I have had serious chronic knee problems for 20+ years now. 5 surgeries and too young for knee replacement (40yrs old) After years of taking 20+ NSAIDS a day my Ortho doc put me on 2.5 mg of Hydrocodone (vicodin) taken 3-4 times daily and @ 6 NSAIDS total daily. I am very very very strict with how much I take- never more than a full 5mg when it's bad. My job has me dealing with the criminal public and I see every day how easy addiction can take over a life, so I have been sooooo careful to take just enough to dull the pain but not give me a high. After 5 yrs of scripts from my Ortho doc I was unceremoniously cut off and was told I had to go to PM for any more narcotic meds. I spent a miserable month and a half rationing out the few pills I had left and finally had an appointment with PM in January. The day before my appt I took 2.5 mg. When asked if I took any meds I told them I took a half of a pill the day before . I wasn't suprised when my urine test came back negative that first time. I WAS FLOORED when I was summonsed to an earlier-than -scheduled appointment this afternoon and summarily told by a PA that my last urine test taken week ago at 8am came back negative too. I took my normal dose @8PM THE NIGHT BEFORE! I was all but accused of being a liar since there was NO WAY I could be taking my meds and have nothing show up in my urine screen. I asked if I could have a hair or blood test done and was shot down as if I was being unreasonable to even suggest such a thing. I left that office scared ******** because surely I must have something seriously wrong with my liver or kidneys that resulted in a negative test. I left a message for my PMP asking to have orders sent to the hospital for full blood work to see what was wrong with me. The humiliation came on the ride home when I realized they all thought I was a liar and a felon (for I had to be selling my pills- right?) I got online trying to find out what could possibly be going on with my body that I am metabolizing the hydrocodone so quickly. After 4 hrs online I am no longer worried about dying of some strange disease but now I am absolutely FURIOUS. I have read all the responses below and have a checklist of what I need to to tomorrow morning- call the PM and find out if they use the Immunoassay or gc/ms for testing- ask what their threshold is for testing, and requesting a copy of my drug test screening report. I also want to ask that a secondary test be performed using the gs/ms if urine is still available. My question is- what happens if they refuse to give me this information? What rights do I have to demand certain things from the PM? I have absolutely NO INTENTION of ever seeing that doctor or PA again- I will never be able to stay civil after the unspoken accusation of being a criminal piece of crap that is summarily shown the door. But I am not going to let this go either. My knees hurt- some days they are too bad to do much more than walk to the bathroom. I'll live without the Hydrocodone for now until it gets too bad. I'll stick to NSAIDs and Celebrex and hope the bleeding ulcer that started this mess doesn't reappear. But I can NOT let this go. I am not a vindictive person but I have to make it clear that I have been truthful from the start and that the practices of this PM are wrong. I'll be damned if I allow the PM and the PA to believe that I am yet another drug-seeking drug-selling liar. Has anyone had any success in fighting back? (and thank you, ALL of you, for being a place that gives me peace of mind that I am NOT losing MY mind!)
I also had a negative test. I have read that there are several other people with this same problem. I have now been cut off from my PM Dr. and have to find a new one! I'm so mad I can't even see straight! My test even came up with ALCOHOL in it and I don't even drink! Don't take cold medicine or anything with alcohol in it! I don't know what to do! I feel for you!
Please don't mix Celebrex and NSAIDS. Taking 20+ NSAIDS a day will also cause kidney disease. And then you have two problems instead of just one.
It is a help, it won't cure big pain but it may help take some of the edge off. Natural Source Rub A535 Capsaicin Arthritis Cream. Capsaicin lowers substance P in the spinal fluid thus decreasing pain over time used. So even though you would only put it on your knee in theory it would help your whole body. The gluscosamine in it won't hurt, but I doubt it is therapeutic.
Omega oils reduce inflamation in the body and will help mildly with pain. Glucosamine 1500mg a day (and some studies say that when mixed with Chrondroitin it works better) has been shown to be as effective as ibuprofen. It increases the fluid in the joint space over time. With Glucosamine you may not notice a difference as it takes up to a month to start working so its effect may be subtle.Glucosamine is already in the joint.
Melatonin doesn't work on pain but will help you get a good night's sleep which I find is one of the keys in pain control. Melatonin is what your body produces to tell it that it is time to sleep. I take 3mg but 6mg is also standard. I am pretty slight.It is a good idea to not take it everyday as I read a study that said then your body forgets how to produce its own melatonin.
