I have been in pain management for 9 yrs, I am being prescribed oxycodone and I have tested positive twice for hydrocodone in the last 4 weeks. I have chronic pain with a past back surgery and both hips replaced. I don't want to lose my doctor, I have not cheated I accidentally took two of my husband's hydros 4 wks ago mistaking them for metformin and have tested positive twice since...PLEASE HELP...I don't know how to restore the faith in my doctor..This is the 1st issue I have ever had in 9 yrs..What should I do???
while researching info on the same situation of testing positive for hydrocodone while taking oxycodone I came across your posts. I have been with my current pm doc for over 3 years for chronic neck pain due to 3 herniated discs and spinal stenosis,and have never had a drug test come back with any problems. I was tested on 7/8 before my usual appt, I take oxycontin 60mg. 3x daily for extended pain relief and percocet 5/325 for break thru and that is all. This morning her nurse called and said my urine had come back positive for hydrocodone and had I been taking any norco or vicodin. I was shocked and said absolutely not, that I had not been on vicodin for over 6 mos. when my dr changed my break thru med to percocet because the hydrocodone was like taking nothing. The nurse said well, sometimes oxycodone can cause a low level positive for hydrocodone and anytime this happens we have to call and ask. She seemed to believe me and I wasn't too worried until out of curiosity I researched it and came across your posts. Should I be concerned that I have lost credibility with my pm doc who I love and have such a good relationship? I see this happened to you in 2010, have they discovered this is a problem with the testing since then as my dr's nurse suggested? any info or advice is appreciated. TIA
Wow man you too. I'm going through the same mess. I take oxy and an amount close to yours. They retested and I haven't gotten the results back yet. I too am big on my word and would never jeperdize what I take for lortab. Please keep me up to date as I would like to know what to do
Hi Again CarJockey,
Thanks so much for updating. I have reread this thread in it's entirety. Very fascinating... and admirable that you didn't give up. You hung in like a bulldog. Kudos.
It appears you were raised as I was, "You're only as good as your word.... And I've given you a great family name that is spotless... I expect you to keep it that way. That's all we truly have in life." Other things that were instilled in me and I bet in you also, "The only right explanation is the truth." ... and... "Never think you have the power to judge someone as that privilege is reserved only for our creator." I could go on... but you get my jest. It's refreshing to know there are others that were raised as I and feel as stronger as I do about these very important issues.
I too have done a lot of research/reading on false drug screens. I couldn't believe what I discovered. My finding were even higher then yours. The VA study that I read revealed closer to 70% error rates in tightly controlled studies. Human error is the leading factor in these high error rates. Yet most PM Clinics will not give anyone the benefit of these conclusive facts. If you fail, you're guilty and out, period.
I understand the PM Clinic position. They have to have rules and regulations for the abusers... and yes the addicts that sadly exist in our society. I am so glad that your story has a happy ending... so many do not. Luckily all my drug screens have been accurate but I am sick to my stomach every time I am subjected to one.
Sara, it is against our TOS to post personal e-mail addresses. I suggest you send a PM to anyone from whom you wish to gather specific information.
Joy, Please begin your own thread instead of adding onto someone elses. You'll obtain better suggestions and information in that manner.
My Best to All,
can i be in the sun if i cover my patch and have clothing over it i was just put on the fentanyl patch and had our beach vacation planed before this happened
Paul...is this the article I am trying to find...http://www.bioportfolio.com/resources/pmarticle/66158/Anomalous-Observations-Of-Hydrocodone-In-Patients-On-Oxycodone.html
Well I haven't had the time to update some interesting things that occuree since imposter this information over a year ago. I'm am thankful for all the support I recieves on and off forum here and I was retested by my PM dr and passed with flying colors, the interesting thing is I did not have the FALSE POSITIVE for hydrocodone in my results. The absolute ONLY explanation for this is simple: several months ago I asked my great PM Dr to 'rotate' me off my medications again on to something else as my tolerances were making my current medication intake useless with regards to pain, so while I was kept on OXYCODONE (instant release) I was rotated to MSER (Morphine Sulfate extended release) and since they came out with a 200mg tab this serves as my extended release base medication and the OXYCODONE is for my breakthru pain. So OXYCONTIN HAS BEEN COMPLETELY REMOVED FROM MY PRESCRIBED MEDICATION - hence that had to be the trigger for the 'FALSE POSITIVE FOR HYDROCODONE ' as the intake levels and the formulas posted by another member in my post works out to that 1% impurity ratio in and during the manufactoring process. The numbers work ALMOST EXACTLY IN HARMONY with how much I was taking as well as the impurity range testing discovered in & during the manufacturing process.
