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    New Pain patient scared of Drug Testing
    johnny888 posted:
    A few weeks ago I saw a pain specialist who specializes in Spinal problems. I have several bulging discs in my Throasic (mid-spine) along with stenosis. Anyway, he prescribed 5mg of Oxycodone to be taken every 6 hours. I have a follow-up after a month. My concern is I saw a message on his wall that his clinic drug tests. He did not give me one at my first visit but he might my second visit. Now I have nothing to hide because I do not take street drugs or drugs other than what I am prescribed. Here is MY CONCERN. In the past I have bought the 12-panel home tests and everytime I test negative for oxycodone after 12 hours of taking it. Once I went to the ER last year and tested negative for opiates after taking 4 7.5/325 percocets the day before. From what I have read on the internet, if you test negative for the prescribed drug, they will kick you out because they assume you are selling your prescription. HOW CAN THEY MAKE THAT ASSUMPTION??? I do not sell drugs but I always test negative when I take oxycodone. What do I tell the Dr. if he drug tests me at my next appointment? I actually didn't even sign a contract with him but like I said I have heard you are suppossed to test positive for the drugs they prescribe. Does the fact the everything else will be clean at least count for something? I would think their main concern would involve patients taking illegal drugs or drugs not prescribed to them. I will run out the say before my appointment so what do I say if it is negative? Will he take my word for it if I tell him I am taking my medication? Need some advice.......
    Caprice_WebMD_Staff responded:
    Hi Johnny,

    I'm sure others will be responding with their thoughts but, in the meantime, I wanted to welcome you here.
    We must let go of the life we have planned, so as to accept the one that is waiting for us. ~Joseph Campbell
    johnny888 replied to Caprice_WebMD_Staff's response:
    Thank you for welcoming me. It seems paradoxical to want a "positive" drug test but I have been reading all these hellish stories about this issue. I just always assumed you passed as long as you were not taking illegal drugs or drugs not prescribed. I hope some experts can give me some advice on this.
    Trudy292 replied to johnny888's response:
    Hi Johnny888,

    My doctor's office does do drug testing also. It is a urine test, but it is sent out to a lab that is not part of the hospital and the test is very sensitive. They do gas chromatography to see the levels of the drugs in your system. For example - I went off of the fentanyl patch on a Friday - that is the day I took off my last patch. The following Thursday - 6 days later I had a drug test and the Fentanyl Patch still showed up in my system but at a very low level.

    The tests that you buy over the counter are no where near as sensitive as the ones the doctors give you. If you are worried that you will not test positive for oxycodone, I would just explain that you have taken the over the counter tests and they come up negative just hours after you have taken the drug. So you are concerned that your test will come back as negative. It takes my doctors office about a full week to get their tests back.

    When they test you (at my doctors office), they test for all of the drugs they are prescribing for you and expect to find them in your system and if they aren't there, they want to know why and that could cause a problem for you. I am taking oxycodone, gabapentin, and clonazepam (a very low dose) and they test me for all three of them.

    annette030 replied to Trudy292's response:
    Ditto what Trudy said.

    My doctor sends out her urine tests for gas chromatography also, it is very expensive, over $300. Last time she did it, she didn't charge me at all, because Medicare won't pay for non-medically necessary tests. The lab just doesn't charge for Medicare folk. She didn't say anything to me so I guess they all came out like they should.

    I had an employer's random testing years ago and it did not show the Vicodin I was taking daily for pain, or the Klonopin I was taking either. I suspect they were using a cheaper and less precise urine screening system. Perhaps they didn't even screen for those drugs back then.

    I would let the doctor know at my next appt. that in the past I have tested negative for oxycodone while taking it, and just see what he says.

    They test to make sure you are actually taking the drug and not selling it on the street or giving it to your friends and family. They hate it if they think that drugs are being diverted illegally.

    Take care, Annette
    annette030 responded:
    I also have to say that my doctor only tested me once in over 15 years. Not sure why, but I think the signs are there to scare away the drug abusers.

    Take care, Annette
    johnny888 replied to annette030's response:
    I find that helpful!! I will tell you though if I am ever negative it would be from running out a little soon. That is also a posibility to consider. A negative test does not automatically mean drug diversion.