The other thing that has been shown to help with chronic pain is low dose Elavil (amitriptiline - spelt that wrong - I am tired and ready for bed). It will also usually sedate you a bit making it easier to go to sleep. And it isn't narcotic so you shouldn't have a problem getting an prescription. I've also been seeing commercials about Cymbalta. Same type of medication.
I know this list is probably very small consolation. But they are all things that can help.
The other suggestion I would have is to ask if you can be given the medication by a nurse so they know you've taken it, and then tested the next day.
This is so very common amongst the chronic pain community. You are not alone in this! Most urine tests are very inaccurate and the more accurate ones are outrageously expensive and there have been reports on this forum of patients having to foot a $300 bill for the test each month!
You are taking a VERY low dose of hydrocodone and we all metabolize medications slightly different. It could very well be that your levels fall below the threshold of the test. Another common mishap is that chronic pain patients test positive for hydromorphone (dilaudid) when they are taking vicodin or they test positive for oxymorphone (opana) when they are taking oxycodone. This is because hydromorphone and oxymorphone are the metabolites of hydrocodone and oxycodone, respectively. The liver produces these metabolites in trace amounts and depending on the the threshold of the urine test, many have been labeled with false positives of these opioids.
Lindahand provided a lot of good info/suggestions for you to consider. I have read some posts where the doctors did indeed let the patient take the medication at the clinic and then immediately test which showed another negative result and at that point, it was recorded in their medical record so that they no longer were harrassed or reprimanded when this happened.
There are tons of great posts within this community that tell similar stories of what happened to other patients and what they did to get justice. Consider doing a search for "failed drug screen".
In Colorado, PCPs are still able to prescribe strong CII opioid medications. My PCP prescribes me the 50 mcg/hr Fentanyl (with titration up to 100 mcg/hr if needed) along with oxycodone IR for breakthrough pain. I have never seen a PMP. Given that you are only taking a low dose of hydrocodone, consider seeing if your primary care physician or group practitioner will prescribe your medication. My ortho doc does not prescribe pain meds either. Some PCPs drug test and others do not. Also, I am not under a contract but I DO follow the rules which are stated in many contracts.
I hope you get resolution soon and treatment for your pain. Please keep us updated on your progress. Take care.
First of all- thank you for the support :) This past week has been difficult to say the least! A few minor updates~ I had blood work done on Saturday to check for any problems with my kidneys, liver and thyroid and meet with my primay care doc on Friday the 18th. When I left the PM office last Wednesday I was scared that something was wrong with me since the PA I saw was adamant that my test proved I hadn't taken my meds in at least 2-3 days and I knew that was out and out impossible. Prior to being on the 2x daily Celebrex and 2.5 mg 3-4x daily hydrocodone I was taking a LOT of NSAIDs, and I knew it could cause organ damage so I need to make sure my health is still decent. I rarely take advil or Aleve anymore since the Celebrex worked better with way fewer pills. I called the Patient advocate for the hospital affiliated with the PM center I go to and requested my test records and that my urine be retested using gc.ms. The nurse(?) I spoke to was cold and snarky and told me that's the test they perform at a lab the samples are sent to in Minnesota (I'm in Ohio). I got the name of the lab and checked out their services. Found out a few interesting things. The test used for a result requiring a simple Negative/Positive is the Immonoassy- NOT gc/ms since gc/ms is considerably more expensive and used for additional testing when a positive result needs more precise results. So in all liklihood I was lied to by the nurse. I went to the hospital on Monday to request my drug screening reports and was talking to the head of the dept that would have to drive over to the PM center to make copies for me. She was very understanding and never approached me like I was being unreasonable or deceitfull. The damnedest thing happened though. At 2:30 Monday afternoon I got a VERY sweet phone call from a different nurse at PM asking me to make an appointment with the doctor for a follow up on my test results. I'd be naive to believe they retested my urine using gc/ms that would show the low levels in my system consitant with the amounts I take. But I think maybe, just maybe, they realize that I am not a liar since it's doubtful I would be following up with blood tests and requesting my drug screening results and information on the testing protocols if I was trying to run a con on them. I'm still saving up to have my hair tested- it costs @$190 here to get it done at a lab accredited with recognized chain of custody proceedures. I've cut back to 2.5 mg 2x a day- 1 pill- and will have to save the few meds I have for times when I really need the pain relief.