So with the process of elimination it most likely would only pull a positive result if your taking OXCODONE and not OXYCONTIN as my personal experience and test results show. Just a sidenote: my doctor is a very humble man, and during all this he kept hianconfidence in me and I don't know even as a 10 yr plus patient at my previous PM center with no infractions I would have been afforded the luxury of a second chance or a chance to prove my innocence. My Dr did change labs and told me that even he got poor 'customer service' when he was attempting to find out more information on my test. I hope that this follow up post helps someone who meeds LEGITIMATE HELP, and just please keep in mind if you come across other forums where information is being trading that showa illegal activity - DON'T SHARE INFORMATION & of you can figure out a way to get the post or even the foum removed take a minute and email the site host. Apparently with freedom of press the legal standing is null, but let's try to do anything we can to discourage this information from being posted, best of luck to all of you and God Bless.
Can anyone pls send me the document about the hydrocodone showing up as a result of the manufacturing process of oxycodone. It may be the only thing to save my job! Seriously, PM for 10+ years, a nurse, and have had the 'negative for opiates' happen also. BUT now I am floored. Pls email to saramc at aol *******. Thank you
As my rather long post spells out my situation, 1st blood tested - NEGATIVE FOR ALL OPIATES, if it didn't happen to another patient I think I be trouble, the the urine test showed HYDROCODONE in my system - there's a letter that's NOT public knowledge that my friend sent me as a 'pre release: URGENT' showing just how the manufactoring process of OXYCODONE, this finding was sent to the AAMRO which I don't have access, but got a copy of the document which confirms WHY & how I tested positive for a drug I didn't take. Since I had HARD DATA and not 'forum discussions, I thinks', maybe this , or anything that was debatable due to newness or insufficent data' I dropped it off to my PM Dr, and I wrote a note to him thanking him for his support and that I finally felt the issue was resolved to MY satisfaction, and would speak no more of it. Of course I'm sure on my next visit in June or so we'll discuss it, I haven't gotten feedback from him yet - as I've explained in post, there is no way j can expect him to fo anything more then call the lab. He isn't going to dive in both feet and fight for MY crediability, I have to fo that. I attempted to contact 'LAB CORP' through their 800 customer assistance number. 2 hrs 43 mins I was switched, flipped, transfer - I don't know who did my urine lab, but I know the blood was done at LAB CORP. when I finally got to a lab tech and explained my situation and wanted to know hoe I could test VOID of opiates - he hung up on me. I told my doc about this and told him I understand where he would speak to the lab - but how honest they going to be? 'Yea we mess up all the time still please send us your business' it's not gojng to happen. As time consuming as it is it's up to use when wr have a issue to take full control of the situation and stick to our guns, on hind sight it would have been EASY to walk away, he wasn't really concerned and told me there had to be a explaination - he just didn't have it, he never threatened my standing in the clinic or anything, but even before I knew the reason, I knew what I didn't take and knew if it showed once, it will show again - then what? So the next time he test me I get dismissed? I had found 6 possible explainations for the result - the 1% impurity factor was in there but I had no supporting data to back anything just slot of 'maybies' which unfortunately don't cut it. I am lucky he is not quick to judge me and is rational or else id be screwed. So as my friend quoted Sherlock Homes 'REMOVE THE IMPOSSABLE & REGARDLESS OFVWHATS LEFT, NO MATTER HOW IMPROBABLE HAS TO
BE THE TRUTH' great advice. As far as the scammers' & abusers - I have no right to judge anyone, but yes they have created this situation for us, and VICODEN is the most widely abused prescription available, understandably, but not on this for joy, and like many of us Im sure haven't 'caught a buzz from our meds in years' we need them to function, they make us able to be as productive as possible, but wr all have been in the wake of DT's and how aweful they are, even after just 48 hrs. I learned alot if interesting things in trying to restore my crediability and I hope the Dr take this finding as the cause. I learned that the Fentanyl patches leave almost nothing traceable in anything - blood, urine, hair. If you want to see a glimpse of just hie bad this whole thing is, watch the HBO series on ADDICTION - named the same, that will show alot you never would believe. God Bless
I have been in PM for 7 years and take random UA's at my job, I also tested negitive for ALL opiates.
