Challenge. A member internal medicine physician was managing a long time patient, a 60-year-old disabled female with several co-morbidities, including but not limited to, fibromyalgia, tendonitis, back pain, and spondylolysis. The patient requested a refill of Vicodin before the prescription renewal date. The physician requested the patient come in for an office visit to evaluate her condition. The physician took a urine sample, in accordance with New Jersey regulations requiring testing at least every 12 months. The urine drug screen results were negative for Vicodin but positive for Xanax, and the physician suspected drug diversion. He presented these results to the patient, who became extremely upset. She admitted to taking Xanax and claimed her psychiatrist had prescribed this medication. In addition, she was insistent that she had taken the Vicodin, although her pain had increased.