    Thanks though annette, your post was very helpful.
    annette030 replied to johnny888's response:
    I am only aware of doctors who are prescribing opiates that are prescribed to be taken daily doing drug tests. But even if you did not take the drugs daily, the basic urine drug screen will show opiates in your system for up to 72 hours after your last dose.

    Part of the reason my doctor's tests are so expensive is that she checks for the amount of the drugs in the urine, not just their presence, and the asst. asks you specifically when you last took a dose and how much you took before she collects the urine. If my test were negative, that would point to a difference about how it was prescribed and how I was actually taking it. Although no test specifically means diversion, that would be a pretty strong clue.

    Everyone has different instructions on how they are to take their meds. I don't believe that drug tests are infallible, the doctors I know just use them as one tool. I have never run out of opiates too soon, my doctor is very good about prescribing a specific number of pills, and setting up appts. for the next RX. She can count, lol.

    Take care, Annette

    Take care, Annette
    TerriP06 replied to annette030's response:
    I am glad to hear that I am not the only one who is having problems with this. My 1st pain management doctor offended me and I fired him. Now my new pain management Doctor screamed and hollered at me at my last visit. He said I am not taking my prescribed prescriptions, my last 5 urine test have come back negative for my prescribed medicines. I can not understand this. He is cutting back on my medication and making me come in every 2 weeks so he can count my pills. He said I have to be selling them and that the DEA is watching me. Everone in my family is shocked. I dont know what to do. I take my medications as prescribed, however some thing must be going on with my body or with there testing. Any ideals?
    Thanks, Terri
    ctbeth replied to TerriP06's response:

    Here is my suggestion:

    Tell your MD of your experience of urine tests coming up negative when you take your meds.

    Bring your prescribed meds with you.

    Have him/her confirm that the med is, indeed, what he/she has prescribed.

    Take them in front of the MD.

    Wait the specified time and give your urine sample.

    Bring a book to read or IPod- something to do while you wait the required time for the med to get into your system.

    Are you taking them as ordered? If so- this should make things better.

    Perhaps call the office first and discuss this with the MD, or other health professional at the office (RN, PA, APRN)

    Let me know what you think.

    bridgette04 responded:
    just started going to a pain specialist too and they do drug tests also...if you do test negative just tell the truth and tell them to test your will show up in the blood panel...other than that if you don't have a long history of being on narcotics and going to different doctors to get them than i dont see him not believing you...
    annette030 replied to ctbeth's response:
    I agree with CBT except, I would talk to the doctor in person with a friend of relative with me. I would not discuss this over the phone with a nurse or asst.That is just me...

    Take care, Annette
    ctbeth replied to annette030's response:
    Yes, good thought.
    mezz1962 responded:
    First off you have nothing to worry about. If you failed one time then they will simply say "You failed" then you can explain it and if it is true the Doctor will make you take a pill in front of him and then wait an hour and then test you.

    I am excellent with my pills. I have to take 5mg x 5 a day and I am always right on.

    Now no one should ever run out because they give you enough for 30 days and normally your next appt is in 28 days so in my case I'll have 10 extra per month.

    But even if it was a tough month for my back and I do take an extra one here and there and on rare occasions my appt is 30 days I always...always have one put aside for the day of the test and then take it when I go to the Dr this way I am 100% sure it shows up.

    But you can fail one test and all they do is warn do not get kicked out of the program I think your allowed one failed test per 12 months
    _swank_ responded:
    I take oxycodone and I have tested negative every time I have taken a drug test used by an employer. I have even taken meds a couple hours before a test and tested negative. However, my doctor sends the urine out to a lab to be tested and it is very thorough. Apparently I "passed" because he has never said otherwise and in the last couple years he has started testing at every visit. The tests they do at the lab are very expensive. If your doctor is testing for oxycodone then you can be reasonably certain that the test he uses is going to test for it.

    If you're running out of meds early then that is going to be a problem. Then he can correctly assume that you are taking more than prescribed. At the very least, you need to take your meds before your doctor's visit.

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