Lindahand- thanks for the ideas! I use Capicin almost daily and have for a few years now :) I have to be careful with it though since I have 3 pups that love giving "kisses"- even on my knees! I do take melatonin 3-4z week- Trader Joe's has a .5mg chewable that does the trick without upsetting my stomach like the 3mg and 5mg melatonin does. Glucosomine and Chondrotin don't do much for me unfortunately. I take 2 packs of Emergen-C daily intended for joint health that has it included in the ingredients. Maybe it does help though? I'm a little afraid to find out by no longer taking it at all because I REALLY don't want to chance my knees feeling any worse. Sooooo.... I apologize for rambling. This has been something that is almost embarassing for me so I have not shared my fears or anger with family or friends. I can't tell you how much it means to me to have a place where others understand and don't judge out of ignorance. I plan on making a call for that follow up appointment with PM tomorrow. I need to make sure my blood tests are okay for my liver and kidneys first. When I see PM I want to have all the information I can get so that I can be informed and educated about my own health before questioning the testing methods and results of the urine screens that came up negative. Thanks for listening. With any luck this will resolve itself and I can move past being called a liar by the doctors I trusted to help me.
Sorry for responding to your post so late. I am usually not online during the week as my job keeps me handcuffed to the desk! lol! But I am so overjoyed to hear this GREAT news from you. If you have time, do tell us how your appointments went later on this week.
It is completely understandable that you were initially concerned about your health when the results from these test came up negative as you did nothing wrong because you have been taking your medication as prescribed.
You are taking such a low dose of the hydrocodone and it is possible that the supplements that you take for your knee pain can contribute to the false results as there are some supplements that can cause false test results, either false positive or false negative.
I don't think it is necessary to get a hair test done. It sounds like justice is being served to you so I wouldn't spend the extra money on that test. You are wise to get your kidneys (especially), liver, and thyroid checked out. These tests should be run at least once a year while being treated with opioids and NSAIDS.
I am curious to hear how your appointment with your primary care doc went today. As I stated earlier, you are on such a very low dose of hydrocodone such that your primary care doc would probably prescribe your medication without a problem and primary care docs typically have less regulation and rules surrounding the refill of your prescription per month. It just seems to me that you are going through a lot of extra hassle through PM when you could bypass it all and still have your pain treated.
We have family in Columbus, Ohio and my father-in-law has chronic pain and from what we know, he is being treated really well by his primary care doc in Columbus. But I think either way you are going to be served justice and will continue to be able to have your pain treated. It is so nice to hear this is turning out to have a happy ending.
Wishing you more days with less pain. I'm looking forward to hearing how things are going.
Thanks for the message Femmy! Well, I saw my primary doctor yesterday and was finally able to breathe for the first time in 10 days :)) My liver and kidneys are fine and my thyroid is a little off but not enough to be seriously concerned about. My white count was at @13,000- (normal high end being 12,000) but my doc thinks it was the stress I've been under. I have lab orders to recheck my white count and fine tune the thyroid results but he wants to wait 5-6 weeks before I have the blood work drawn. Otherwise I am HEALTHY! yea! BP is excellent, cholesterol....all of it is excellent. So NOW when I call to make that appt with PM I can unequivacally state that it is NOT something wrong with me that led to a negative test result. Unfortunately in Ohio our Atty General has been leading a Jihad on docs that prescribe pain meds- a lot of paperwork has to be done on the doc's end to justify scripts for narcotics more than 30 days out from a surgery or injury, so it seems everyone is being made to go to a PM center. Your father in law in very lucky to have a primary care doc that will go to bat for him. My ortho doc is wonderful and has become a friend as well as my knee guy, but he has a big practice and I guess I can understand how there isn't enough time to do all the extra paperwork the DEA and the state needs for him to be the one that writes my scripts.
