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Why did I get a negative result for my pain meds?
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Why did I get a negative result for my pain meds?

I survived a major accident resulting in many back surgeries, resulting in my need for medicinal pain management.  I have been going to my PM Dr. for 3-4 years now, and I am visibly disabled.  I was prescribed fentanyl patch 100mcg every 48hrs, and lortab 7.5/500 QiD for breakthrough and soma 250 mg TiD for spasms.  My doctor has rotated me off the fentanyl patch, replacing it with ms contin 60 mg TiD.  I have been on the new medication for two weeks and submitted a urine sample.  The instant result before a lab test is negative of any of my medications.  Should I be concerned?  With the level of pain I am in, I count the minutes to my next dose.  I cant stand to open my eyes without my pain medication.  My Dr. says these results can happen, especially from an instant urine test, and doesnt seem all that concerned.  I on the other hand want to know how such a significant amount of opioid medication can fail to be detectable.  I took my medicine as prescribed, ocassionally a little more, and an hour and a half before the test.  What can cause a false negative of three different meds, and how can I rectify this?  What should I do?  Please advise.
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16 Comments Post a Comment
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Avatar_f_tn
The 'instant tests' are not as reliable as when they are sent away and done in the lab.... i believe your doctor wasn't too concerned because hes seen it come up negative in the instant tests before and then positive in the lab tests.

The fact it gave a false negative to not one but three meds indicates to me it is a dodgy test...

I know you probably won't be reassured and relieved until you get your lab results... but please do remember they are not as accurate. You have had many back surgeries.... your doctor knows this alone will cause ongoing back pain issues.

I'm sorry you live with this pain...... and do hope better days are ahead for you. We don't think that every time we get in a car we take a small risk....

When do you get the lab results?
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Avatar_m_tn
I was just going to wait until I go back to my doctor in two weeks to find out what he says then.  Do you think I should call Monday and ask if there is possibly something in my diet that could be affecting my absorption of the meds so I could avoid it in the future?  I hate worrying about this, especially since I did nothing wrong.  I truly do appreciate your concerns.  I broke my back 3 times in the line of duty.  Thank you for taking the time.
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Avatar_m_tn
Thank you so much for your response.  You actually confirmed my thoughts and reasoning.  You really helped put my mind at ease.  In hind sight I do remember my doctor saying that I shouldn't worry about it, that the instant results are often wrong and to wait for the results from the lab.  I want to call so badly, but don't want to convey the feeling of concern to be mistakenly interpreted as if I have something to hide.  I think I am reading to much into this.  I don't like this.
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Avatar_m_tn
My worrying is making my pain that much worse.  I am in agony and wish I could just be comfy and sleep.  My legs and feet feel like they are on fire from nerve pain and my back itself always feels like someone is standing on it, while two guys are taking turns with hammers me.
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547368_tn?1332173665
Hello and Welcome to the Pain Management Forum.

My Chronic Pain, Disabilities and limitations also come from a MVA, one that they said I would never survive... but here I am! My heart goes out to you. And as said by Perch your PMP probably knows about your high levels of pain and the fact that you require and take your pain medications.

We often hear about failed drug screens.... they are not as accurate as we would hope they would be...with inaccuracy rates running as high as 70-80% in some instances. That's why your astute physician was not overly concerned. The largest reasons for inaccurate results????, Human error.

Please don't obsess over this as you stated it just increases our pain levels.

Your inaccurate results are not from your diet in general.... and I highly doubt it has to do with anything do with what you may have eaten one time. Our archives are full of similar posts. Quick urine screens are not near as accurate and even the more detailed and costly ones can be inaccurate also. Just be happy that your PMP trusts and believes in you.

If it makes you feel better you can talk to someone at the clinic, please do so but I really don't think that is necessary. I have malabsorption syndrome which means along with food/nutrients my drugs are not absorbed as well as they should be. I have not failed a drug screen but I do understand your fear. I have discussed this fact with my PMP and have been reassured that if I ever did fail one, all things would be taken into consideration. I would not just be booted from the Clinic.... which is a fear for all of us. You may need that same reassurance. Of course the first response I got was if I tested positive for illegal drugs.... I said no, no, no that was not my concern. My concern was I would be "light" or maybe even negative because of the malabsorption.

I do think your pain levels should be less. Realistically we know that we will never be at a 0 or even a 1, 2 or 3 but you should not be at an 8 or 9 consistently.

The journey through Chronic Pain is not an easy one. Dealing with Urine Drug Screens that can be inaccurate and demoralizing comes with that journey. We get it.... we've been there so please remain an active part of our community. Feel free to respond to posts and continue to ask questions or just vent. We are here to offer our support to one another.

Please also let us know how your next appointment goes. I'll look forward to your updates.  