Something wrong w/these test's
Oh and I can't believe you did all that on an iphone! I am so bad on mine! :)
I have been ranting on about the people who abuse the medications we have to have to function here as members here know and I wish it really did some good but honestly I do not think it does. A member of the SA ( subtance abuse community) came to the community here and apologized for all the grief she had caused us PM Pt's awhile back and I thought that was great because she realized what her actions had done to us. The people who take these medications for "fun" do not even comprehend that their actions directly affect the PM Pt's. And to be quite honest the ones who do know just do not care.
I have posted the results of the VA study as well as the 13 drugs on my journal. I believe their should be more studies done on this. I have been personally effected by incorrect lab test and it is embarrassing and I am one too that believes one's word is their bond so I was feeling like a liar. I did eventually "clear my name" but the fact was I was still wronged!
Who pays for these false positives? WE DO! Not the labs or the doctors it is the Pt's who pay. The labs should have to be regulated and have to pay fines for false results!
There will be no changes made until they are held accountable.
I am glad you have not been released from your PM doctor. It is all too common to be released with no chance to redeem yourself and then your red flagged the rest of your life.
Thank you very much for posting all the information you have found. I know it is a lot of work:)
The 'FAMILYPHYSCHIAN' (sp) wrote:
The American Association of Medical Review Officers (AAMRO) recently sent this update to their members regarding the issue of unexpected results on drug testing. It includes a chart on the acceptable and typical levels hydrocodone in commercially available oxycodone. The hydrocodone is caused by a small side reaction during the manufacturing process.
You are on a total of 1500 mg of oxycodone (combined dos of your IR and sustained release). At the top of the "typical" impurity range, you would be consuming 1.8 mg of hydrocodone daily. (0.12% of your total dose). At the maximum allowable contaminant (1%) you would be consuming 15 mg daily. This amount would definitely cause a positive drug test.
Your doctor should find this information useful, and may even want to contact the author of this presentation.
As I said once I find the document is public domain and I can post it I will. GOD BLESS
To all my new friends I have met here and to those I haven't met yet. This is PART 2 to my recent post. Feel free to email me off board with comments & if you have any information that might help me get my credability back:
1% impurity in the manufactoring process of Oxy will cause FALSE POSITIVES for HYDROCODOBE
There are 1200 labs in the US, less then 100 of these labs meet the federal goverment standards for drug testings and State standards are NOT required in most states. Thus results in a 4% to a whopping 50% in False Positives & False Negatives, as well as other problems.
There (I think it is somewhere in this forum ) a excellent post by a person who obvious is a pharmacologist or chemist, it's mentioned that in about 7% of caucasins there is a genetic absence of a gene which metabolizes opiates. It discusses their binding powers and the effects of FALSE READINGS in test if your among the '7%' with this particular gene missing. The article is excellent and extemely technical, I had to keep looking up words in the dictionary, but well worth reading.
How there is currently a study underway about people who take relatively large amounts of ibuprofen that will cause a FALSE POSITIVE for HYDRCODONE or other opiates. However this testing is in it's infant stages and while there is a link established between the two, it's unclear if it just HYDROCODONE, other opiates or a combination.
There is also another study that was done by the VA and FALSE POSITIVES & NEGATIVES in drug testing. This test is too long to post but basically all the patients were monitored at intake of medication and testing. The result was 44% had FALSE test results. The study is accessable through the VA.gov forums.
Yet another test proving 12 or 13 (mentioned by exact drug in this forum as well by another participant) of medications called ' QUINOLONES ' which is pretty much every antibiotic out there. I won't list them, it's easy enough to find. Apparently these medications, one I was using as a ear drop, another I was using for a infected tooth'. These medications have been know to cause FALSE POSITIVES for opiates including HYDROCODONE.
