Help with Negative Drug Test Results

[nottrue]

Hello...I have been seeing the same pain management doctor for about 5 years now.  I had DDD and I also have epilepsy which led me to a herniated disc in my neck from one of my falls during a seizure.  I LOVE my doctor...he is actully my favorite doctor in that he listens to me and takes time with and trys to come up with different solutions to manage the pain I have.  Well in October all of the sudden I was given a drug contract to sign that stated they could drug test me randomly (which I had no problem signing) and then at the end of my visit they had me do a drug test.  it was really informal in that I just left the cup in the bathroom not labeled or anything.  I went back in November and there was no mention of the test so I didn't give it a second thought.  Now I go back in December and the doc comes in and says that he needs to discuss my drug test results with me and that I tested negative for the soma and hydrocodone that he prescribes to me and that I tested positive for Neurontin (which I do not take).  The funny thing too is that it did not show the actual seizure medicine I take.  So since Neurontin is an anti seizure medication I asked if maybe that was coming up for my Keppra (seizure med) he siad he would have to look into it and then gave me prescription for only a week's worth of meds and made me take another drug test and said pending the results he would determine if he would give me more.  He also made reference to that he wanted to make sure that I was actually taking my medication.  I do take my medication and I am perplexed by these results.  About a year ago I started a new job and was certain that the drug test for that would show positive and they would have questions and I would have to show them my prescription...why am I testing negative for my meds.  I am suppose to call the doc tomorrow about the results of my most recent test (I thought they were instant...guess not) and I am worried that he is going to drop me...why would I test negative for the meds I am really on and positive for something I do not even take???

[sandee1818]

An unexpected negative UDT may have several interpretations.

Talk with the lab/MRO because the drug may be present, but below the lab’s cutoff
concentrations.

Ask for “no threshold testing” to see if the drug is present at low concentration.
• If the prescribed drug is not truly present, one or more of the following may be explanatory:


The patient did not take the drug in the last 1 to 3 days.

The patient excretes the drug or its metabolites faster than normal.

UDT was not sensitive enough to detect the drug (applies to immunoassays).

Clerical errors caused a positive UDT to be reported as negative.
o Patient presented an adulterated specimen.


True negative UDTs raise concerns about drug misuse/addiction (binging, overdosing, or
escalating dose leading to running out early), lost drugs (stolen, misplaced), or even diversion
(selling, giving away drug, diversion to friends, family, or the street).


If you look in my journal pages you will find alot of information and articles on false negitives.

http://www.medhelp.org/user_journals/list/356518?personal_page_id=863283

[flower12345]

It really sounds like they mixed up the samples. I'm glad that your doctor let you be retested. Please keep us updated. This seems to happen more often than one would think.

Flower

[sandee1818]

Hi,
I am sorry your having trouble. It is very common unfortunately. I was looking at some information on how Keppra is metabolised to see if it can possibly be shown as Neurontin in a drug screen. I have found a couple instances online but they are not reliable information. I will keep looking. There are several drugs that will cause a false negative and they are listed in my journal I will get the link for you.
When taking a drug screen you need to follow very strict rules.
1) Always make sure you tell the nurse what medicine you took and when and the amount.
2) Make certain your name is clearly printed on the cup and is done so by the nurse.
3) When you turn your cup in initial it in front of the nurse and have her do the same.
4) Watch the nurse seal it in front of you.

These things help ensure the test sent is yours. There are mistakes made at the lab and that is out of your control. Your Doctor is very good to let you take a second test as many do not allow this but simply dismiss you after the first test.
There are also cut off levels on test that may be low and are not detecting the medications. Depending on when you took it and the cut off levels this may be a problem. I have some information on this as well in my journals.
It is hard for some to understand Doctor's reluctance to prescribe more medicine after a test result shows none in the system but the Doctor has to answer to the board and even the law if a Pt misuses their meds or diverts them.
I hope your test come back correct this time and if not I would suggest you take the research to him showing that it is common for false negatives. I am sure he knows this or he would not have ordered the second test and he would not have given you another chance.
Had you taken the medicines prescribed the same day? When you take medications on a daily basis it should show up and depending on when you took them last how much as far as the level in your system at the time of the test. Some do have metabolism problems and the medicines do not show up in these test. Those with a faster metabolism will have trouble with the test. I assume they are sending them out as an instant test would be done in the office. This is good as they are more advanced.
I will post the links for you to my journal's:)