I have been in pain management for over a year. I was first prescribed 5/500 Lortabs 3 x daily as needed. I was drug tested within a few months, there was no issue. The dosage was upped to 7.5 over winter, I was tested 3 months ago and was caught completely off guard when my test came back negative. I was only going in every 2 months and didn't even know about this until 2 months later, when I went in last month. No one had contacted me from my doctors office, nor had my refills been canceled at my pharmacy. I was told one more negative and I would be immediately discharged, after it was suggested to me I could be selling them. I insisted I had taken one even that morning, which I was told was not possible. My PM doctor was adament it was not in my system. I started googling, found this site, read back over my PM contract to see if there was an option for blood testing in this event and there is not. The testing had changed from my first one to this last one. The first one I had to sign the actual urine sample, that was sent to a zero tolerance testing. The last one was done in the office, I was told "I was cool" whatever that meant, assume it was sent for further testing and have no answer to why it came back negative. I'm anxious now as I have another app't in 5 days and I no longer have faith in drug testing, after never questioning all of my life in employment testing. I'm anxious to even see my doctor again knowing my chart is flagged. I have not changed any medications between the 2 tests, the only thing that I am aware of is I am also on Dilantin and my LFT's came back out of sight about the same time as this test and my labs were just repeated for that by my primary. I can really use some suggestions or information about false negatives, as I cannot afford to lose my PM doctor and don't know what to do any differently than I always have been doing. Thank you
Hi Tara and welcome to this forum .We are all chronic pain sufferers here so we can sympathize with what you are going through .If you happen to read some of the posts on here there are a lot regarding false negatives.It seems like these urinanalysis tests are not very accurate.What you are going through is every pain patients worst nightmare.I mean you take your meds as prescribed but the tests don't show that. The PMP are under a lot of pressure from the DEA so if you have a negative they automatically assume you are selling your pills .If they said you were cool maybe they did send it out for further testing .I am not very knowledgeable about these tests but we do have some members who know a lot about them .I am sure they can help you with this better than I but I just wanted to welcome you and let you know how bad I feel for you .Take care Melissa
Hi Tara: Welcome to the forum. The only suggestion I could offer is maybe you could suggest that you come in every 2 weeks for a pill count. That might help. But it doesn't explain the test. I've heard of this happening to others but I don't know why it happens,
I'm so sorry that you're going through this. I'm glad you're seeing your doctor soon. I would explain what happened and ask him why he thinks it came out negative.
Do they use GCMS testing (Gas chromatography-mass spectrometry)? It's very accurate and can tell you the levels of the drugs in your system, but it is possible that they could mix up your sample with someone else's sample.
I'm confused.. Was the dipstick negative? Did they do a dipstick that day? Blood tests are always an option if you have a negative dipstick, but not if your doctor sends it to the labs, because they take time to process.
Did you take your hydrocodone within eighteen hours of your urine test? I have read that some people can metabolize them that fast--in eighteen hours! I don't know about the other medications that you're taking in regards to if they would effect the results.
I'm trying to think of reasons. I think, many times people don't find out why they have a false negative--but it seems to happen often! It's not right that you could get dropped for this. What is your relationship like with your doctor? I would talk to him, and see what he says. I'm surprised they never contacted you. They should have.
Hello Tara, I just found this forum as well for the same thing, I had posted this week about a false negative with my morphine that I have taken for more than a year. My doc as well did not inform me until Monday that my test taken 6 weeks ago was negative, yet I did not get a second chance, He gave me my 30 day supply and said good luck., After searching and searching on how to negate that test, I came up with a hair follicle site. They have one about 60 miles from here so I can do it in person. Even though he will not take me back, I am hoping that since that test goes back 90 days and exceeds the 7 weeks now since I have been tested then I may at least have some hope to Prove the lab wrong.
It is shocking, emotionally draining, and to just be called a liar when you are taking pills that you DONT want to take in the first place, blows your mind.
good luck to you, will let you know how my hair test went. Insurance doestn cover it. I put a notice on my facebook and my friends and family, who are on the opposite coast are all pitching in to pay for it. yay! 109 dollars I just do not have.
take care and hope it works out. This forum is just a great site and LOTS of information and very understanding people!