Last on this particular posting list is: DEXTROMETHORPHAN which is found in ROBITUSSIN as well as many cold & flu medications, this once again causes FALSE POSITIVES for ALL opiates!
So that's the latest. I'll keep looking for more and whatever my Doctor shares I will post that information along as well. Please, keep posting and keep me informed! We need to stick together and CANNOT depend on our Doctors, as great as they may be to clear our drug testing issues themselves. They don't have the time, staff or ability to practice medicine and take on a 2nd job as 'researcher/crediability clearer/ patient screener, etc' if you read other forums as I mentioned in the beginning that talk about abuse, sale, purchase all the stuff that makes us honest needing patients appear dishonest - SAY SOMETHING, COMPLAIN, EMAIL THE HOST, HOSTING COMPANY, RAISR HELL TO GET THESE SITES REMOVED AND THE INFORMATION BLOCK. Call the DEA! Do ANYTHING, but do SOMETHING! God Bless and I'll try to answer questions if possible. I'm a patient, not a doctor. If I can help a honest person who has followed the rules I will.
MY F/U POST IS PRETTY LONG SO ITS BROKEN UP IN PARTS, THIS IS PART 1:
Well - it kept eating and eating and eating to the point were I wasn't sleeping, spending all night researching how I could test for HYDROCODONE when I don't take, don't WANT TO TAKE IT and in 14 yrs in Pain Management I've never NEVER tested 'dirty'.
At 1st my wife thought I was going crazy and I was needlessly concerned, that is until I showed her & explained to her just how serious something like this is. I had her scroll for awhile, and I have to admit I was really ticked when I came across a post where people were openly selling their medications. I have no right to be judge, jury or executioner but this is 75% of the damn problem. It's the scumbags and dealers who made it he'll for legitmate patients to get the medication we need, to get our Dr's to up our volumes if needed, why it's so easy to get dismissed from PM and why I hadn't sleep a decent sleep since thus happened. I wrote a really nasty post, but big deal - as that's going to stop anyone from 'buying' these meds to get 'fu$ked up'. If that's not bad enough these people are telling everyone how to 'multi doctor', exactly how to abuse the medication, the fastest way to cut the coating, how to snort it, shoot it, use it in a suppository, anything you SHOULDNT do is there in full description, I actually started to tast vomit in my mouth. Of course after reading other forums & postings my wife soon realized just how serious this stuff is. I haven't had a 'high' feeling from my medications in years, my receptors are probably so saturated with opiates I don't thinknits possible, even at my levels of intake. 1500 mg daily would kill some people, as I've said before I'm not proud of my intake, and certainly not happy to rely on pills to have ANY quality of life but I do. Without these medications I couldn't hold my 4 yr old, or held her as a baby, walk even a litttle bit with my wife, be even a remotely pleasent person or even get out of bed. I need these medications, and thank God for 'pain management & doctor's who comment their genius to this field' no wonder they dismiss so many patients for slight infractions, what Dr has the time to be the 'researcher' to figure out why these test come back incorrect, or has the patience to wade through 100 patients in quest of the 5 that follow the rules, do what their told, suffer horrible without their meds, stick to thr contract, and TRY to have a relationship as well as a mutual trust with their PM doctor. I would not risk 12 yrs of my education, over $500,000 in medical school tuition on a patient, would any of you? No wonder why these doctors are skeptics to say the least. No wonder why they don't even want to listen to legitimate patients about 'False Positives' and cries of innocence.
Sorry I went completely off the deep end, excuse my rant.
My Dr is a wonderful Dr, man, humanitarian, and a brillent pain specialist. I was going so crazy I made a appointment 15 days early then when I needed my medication. I told him the truth that I was so 'distraught' & 'upset' by this I hadn't slept, and it was eating me alive. He looked a little baffled at first. I reiterated what I said about not taking anything I wasn't suppose to, how I was raised that my word is my bond, and signed contract or no signed contract I had given him my word. That I had called ALL of my doctors that have treated me in the last 2 yrs or were treating me and asked if the knew of any reason HOW or WHY I could generate a False Positive For Hydrocodone, even if the levels were low (1052 nl/mg), and it didn't matter to me WHAT the reading was, it was the fact that it was even there and I feel compelled to defend my honor, if you want to put it that way. I really got no information from my Doctors besides there are alot of false positives, the ones who have known me for quite a bit even offered to call my doctor on my behalf, if I was released from the PM program. I was moved by the sentiment, and it wasn't a BS one, it was heart felt and sincere.