Monday morning I'll be calling PM to be setting up a follow up appointment. I'll be picking up the copies of my screening test results to from the records dept so hopefully that will show that it was Immonoassay and not gc/ms that was used to test for a positive result. After all the research I've done into threshold levels and testing methods as well as all the help I've received from all of you, I'm pretty confident I can sit down with my PM doctor and have an educated conversation about why my tests were negative for use. I love your (Femmy) suggestion to take my meds in front of the doctor and then be tested the next morning- if nothing else it would proove that it's possible to have a negative urine screen 12-16 hrs after taking 2.5 mg of hydrocodone. I'm putting the hait testing on hold until I meet with PM- I'm hoping it won't be necessary since it will cost almost $200 to do, but I'm willing to do it if PM still refuses to belive that I was not lying about taking my meds before my last screen. I'm so grateful for the support I've found on this site! I'll give an update once I see my PM guy- *fingers crossed* I will be able to walk out of that office with my head up and a small measure of my credibility and integrity restored :) Have a lovely weekend!
Thanks so much for your cheerful update! I am so glad that all of your tests came back NORMAL! Such great news. I hope all goes well at your PM appointment next week. Please do update us on whether or not they will continue to treat you there. I think you have a lot of favor on your side.
I did not know the lawmakers were getting inbetween doctors and patients in Ohio too. That's terrible! I guess my father-in-law is truly lucky as you said. That is just awful! Things are so tough on chronic pain patients these days.
I am so glad you were proactive on this. There have been so many on this forum that simply gave up when this happened to them. I think at your appointment next week you will demonstrate to them that you were not abusing your meds. I hope they will let you take the test again shortly after taking hydrocodone so that the negative results will be in your medical records. They should not fear the DEA as they have evidence to back up the negative for hydrocodone. I don't know why PM clinics always think tests are right 100% of the time when the medical information out there shows the exact opposite.
I hope you had a great weekend too and I look forward to reading your updates next weekend! :)
It's been months since you posted, I'm going through a very similar thing with my son at the moment and was wondering how things turned out for you? Did your PM Dr figure out that you weren't lying or scheming against him? How did you finally prove you really were taking your medication as directed but the test was wrong?
My son was accused of skipping his medication today due to a negative urine test he had last month. Because of my sons age I give him his medication and watch him take it so I know he really does. However, he has a stomach bug about 4-5 days before his test and although he took the majority of his doses he did vomit quite a bit during those days and I believe that's what led to his negative test. The Dr wouldn't even listen when I told him this and he cut my sons medication as a result and informed us that this will be the last month he will get them. Problem is, he does take his medication AND his injury is still there. Any advise?
Sorry for all the questions, I'm just not sure what to do or where to go from here.
I am having the same issue as above. I had a botched back fusion years ago and had to have my hardware removed bc the doctor put the screws through arteries and veins and was occluded. Had a DVT, Pulmary Embolism, very serious. I reinjured my back a year and a half ago. Been taking MS cotin, percent and naproxen since then. Never once tested. I came in for my month check up and told them I had the stomach flu, would not even shake there hands. I also want to get pregnant at some point and wanted to see where I stood baseline with my pain levels and took myself slowly down. Also had told my pain management physician this. Never once have I ever been accused of anything so never thought to tell him to document it. They took a swab test and I told the staff I had been vomitting for days as well as sleeping 12 hours at a time and could not keep anything down. I just woke up and went to my appt was feeling slightly better but hadn't taken any meds yet so he could see my pain levels to readjust my meds if needed. Next thing I know I am dropped from Vocab Rehab and told I tested negative and banned from getting narcotics from doctors and my pharmacy. I cannot stop cold turkey on my meds and just got out of poverty getting back to work after 7 surgeries and would be on the floor in tears without my meds?
If anyone can PLEASE give guidance, I DO NOT know what to do. No one will call me back or help me. I am trying to find the next step to fight this. This is ridiculous and so hurtful!
So I just have a simple question my sister has a REALLY BAD BACK an shes prescribed tramadols an her dr doesn't even want her on those all the drs up here are mormons an they believe everyone should suffer even if you have cancer they dont give out pain meds an they been LYING about her urine results saying she has NOTHING in there when i see she takes 4 a day as prescribed. ( she went to her drs to get a unrine test, said it would take 3 days ) she called today being the third day saying that there was NO TRAMADOL in her system but the urine test only showed IBP!!. is what they are saying which is a LIE from the dr when i seen her take them every single day.
This is the second time the same dr has lied to her an now cut her off an is going to let her go through horrible withdrawals an she has two kids to take care of!!!
what number should we call to make a complaint this dr needs to be sued an lose his licensee for LYING about a urine test just to get honest patients off there meds!.
Please reply with a number we can call this is RIDICULOUS HOW ****** THE DRS ARE HERE!.
