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False negative urine test....

Jun 13, 2009 - 8 comments

With all the posts inquiring about false negative urine test I wanted to put this in my journal for reference.
When this issue comes up I always have to research the information so it is easier to just add it here in my journal. It is unacceptable that this is happening to anyone who religiously takes their pain medications. When they are tested and then fired because their test are negative for the medications they are prescibed it is unfair. there are too many variables to fire a patient on one negative test and the mistakes that can occur are too many to name. We need to have a contract with our docs just as they have with us only we need one assuring us they will not abandon us over one false negative result.


A drug screen is a complex thing and the higher tuned (more sensitive)
it is the more complex it becomes. You see, drug screens can be
adjusted to detect various trace amounts of many different types of
drugs. Some test react positively for the presence of drugs
(substances or derivatives) only if those traces appear in the test
medium in certain volumes. For example, a person on parole may be
given a test for marijuana (cannabis, hash, etc) that will respond
positive if the test medium contains traces above  a certain “cutoff
level” where the cutoff level is very low (10ng/ml possibly) . Whereas
a person applying for a job may be given a test for marijuana
(cannabis, hash, etc) that will respond positive only if the test
medium contains traces above a certain “cutoff level” where the cutoff
level is very high (50ng/ml possibly).

There is some recent history with false results as is evidenced by
studies conducted by the Veteran’s Administration (VA). For example,
the VAGLAHS Outpatient Pain Program (OPMP) utilizes a standard Drug of
Abuse (DOA) immunoassay and Biorad High Performance Liquid
Chromatography (HPLC) Remedi-HS. These tests are used to monitor for
medication compliance. In 2004  as many as 44 % of patients tested
were found negative for opiates despite patient prescribed opioid
medication. The VA concluded that the DOA test was not sensitive
enough (in other words the cutoff was too high to detect the presence
of opioids commensurate with what the VA considered minimum
requirements)
.‘Result of Urine Toxicology in VA Patients Treated In a Pain Clinic’
http://www1.va.gov/hsrd/about/national_meeting/2004/abstracts/2047.htm

In order to test positive for our meds we have to have the required amount in our system that the test requires in order to test positive. If one test requires only trace amounts then surly there will be no problem, if one test requires that a high level be detected then we will have to have that level in order to test positive.

There are thirteen drugs known to cause false negatives in these test. I have posted them before and will find them and re post them. I am aware that a lot of people are having this problem and as you say it could be the labs but there's no way to know for sure. I would ask for a blood serum test.


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by LeahParry, Jul 22, 2009
My husband is on a low dose opiate for chronic back pain.  His doctor tests him weekly to make sure he is taking them and not selling them.  He tested negative even though he is taking them as prescribed.  His doctor threw him out of his office!  After all the research I have done I found that this is a common problem and I am so grateful you have addressed it.  How is it more doctors can't do the simple research I've done to find this out?


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by sandee1818, Jul 23, 2009
I KNOW IT IS A SHAME THAT THE DOCOTRS DO NOT DO THE RESEARCH AND THEN APPLY IT TO THE pTS. IT IS A VERY SAD SITUATION THAT WE CAN FIND OURSELVES IN WHEN THIS HAPPENS AND WITH NO ALTERNITIVE TO PAIN CONTROL WHEN IT HAPPENS.


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by sandee1818, Aug 22, 2009
These are the drugs that will cause a false negitive.....

The reactivity of 13 quinolones (levofloxacin, ofloxacin, pefloxacin, enoxacin, moxifloxacin, gatifloxacin, trovafloxacin, sparfloxacin, lomefloxacin, ciprofloxacin, clinafloxacin, norfloxacin, and nalidixic acid) was tested in 5 commercial opiate screening assays from September 1998 to March 1999. In 6 healthy volunteers, we confirmed the cross-reactivity of levofloxacin or ofloxacin with these opiate screening assays. be positive, therefore some will and have failed these test.

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by wittlewabbitfufu, Aug 30, 2009
  