Hi Melissa and thank you for welcoming me. I have read a lot of posts on here since I first found this site. This was the first site I found that truly addressed the issue of false negative tests. Almost everything else I pulled up googling was about false positives or how to get around testing positive. I have read more about drug testing in the last 3 weeks than I have my entire life. And I don't really comprehend most of what I am reading. It's far above me. I had a multiple level cervical fusion with plate surgery 2 1/2 yrs ago, after waiting 8 years. I was always afraid of spinal surgery and kept putting it off. I had never heard of PM until my primary referred me out when I continued to have pain. At my first visit my PM doctor explained to me how different PM is from other practices. How they are monitored by the DEA, that DEA undercover agents actually can visit their waiting rooms, listening to whom is willing to sell their prescriptions, to make arrests, etc. I almost said thank you, but no thanks. I had never heard of anything like that. This is my worst nightmare being in PM, after never being totally comortable in the environment. I feel I have done something wrong, when I haven't, with the NP I saw on my visit being so adamant drug testing is fail proof. I know now that it is not. Thank you for responding. Tara
Hi Sara, thanks for welcoming me and for your suggestion about pill counts. It is something I have written down to take with me when I go in Tueday. I have never even been called in for one during my time in PM, even though it is on my PM contract. Thank you for responding. Tara
Welcome to the Pain Mangement Forum. I am very glad that you found us and took the time to post. However it makes me sad that another cp sufferer has failed a drug screen. Please forgive my tardy response.
Some of the studies done regarding failure rate with urine drug screens show a 70-80% failure rate. These were done with subjects that we in a controlled setting yet they failed also. These studies included the GCMS testing (Gas chromatography-mass spectrometry). I wish they were as accurate as the general public and medical community seem to beleive they are...but fact is they just are not.
The largest error rate of course is human. A variety of other things come in to play. Unfortunately when you fail you have little to no recourse. You do not always have the option of having an immediate blood test. Indeed most PMP will not even allow it.
Of course you always have the option of an independant blood tox screen. However it is a race to get it drawn on the same date, etc. Factors change. Basically you are left with whatever result your PM Clinic determines.
If you search our archives you will find many threads on this subject. Most of them should contain some great information. I hope it helps to know that you are not alone.
I wish you the very best and hope that you need screen will be accurate. Please keep in touch. I wish you the best.
I am anxious about seeing my doctor this Tuesday. I have always had a good relationship with him. He has always explained other procedures I have went through doing 2 nerve blocks last Dec, doing trigger point injections several times which are great, but only last 5-7 days, referred me out to PT last summer. He has always answered any questions I have. The normal protocol is going in monthly, which he suggested about 5 months ago to start bi monthly, as I don't drive, use public transportation. I saw a new NP 2 visits ago, who challenged me on why the bi monthly, to the extent of asking me why I don't drive. I told her it's in my chart I have epilepsy, have been tring to get my license back, it's even on the medic alert necklace I wear. She actually pulled the medic alert up to her eyes to read and commented, "Oh I see that you do." She was the one who ordered the drug testing, but it seemed that day everyone in the waiting room was having them.
This last drug testing was very different from my first. My first drug screen iincluded my signing my name across the strip on top of the urine samle, along with signing the form that was being sent off to a zero drug testing facilty. I read the form once I got home, saw it was tested for a host of illegal substances, along with testing you were taking the med pain prescribed, ruling out other meds precribed that one could be obtaining illegally though whatever means, that also would be ruled out. I understood the importance of ensuring you were only taking what you were precribed and could be discharged for testing positive for another pain med, as well as illegal substances.
The last drug test, I noticed when I took the bottle into the restroom had different colored bands all around the bottle itself. I read several which included TCH, Meth, Cocaine and a host of others I didn't read any further on the bands. When I returned the urine sample to the nurses station, I was told to wait while it was read, they were doing in office testing then at some point the nurse told me, "I was cool" which was needed to be approved to get a new 2 month presciption. The dip stick was fine for whatever was being tested on it. From what little I gathered when I went back in last month, saw the same NP, the sample was then sent out to test for the exact meds I was taking. That's when it came back negative, although at this point I am not even sure what exact testing method they are using. I was too upset by the NP's insistence I wasn't being complaint, and when I told her I had just taken one that morning, she out and out dismissed me as being dishonest, could be selling them. She would listen to nothing further I had to say. She said she was scheduling me for a new MRI, would be required for monthly visits again, and actually walked out of the room on me, leaving me in tears, for being unwilling to listen to what I was saying I was left feeling completely dumbfounded and confused by the entire visit with the NP, which was compunded by her simply walking out on me.
