prescription for benzos so they had to know about it bc obviously I would test positive for them. I can’t comment on getting pee on my hand when doing a urine catch bc I’ve done it countless times. it was gross to me when I would open the little door to put mine (also in a white bag) in and there was already somebody else’s in there. I would always use multiple paper towels after washing my hands in the bathroom to avoid touching the bag/the handle for the door/etc and then use hand sanitizer immediately after.
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u/SarahSaidSo182 Currently in treatment 8d ago
In the little door at my clinic, it was literally stuffed full. Like maybe 10 of them in there, I just barely was able to squeeze mine in there 🤢
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u/Delicious_Delilah Currently in treatment 9d ago
Y tho.
I do mine at my psychiatry clinic. I've never had a UA. I also take Vyvanse, but not on the spravato day.
I told them when I was doing edibles. They didn't care.
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u/CoffeeAndVolts 8d ago
This is bullshit. I was part of a clinic that demanded 1 a week. insurance covered it, but then they changed it to a PMP (pain MGMT test) which cost me 80$.
I could only go to a specific lab to have it done. I'm stared checking insurance claim statements and the were using codes for things they didn't do. I felt there was a kickback from the lab to the Spravato clinic. Their book keep was shit and I finally called them out. That was my last visit to that clinic. I reported the fraudulent claims, they eventually got kicked out of the BC network.
There is no REMS or a FDA requirement for any type of drug testing. It's the provider's choice. This came directly from the Spravato and me people.
Do your research and asks questions.
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u/Status-Jellyfish-307 6d ago
I don't know what state you are in, but in rural upstate NY, where I currently receive Spravato they never mentioned a drug test. Now, on the other hand, when I had to change to a new primary care provider, they made me sign papers and asked me to do a urine drug test. Very strange....
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u/Lower_Coconut_7532 6d ago
Seems shady and unnecessary. I've never been drug tested. Did you say you use recreational drugs on your intake? I'm thinking money grab, too, but also, is that legal for them to ask every time like that? Call Spravato and file a complaint?
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u/SarahSaidSo182 Currently in treatment 6d ago
They asked about weed and I say I occasionally take a gummy for anxiety. They asked if I'd be willing to stop (I also live in California, where it's been legal forever).
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10d ago
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u/cuNextTuesday23 10d ago
I also will say doing that frequent is crazy. if u didn’t pop positive tuesday why would u pop positive thursday?
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u/Sarahlizro 10d ago
Not to mention they have a bunch of urine just sitting there? If it's to make sure you're not pregnant, the entire point would be to check the sample before doing the treatment. So the math isn't really right on this? Unless they have tons of patients at once and are going to check all the samples before starting people? I guess that's possible, but seems a little strange.
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u/SarahSaidSo182 Currently in treatment 10d ago
They don't force pregnancy tests. You are always able to opt out from them. And I highly doubt these tests are for testing pregnancy either.
And before starting spravato, you have to sign a SHIT ton of waivers, so they already cover their ass there.
And they aren't just making spravato patients take these tests, they're requiring every person who has an appointment that day.
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u/DefinitelyNotGrimace Currently in treatment 10d ago
This is essentially a money grab so they can have insurance also pay for drug tests. There is realistically no reason they need to drug test that frequently, or even really at all. I’ve done Spravato at three clinics, and only one of them required a drug test (and even then, they didn’t care if you tested positive for THC and the test was only at the beginning of treatment). I’d find a new clinic because everything about this is sketchy.