False Negative for opiates in urine screen

[justlyjaded]

I was involved in a serious car accident in 2007 resulting in 4 cervical and lumbar disc herniations, in 2009 another serious collision herniated 4 more disc herniations including 2 thoracic discs. 4 of the 8 herniations are compressing my spinal cord....I am being treated at a local pain management clinic with flexeril, cymbalta, an anti-inflamatory, trazadone to help me sleep, and percocet 7.5 for pain. Injections in my back and neck failed. I also underwent RFNA (basically had the nerves to the affected areas burned), this procedure also failed. The clinic I attend, as do most clinics, require regular urine screens to assure that the meds are being taken properly. I have had two urine screens so far and both have returned negative results for opiates.
My pain level (without medication) on a scale of 1-10 with 10 being most severe, is on average a 9, and with pain medication 3. I take my medication as prescribed, sadly, they are my lifeline, without which I would be unable to function and I ultimately end up virtually bed ridden.  I don't know where else to turn, have you encountered this problem, and if so, can you tell me what is causing the pain medication to go undetected. Also, is there a protocol drug testing facilities must follow such as preserving samples that can be retested either by the same company and/or by an independent tester? Is there a procedure for appealing these results?
The test results were just given to me on Friday, July 30, 2010. I ran out of my medication two days earlier and the office is telling me that I cannot get an appointment to see the doctor for another week.  I have already begun to experience withdrawal symptoms and I am really sick and really afraid.
In addition to all this, I have been very sick for the past three weeks and had to be taken to the emergency room last week with symptoms including a very heavy feeling in my chest, dizziness, profuse sweating, extreme fatigue, and irregular heart beat (pulse was 50 during er episode). I have had blood drawn four times so far with varying irregularities, could the negative results have anything to do with whatever is going on there?
I'm only 43 years old and I live in pain everyday. It has taken nearly the full 3 years since my accident to find a medication regimen that controlled my pain and improve the quality of my life. PLEASE HELP!!!!!!!!!

[beanoville]

mollyrae,  Percocet or its generic equivalent comes in 2.5mg, 5mg, 7.5mg and 10mg
tablets.:-)
Whoever did the urine screen is supposed to have enough to run it again.  If you hadn't had any in two days, I suppose it is possible to test negative.  I think you need to explain to the doctor why you ran out.  My experience with urine screens is that the doc thinks they are foolproof and only science can trump itself.  I took a valium once and it came back as temazepam (restoril) instead of diazepam (valium).  My doc was POSITIVE I took the restoril (A BIG NO_NO) instead of valium (ok'd for 1 dose).  Since they produce a lot of the same metabolites, a second test was done to further determine which benzo it was.  Bingo! It was valium! Next visit she muttered, "it was valium, you're ok" and that was it.  The earth's axis was restored.

[Tuckamore]

Hello Justlyjaded,

Excuse my tardy response. Welcome to the Pain Management Forum. Chronic pain (CP), especially severe CP is a horrid condition that wreaks havoc on our daily lives. It's obvious that you know that all too well. My heart goes out to you.

I am very sorry to hear about your current situation. Unfortunately these errors in Urine Drug testing occur way too often. I have seen statistics that claim error rates can be as high as 70-80% with the majority of errors being human. I cannot guess why your drug screen was inaccurate.  

As far as your recourse you have little if any. Sadly when you signed the PM Contract it was to protect the clinic or physician and not you. Most clinic do not allow for an appeal process. The information should all be contained in the contract that you signed.

I do not know if your clinic maintains the actual urine sample, for one they do not remain stable for long periods and would be useless for testing purposes after a given amount of time. I assume the clinic's storage capacities are probably minimal.
If you have been or will be dismissed the only choice you have is to locate another PMP as quickly as they can. Your current PMP should provide you with thirty day med supply but this is not always true.

Why did you run out of meds before your appt date? Does the PM Clinic not schedule your appts every 27 days or so?

I am sorry to hear about your other undiagnosed symptoms. Please let us know how you are doing. I will look forward to your updates....we are here to offer our support.

Take Care,
~Tuck

[Mollyrae]

Sorry to hear this. Some of it's confusing though. Percocet doesn't come in 7.5mg strength. You must mean Hydrocodone.

The symptoms you experienced in the ER sound almost word for word like Withdrawal symptoms. That can make you sick as you were speaking.

I'm not sure why the meds didn't show up in your system. The only option I feel that you have left is to find a different Pain Management Clinic. How does your PCP feel about this? Maybe he can treat you until you find different pain management.

Good luck,
Mollyrae