During my visit Thursday I explained all of this to my PM doctor. As always he was attentive, listened, compassionate, understand and seemed somewhat taken back by my 'crusade' for the truth. He informed me that he spoke to the lab, and was awaiting so more information. I told him I couldnt explain my feelings about this and how horrible it was making me feel though I was innocent, and that it was more a matter of principal then anything, so much so that my only concern at this point was my crediability with him in this matter. I personally called the lab that returned my blood test 'negative' of ALL opiates. I contacted LABCORP customer assistance (that's a joke) and spent almost 3 hrs on the phone getting transferred, rerouted, put on hold, etc. I was never given a copy of my paperwork so I did not have the reference numbers, but provided all the information needed. Once I was asked by a lab tech what I wanted, and not politely, I told him that I was a high intake opiate patient and I wanted to know how I came back completely 'void' of any opiates. He told me that the Dr must have messed up the test, I told him no, I read the test, the coding numbers, and precisely what was written by the doctor 'Opiate Blood Level' - the jerk hung up the phone on me! So I told my Dr that I didn't have much faith in the lab stepping up to the plate and admitting a mistake, I also told him that he is a medical doctor and it's not his job or station in life to clear my name and I didn't expect him to do nearly any of the amount of research I had been doing, how could he possibly? How can I expect him to research this to find a answer, deal with his other 100+ patients, and have a life? I forget his exact words, but it was something to the extent that I was right, and how I had always been so forthcoming in the past, at this time we really had no 'issues' and while I would be drug tested again I really should worry so much. I was welling up in his office as I telling him how crazy this has made me. I don't know if I seemed 'guilty' or just insane, or really how it 'looked' to him. I told him that expected the urine test after the blood test negative and over a decade of strict pain clinic protocal put me in this mindset. I think maybe my PC called him and told him how upset I was I don't know, but it wouldn't be out of character for her to do that, she too is a wonderful Dr.
So after spilling my guts proclaiming my innocence yet again I told him of about 5 or 6 results I found as fad as 'False Positives' go, and while I had a tidy package to bring with me that morning, my daughter was acting up, my printer wouldn't print, so I couldn't give him the references I had, along with the study information , sources, etc. While on my way out the door to see him I grab a paper with a bunch of information on it, which just happened to have been used in an artist practice of my daughter practicing her favorite shapes.
Here's what I was able to discover about MY situation. I do plan on taking thus futhur for my own knowledge and maybe just maybe I can save someone else. I thank God my Dr has seemingly given me another chance and while I think I have sone ground to recover at least I'll have that opportunity.
Yes I always recommend that as soon as you have one drug screen cone you immediately go to another facility an have another done. I don't know how feasible that is for ppl but at least you have a back up screen done hours (at the most) apart.
You may never find the reason your test was inaccurate. Remember the most common cause is human error. You can't track that down and no one will ever admit they may have made an error. Next UA Drug Screen request that they take two samples. If you don't already, watch them label both specimen containers and initial on the specimen cups that they are yours.
You are very fortunate that your PMP has not dismissed you. Apparently he not only trusts you but he knows the statistics. However blood drug screens are much, much more accurate, almost fail safe. They will stand up in a court of law. That is the test failure that you should find more concerning in my opinion.
Have you spoke the lab that preforms the tests? I would try to do that and ask for any explanations that they may have. Another poster did that and finally obtained the answers she was looking for. Again good luck to you!