This past week, I had (or pretty close came to having)
a nervous breakdown over my damn false negative results on my oxycodone urine test. I take this medication for severe chronic pain, it's a God sent. My doctor sent me a certified letter letting me know that due to the results of this test, he would no longer prescribe me this medication (insert nervous breakdown here)  OMG....IMPOSSIBLE....absolutely IMPOSSIBLE that this would not show up in my system. Of course everyone thinks the worse, I saw the secretary girls whisper when I walked by, when I went to my Dr.'s office to pick something up a few days ago, I can hear them now "would you believe she's been SELLING her pain meds, how god awful !!"  I spent at least 40 hours this week on the interenet reading and reading and reading ANYTHING I could find on this med, testing done, possible test outcomes etc....
I called my Dr's office and spoke to my Dr's nurse, I told her I was absolutely protesting the results of the test, she gave me a "yea right" sigh, I asked her to ask my Dr. if he could order a re-test of my sample. I went through the week going over EverY possibility as to why the false negative, cross checked every single morssel I put in my mouth to see if that could cause a false reading, walked through the entire urine collection process and concluded that if in fact showed up false negative, it simply could not be MY urine, I was prepared to tell my Dr. I felt his office messed up labeling the correct urine. I mean for God sakes, there HAD to be an explaination.
To my surprise, the nurse told me the Dr.agreed to call the lab to see if they had any of my sample left and to have it re-tested. My Dr's office (secretaries/nurses) were getting P.O'ed with me because I kept calling with questions about my test, which one exactly they preformed, how things were spelled etc...well TOUGH COOKIES sooooooooo sorry to inconvenience you (yea right) sooo sorry for being annoying, I know how it looked, I'm selling my meds, making a TON of money, now that my test came back negative, I'm running around like a chicken with my head cut off trying to save my "source of income" (bull)  so let me wrap this up....I stopped by my Dr's office Friday with a large folder stuffed with printed info I wanted them to read about the info I collected on how these urine tests often come back false negative or false positive. I was soooooo surprised to learn that the      test most Dr's use to test for the presence of oxycodone is VERY unreliable. Many many times this test will come back false negative/positive and Dr's automatically jump to the conclusion that the drug is being misused. So Friday, when I stopped by the office, I wanted to tell her that the test that SHOULD have been done is called a Liquid Chromatography-Tandem Mass Spectrometry
this test will give a much much more accurate reading. I was prepared for her to say one of two things to me, 1) we heard back from the lab and they didn't have enough urine to re-test  2) once again the test came back false negative.  she said to me "Oh, I just got a message the test results are back", she told me indeed they did use the correct test the 2nd time around,being - Liquid Chromatography-Tandem Mass Spectrometry  test . So now it was do or die time, I began sobbing when she said "the test came back positive", In other words, yes indeed the med was in my system (like I knew of course it was) I think my name is finally cleared !!   My whole point of writing all this is to hopefully give someone in my situation a little hope, if you do get back a false negative/positive, immediately look up the IMMUNOASSAY test that is routeinly given when testing for oxycodone. This is NOT an accurate test for this particular drug and you'll be AMAZED to read just how common false results are. Why do they use this test then ? Well it's cheap, it's easy to perform. Insist a  Liquid Chromatography-Tandem Mass Spectrometry  test be done for oxycodone. Look up and print out the reports put out by the Mayo Clinic, the VA, the government, etc.....showing how this routine test is often inaccurate and not recommended by these groups.
I have an appointment with my Dr. in a few days, I guess I'll have to see what happens, will he continue me on this med now that he's said he's cutting me off ? I guess I'll have to wait and see but if anything, this re-test using the L.C.-T.M.S has taken a great weight off my shoulders. good luck~ wabbit

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by james918, May 21, 2010
mine too came back negative for oxycodone and my dr said she absolutely believed me when i told her i was taking my medicine, she told me that a small percentage of people had an enzyme in their body that amde them test negative for certain opiates. she at least unlike your dr did research on this matter and without her i would be in serious pain due to 2 major back surgeries a faild fusion and femoral nerve neuropathy. your dr should have had enough knowledge to know this, thank god u didnt give up and u researched eevrything u could. im glad your tests are now positive and i think all drs treating people for pain management needs to take the time and do their research just like u did, of course  they shouldnt have to be told to do this. good luck

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by jstducky, Jun 18, 2010
I probably have stuffed your messages but obvipuly with reason.  Your story from a journal entry here is mine.  I had the week from hell for pretty much the above.  I left my email too.  In fact if I could call I'd already have done it.  Hope you get this am in Oregon and see th
e doc Monday for the infamous show down.  I. Saw him this week but was so numb and blown away I'm sure I looked and reacted like a psycho. Please write and I'd love to talk briefly.

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by Cham593647, Jul 04, 2010
I take Oxycontin 40mg 3 times a day. I Too 10 more then I should have one month. And i ran out a few day early. I was in so much pain I smoked a joint with my uncle and it had Cocaine in it And I did not know it. Until i took a hit. Now my DR. know i smoke pot. But when i went for my apointmen it was 2 day's after smoking a hit of coke. And at my appointment I had to take a urine test. I got a call from the maniger of the office and she told me they may cut me off do to having cocaine in my system and none of my oxycontin. Now it looks like i am selling my pills to buy cocaine! And  that could not be more wrong! I just messed up by taking more oxy's then I should and took cocaine on accident. How in the hell do I explane this? If i loose my my med;s I can not walk! Do to a broken Back. So now I am so scard! I cant go without my pain med's. What do I do? Please I will use any excuse if it sounds good. And I can only promis it will neaver happen agine. I am only human. I have to get one chance! Any help will be grate!!!!!! Thanks, Chris.

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by Keithbrandee, Jan 31, 2014
I am in drug court and recently tested pos for opiate, I have not used opiates in over a year. I am 5 months pregnant and take prenatal vitamins and extra strength Tylenol, the only thing I've done different was eat an everything bagel about 3 hrs before screening, I have asked my Po to send to the lab but this is really stressing me out, I know I have not taking any kind of opiate has anyone had any experience with this and can maybe tell me will the lab beable to determine the truth just freaking out!

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