I'm so sorry you're going through this. Tuck is right, we hear about failed drug tests a lot on the pain forum. No one should have to live with this kind of fear when they're doing nothing wrong. It would probably be a good idea to sit down and have a talk with your Dr. Ask if he knows about what Tuck posted and ask which test they're giving you.
It just makes no sense that any pain patient should have to go through this. If we chronic pain patients can get this information they why do so many pain Drs not already know this?
It's very clear to us that you do need your pain meds and you're not selling them. The problem is with the test. Please do not let them give you another test without your Dr having this information. We don't know which med did not show up but your Dr can clearly see that you had your patch on.
You received great advice from Tuck, as always. Please keep us up to date on how things are going. We're always here to listen and help anyway we can.
Hello and Welcome,
I'm sorry for what you have and are going through physically - and now the mental anguish of a failed UDS (Urinary Drug Screen). I hear your story so often here - and I hold my breath every time I have to take a UDS for fear my results will be misread - or a human error will occur. Most of us live in fear.
UDS have become much more accurate in years past - the one factor science cannot control - the human factor, human errors. The actual test, such as the GC-MS has an accuracy rate of 98-99% when performed perfectly - however this does not take into account that one uncontrollable factor - human error. It happens. What method is your physician using for UDS? Is it the simply, immediate and less costly screen (immunoassay) - or is it being sent out for the more accurate GC-MS?
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:
Fentanyl (Transdermal, Transbuccal, Transmucosal, Sublingual)
Norfentanyl
4-N-(N-propionylanilino) piperidine
4-N-(Nhydroxypropionylanilino) piperidine
1-(2-phenethyl)-4-N-(Nhydroxypropionylanilino) piperidine
So are neither opiates showing up in your UDS - or just the Fentanyl? If it's the Fentanyl then your physician may just need some education is reading Fentanyl UDS results.
It's not your other medications that are influencing the results of your UDS. I wish it was that easy.
I'll be interested to hear more from you. Hang in there my friend in pain.
Peace,
~Tuck