Thanks for your support. I had to trim my original post back by almost 1/2 as I went way beyond the word count. I've been in PM for 14 years and I take this seriously. While on this visit I was 'spiked' in pain levels, but the meds I'm one keep me at a 4+ which to me is a GODSEND. I've been stressed lately for alot and know well that's why I'm spiked at a 7. I know if he doesn't come up with a 'reasonable' answer then IM GONE. I don't even drink, and know the horrors of false positives but never had it happen till now. As j said he's more then fair and reasonable but I know that I didn't do anything wrong. A week before that he sent me for blood work and I came back NEGATIVE FOR ANY OPIATES, had this not happened to a other patient I would have probably been dismissed right there. I know what your saying about the dentist and I won't even take scripts from him for pain. I broke a couple
of toes a couple mos ago and same thing I refused the scripts. I have since called my PC, UROLOGIST, former PM CLINIC and there seems to be no answer. If I was taking anything why would I torch ever bridge I have? I called trying to find out why. I have a great dr and it took me a awhile to find him when I moved from MA to FL. I went to 11 other Dr's and didn't like a single one. I'm funny about my Dr's - I a tually commuted to BOSTON for 18 months because I wanted to say with my clinic then my Dr got sick went out on leave and passed a year later. Im so angry about this. Of course I don't want to be 'blackballed' from anywhere - this Dr got my sciatic pain pretty much to 0 ! O told him a long time ago id be his 'guinea pig' anytime. Back to the dental work - I brought in the 2 oral solutions that I have cause I can't afford to have the work done, he looked them over and said he didn't think that it was that. He's not a BS'er and if he doesn't knownthe answer he'll tell me, and he will find out. I'm open to retest of ANY kind to cllear my name, I mean for me to jeopordizw my ability for any quality of life for. Couple vic's is Nd would be stupid. Considering what I take it like taking baby aspiren! I knownim innocent but as I stated my concern about retest - what if it shows up again or not at all? If it shows up again I'm cooked. and not at all my crediability is gone. How is possible that if you take a ALOT of hydrocodone you can false test positive for oxy but not reverse? I take over 1500 mg a DAY of the oxy sisters. I'm not proud of it, I have a high tolerance. It's literally eating me alive and Ive been pissed off about it for 2 weeks. If id been smart I would have of had another test done right away - but I didn't think of it, that advice was posted here by someone else. My next appointment is June and my next need for meds is the beggining of April. I'm going to make a visit to see him for the April scripts as opposed to just picking then up - provided he let's me do that. I'm sure he wi retest me which is fine, it's just a mess. I appreciate the support and will keep the post as current as possible. Of course any suggestions are greatly appreciated. God Bless
Welcome to the Pain Mangement Forum. I am glad that you found us and took the time to post. However I am sorry to hear about your inaccurate drug screen results.
First of all urine drug screens have been known to be as high as 60-80% inaccurate. Many times it is human error. It happens to a lot of ppl...but when it actually happens to us it very, very disturbing. You may never discover the reason your test was inaccurate. The lab will not admit there may have been a mistake made. Or who knows what combination of OTC meds you took and/or what you ate that may have changed the chemical make up of your system. I have little trust in the accuracy of drug screening...and no I have never failed one. But I do know ppl that have and I know that it was the test that was in error, not the patient.
It sounds like you have an excellent doctor. Most ppl are dismissed immediately if a drug screen does not reveal exactly what the clinic values dictate it should reveal.
I too was raised the way you were. We really only have a few things that are important in this world, two of those things is our word and our name. I beleive that if we live our lives in that manner it shows, your physician most likely recognizes that in you.
Please let us know how you are doing and how this concludes for you. I will be interested in your updates.
Best of luck to you and take care.
I don't know what to tell you. Are you sure that the Dentist didn't give you something. They generally always prescribe Hydrocodone when a patient is in pain and needs relief. That is their drug of choice in those offices. Don't know why but it is.
You did a nice job of standing up and explaining yourself. It sounds like he believes you and will keep you on as a patient. In all the years that I have been in pain management and that is about 13, I have never ever had a problem. I can't understand why so many ppl do have these problems. My guess is that they are not following their Doctors orders and taking more than needed.
Some ppl are just in more pain and their medications don't work as they should. Therefore, they take more than prescribed. That is very common and it's a real shame that the Doctor can't adjust the medications to make these patients comfortable.
It's up to your Doctor whether he will keep you on as a patient. It's going to be an uncomfortable wait until you hear back from him.
I truly hope that things will work out for you.