My appointment Tuesday is with my PM doctor himself, not the NP, which I am going to request to see the former NP I was seeing, if she is still in fact in the practice. I had built up a rapport with her also. I am writing down questions to take with me, to discuss with him. I have no idea why I wasn't called when my test came back negative. I had no idea anything was wrong. The only thing I noticed thinking back on it, was when I went into have my meds refilled, my pharmacist told me I would have to wait the full 30 days, because of new insurance regualtions. I have used the same pharmacy for 3 years for other prescriptions I take, have always tried to keep them in synch being filled, because I don't drive. My PM group opened a new, long awaited office during all of this, which includes an onsite pharmacy. I was asked if I wanted my meds filled there, said that was fine, I heard a statewide DEA background being done on me about the possibilty of obtaining controlled substances through other doctors, it came back fine, they filled my prescription and it had only been 28 days since my last refill at my pharmacy.
I want to be able to have an open discussion about my most recent MRI results, what drug tests they are using now, how they even work in laymans language, what could cause a false negative, in hopes he will not be as adamant as his NP I am not taking them, and how I feel about being flagged now on my chart and hope we can continue having the doctor/patient relationship we have had in the past. I cannot believe any of this happened to me. Thank you for taking the time to respond to me. Tara
Thank you for responding and sharing your own experience with me. We both found this forum for the same sad reason and I along with you am reading a lot of posts, trying to gain as much knowledge as possible into the whys of this, if they are truly any answers. I do not understand why PM doctors do drug screens, then if they come back negative, do not contact their patients immediately. I am only learning my own way around this maze of PM. In the past, I have sadly never really questioned drug testing throughout years of employment screenings, or random testing. I went back and read my PM contract line by line, several times over after reading other posts here. Mine does not give me the option to go back, to ask for blood testing in the event of a failed urine test. I can be discharged immediately for failing to adhere to my of the PM contract. No 30 supply to get me through any withdrawals, nothing. I know it has to be much more difficult for you, being on morphine, looking at the propect of withdrawals, along with trying to find a new PMP. I am extremely fortunate I wasn't immediately discharged after having a false negative, after reading through so many posts here. From what my NP told me, my chart is now flagged. I was emotionally shocked to hear I had failed a drug test! I wish you the very best and please keep me posted on what you find out.
Tuck, thank you so kindly for welcoming me to the PM forum. I am so glad I found this site. It has made me aware I am not the only one who has failed a drug screen. I felt very alone when this first happened, was brought to my attention 2 months after the fact. I was almost in a panic, not knowing where to turn. I have spent a great amount of time reading and yet still do not understand how drug tests work. Only I have accepted their results blindly throughout my life, because I have never had a problem with one.
I am going to continue reading, gaining as much knowledge as possible, perhaps even printing out some of the reports to take in with me for my next appointment. I don't know if it would behoove me, but right now I am praying future drug tests come back positive reflecting what is in my system and not feeling at all confident that may be the case.
Hi again. It's so upsetting that you were treated that way. I wish that I could help you more. I really have no idea why the test came up negative. Hopefully, your doctor will be able to explain things. It sounds like you are very prepared for your visit. It's shocking to me that you were not notified of the results immediately.
My PM doctor screens patients randomly, and it is truly random. I never know when I will be tested, but I do know that it is a possibility at every appointment. I hope that your appointment goes well. Please keep us updated.
I am experiencing the same issue as many of you. I recently was discharged from my pain management office after a restructuring and my doctor of 12 years retiring. I missed an appointment, (that I knew nothing about) and was subsequently discharged and now am having difficulty finding another pm doctor due to all of them being associated with the same medical group. Okay, enough of that. I finally did find an out-of-network doctor to treat me and during my first visit, he did a urine screen. He stated that my results showed negative for Norco which I am prescribed 5- 10/325mg per day. (I guarantee I take them) He subsequently refused to treat me. After extensive research, I have found several articles related to false negatives and false positive urine screen results. Both are from legitimate medical sources and not just regular people like you and I. Here are the links:
-This article discusses the levels on inaccuracy and outside factors that can affect your drug screen results. It states that many doctors, including pain management doctors are not educated on the ins-and-outs of drug screening, appropriate levels or outside influences that can result in false negative or positives.
The next article:
-This article discusses that something as simple as OTC cough suppressant can result in a false negative and that at the occurrence of a false/positive drug screen, that blood, hair or saliva testing should occur.
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