Annual Check Up/Drug Screening?

Anyone know if it’s a requirement to conduct an illicit drug screening test during annual trt bloodwork?
During my annual checkup my PCP reviewed my bloodwork.
He said everything looked good except I tested positive for Xanax and THC!
This totally caught me off guard. Anyone experience something similar and do you know if this is a state or federal requirement or just the individual PCP?

Definitely not the case where I’m at. Only time I’ve been tested for drugs is when I get popped for a random at work.

It is not a requirement. I never would order those tests.

However, I have heard PCPs claim that testosterone is “addicting” and patients will want more and more if they start. I am also aware of some who will check for drugs as part of the follow-up for TRT patients. They are less interested in the testosterone level than in anything else they may find. Some will stop prescribing test if they find anything. Hopefully, yours will not.

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Thanks for the response.
He definitely seemed more interested in other substances than important variables like SHBG and E2 which he’s never requested.
I probably should consider other options.

Yeah because we are addicted to feeling normal, having robust erections and a strong libido. I do believe guys can get addicted to the act of injecting T as it becomes a daily ritual, but don’t see testosterone addicting per say.

Not at any clinic I’ve used. I know some ppl’s jobs do test for this annually.

Edit: did he tell you he was checking for those things? Was he joking with you?

Not job related at all, it was my PCP and a required follow up for my trt prescription.
I’ve submitted lab work for him 2x a year for 2 years.
He just added it in there this time without mentioning it.
I didn’t receive a copy of my lab work before the follow up appointment. So it totally caught me off guard.
After reviewing everything, telling me it looks good with the exception of TT “a little too high” at 750.
Then he said he has some concerns and proceeded to asks me about Xanax and thc.
I had no comment. I definitely felt violated and disrespected. I suppose he has the right to check what he wants and clearly did. But I have no idea what his goal was and question his priorities and motivation.
I’ll be looking for another PCP before my next follow up.

There is right, wrong, and legal. That was wrong and legal.



Time to look for another GP. Any doctor that thinks 750 is a little high shouldn’t be prescribing TRT.

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I’m not sure about that. Not without your knowledge. I wouldn’t like it if my doc just said “oh by the way we tested you for narcotics” without first telling/asking me about that. You don’t have a chance to refuse if he doesn’t tell you it’s happening. IDK, i’d be upset about that one too

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They do. His rationale would be that since he was on testosterone he may be more likely to use illicit drugs. Obviously, that’s a poor reason, but it passes legal muster.

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Wow, that’s wild

I agree it passes legal muster since he’s prescribing a controlled substance….
But it’s for a hormone deficiency not methadone or something similar. If that were the case, I could understand the logic. Confirming patient wasn’t double dipping.
In this situation I just felt violated. I’ve made no complaints to him of substance issues. I display no signs. I have no substance issues. It was a rare occurrence and bad timing.
I would of MUCH preferred a frank adult conversation first asking about such issues AND then being informed it may be screened for in the future.
My patient/doctor relationship with him is completely different now.
I see him as someone who’s out to pull a “gotcha” instead of an ally for overall health.

Ask him if he checks his Type 1 diabetic patients for illegal drugs.

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