Thanks you so much for expressing how you felt after your urine tests came back negative. I am going through the same stress right now and feel exactly like you do! I take my clonazepam exactly as directed, 1mg at night for dystonia and the next day the test comes back negative. I went through this twice now and have been asked to come in yet again to sign a narcotics drug agreement and of, course, pee in the jar again. When I expressed to the doctor and her staff how that makes me feel, I get a lot of; ''Oh, don't take it personally. It's just a policy put in place to prevent misuse of narcotics.' Well, I am telling you, when I have to go personally to the doctor's office to pick up my script, pee in a jar and when then I am told that the test came back negative, making me look like a liar and a drug dealer, I take that VERY personally and do not feel at all like I am just part of the larger picture!
I will have one more talk with my doc and if I get more of this crap not to take it personally and sorry, we can't give you your prescription unless you sign this paper etc. etc., I am going to drop off my meds personally and go cold turkey without. I can live better with that than to be thought of as a liar and drug dealer. This whole ordeal has caused me a great deal of stress, causing my dystonic condition to flare up. This is doing me more harm than good. And I am supposed to trust her with my life when I don't get an ounce of trust back? That is not a relationship that can work!
I am so glad to hear there are other people out there who are going
through what I am going through! ! was furious,humiliated, and felt like i was being accused of being a common criminal and I am a 51 year old grandmother with terrible back problems. I was on the Fentenyl Patch which I was wearing at the time of the test and it came out negetive for
narcotics! The Dr cut me off immediately and cancelled me as a patient
completely. I went threw the worst withdrawals you can imagine. I am getting a lawyer and we are doing a hair folicle test to prove my case.
This thread is such an old thread that most people won't even look at it. :(. I'm going to ask you to go up to the top of the page and click on the "red Ask a Question" and RE-post your statement as we have this problem with the tests all the time. Your solution has a chance on really possibly making a difference with your Dr. (I hope.). I want as many people as possible to read your comment. Looking forward to your NEW POST!
Hello and Welcome to our Pain Management Community.
Sherry is right. I almost your post it. This is an old thread and will not get the visibility that it deserves - or the responses. I want your thread/post to be read. It's very important.
It's also important that I tell you how very sorry I am that this has happened to you - because I'm going to congratulate and thank you for obtaining an attorney and fighting tis unjust dismissal!
Let me say Bravo!!! I
A bit about Fentanyl that even many practitioners don't realize/understand.
First, synthetic opioids like fentanyl are not detected by all immunoassay tests.
Second, fentanyl, being 100-times more effective than morphine, is dosed, not in milligrams (1/1000 of a gram) but in micrograms (1/1000000 of a gram), and operates at such a low serum level, it may be difficult to detect even in chromatography.
For your info, fentanyl metabolites are as follows:
Many of the ppl that come here with a false negative UDT (Urinary Drug Test) are on Fentanyl. Not only is it my personal belief that practioneers don't understand the way Fentanyl does or doesn't "show" on a UDT - there are also articles to back me up.
If your attorney is astute in UDT he'll understand exactly what I am saying. I have to admit that I do not have a good understand of chemistry. I can't interpret any of this - but I am smart enough to know that.
I have been waiting for your post - for someone to come here and say, "I've had it. I'm not going to be treated like a criminal. I did nothing wrong and I have an attorney to fight this unjust system." Indeed I have been saying that here for a very long time. You have made my day!! Thank You!
I'm going to ask you once again to begin a new thread. Just click on "Post a Question" - select a appropriate title and add your comments. You can even copy and paste what you wrote here into the new thread.
If one "fails" a UDT today it's very common that they lose PM (pain management). The PMP becomes judge and jury - you're guilty without so much as being allowed to question or submit your case. You're guilt, you have no rights. Due to this guilty judgement you may forever be banned from PM. I just read the other day that a PMP threatened a patient with prosecution if he even tried to consult another PMP. That simply has to be against our rights as a human being. How can that be legal? Denied pain management ever? We have no rights - and we'll have no rights until ppl like you take this to court! I can't tell you how delighted I am to read your post - but than I guess I've said that too many times!
Please, please keep in touch with us. I can't wait to here how your case is progressing - and the outcome. This will be watched closely by many. That's one of the reason I encourage you to begin your own thread. This has the potential of changing so much!
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