Take Care,
~Tuck
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Avatar_m_tn
Thank you again Tuck.  I am so glad I found this site.  The interaction between others in the same predicament offers comfort on so many levels.  Thank you.
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547368_tn?1332173665
You are so welcome. I hope you'll remain an active member.
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Avatar_m_tn
Hi Tuck,

I just wanted to clear something up.  My injuries were sustained in the line of duty.  What actually happened each time I was severely injured, I really can't disclose.  I can say that in one of the instances I was struck by a large moving vehicle, and I wasn't in a vehicle myself.  The other times were equally devastating.  Sorry I can't say more, but I am sure you understand.  Thank you again for your support.
Be Well,
disabled
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547368_tn?1332173665
That's for clarifying your information.... and please allow me to thank you for serving our country. It is greatly appreciated.

If I understand correctly your condition is a direct result of your service to our country. This makes your situation even sadder.

I wish you the very best!
~Tuck
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Avatar_m_tn
You are absolutely welcome.  You are a sweetheart, the feeling is mutual.

Disabled
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Avatar_f_tn
Hi DS75....I just found this site after being in chronic pain from a car accident 3 1/2 years  ago.  I came across your post and just wanted to say....Thank you SO much for your service!!!  You are a HERO!  Thank you for sacrificing your life for my freedom!  

I have been extremely depressed due to the pain "wearing" on me (6 surergies..the last one last Thursday) and all my effects this accident has not only my physical...but finanicially...mentally ...and emotionally!  

Reading your story has giving me comfort and peace...a reason to keep fighting!  

Grateful.....

God Bless!

Christie
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Avatar_m_tn
Hi Christie,
You are most welcome, thank YOU for the gratitude.  I am so sorry to here you needed another surgery.  Oh, and we are all heroes, it takes the love and support of our families and communities to inspire service men and women and civil service men and women  to insure a safe place for us all to live.  Sorry to go back and forth, like this, but you should put a smile on your face and be happy and proud that you have the strength and courage to improve your quality of life by any means you can.  Don't let pain get you down and take control.  Money and objects don't define us either.  We all have something beautiful to add to this world we live in.  Please don't let the negative stuff hide your contribution.  Your the hero this time, you went through battle Thursday.  I know sometimes it's hard to overcome, but You can do it.  Be proud of yourself.
All My Best,
Dis-spine
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Avatar_f_tn
Another thank you for serving our country and keeping all of us safe!!  Sorry about your injury.  I know little about failed drug screens, other than they seem to happen often.  I am glad, though, that your doctor didn't just discharge you from pain management, which a lot of doctors do.

I agree with Tuck that if you're having a high level of pain, despite the meds you're on, that you should talk with your doctor.  Living consistently with a pain level of 6, 7, 8 or higher isn't healthy.  Chronic pain, as we all know, impacts are lives on every level.

I have had a hard time finding the right medications to control my pain and I'm still not where I'd like to be (a 4 for me is manageable).  Some of my procedures help, but usually for not more than a day or two.  I hope you'll get some answers to the failed screening.  I know if I failed a screening I'd be wanting to know why as well!!
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Avatar_m_tn
Your welcome, thank you for that.  I'm sure my lab test came back positive for my meds, there's no way it couldn't, I shouldn't say that huh?  Oh well, I am in so much damn pain that I am spasmed up and clinching my teeth.  I can't take it.  These ms contins  are not working for me, they are a joke.  I don't know what to do.
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Avatar_f_tn
Keep talking to your doctor.  I know it seems like it takes so long to find the right fit but it's the nature of chronic pain sometimes.  I've had things work and then not be as effective or find that where I never had side effects with something, they suddenly crop up.  For some people, it takes some switching around.  I still haven't found the right fit.  I'm back trying morphine but it's not great for me.  Pain control isn't terrific and it causes me headaches.  What worked great in the past for me was oxycodone but it started causing me nausea and vomiting, something it never did.  It's a really frustrating process for a lot of us. Keep talking with your doctor and hopefully they'll come up with something!!
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596605_tn?1369950227
Here are some are foods/ medications that I've read can affect urine tests:
-Grapefruit
-Over the counter cold medications like Niquil, Vicks & Triaminic
-Ibuprofen in high doses
-Certain antibiotics
-Some asthma meds
-Mydol
-Some prescription antidepressants such as Elavil and Tofanil can show up as positive for opiates such as opium and heroin thus confusing results
-Valerian root is reported to cause false positives for benzodiazepines. -Other herbal supplements such as Kava Kava and St Johns Wort may also affect body chemistry such that false positives are produced.
-Zoloft is reported to cause false positives in urine screens, although for what specific substance isn't clear.
-Primatene can also show up as positive for barbiturates, and
-Benadryl can show up positive for Methadone.
-Alka-Seltzer plus, Allerest, Bronkaid, Contac, Donnagel, Sinuntab, and Sudafed can cause drug interactions

So false positives/negatives can come from a LOT of things.
This is by no means a complete list but it shows that if you know that you are taking your meds as prescribed, and you get an unexpected result on a UA, be sure to really think about whether you've taken any of these things (or others) that might affect the results

Horselip
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