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So confused by UDT results and meds not working right.

I had an ACDF in may 2012 following a car accident that occurred in March of 2012. After the surgery I felt great and went on back on suboxone with the same doctor that put me on it before the accident. Was doing great it didn't last long.

Around mid Dec. 2012 my symptoms before the surgery came back worse then before. I went to my suboxone doctor and he did a cortisone shot, trigger shots, mri, and prescribe a muscle relaxer. The muscle relaxer helped a bit, but the no amount of NSAIDs or suboxone seem to help with the amount of pain I was having. The same doctor urged me to start Percocet which I declined for a few weeks until I couldn't take it any more, so I gave in.

The Percocet barely helped with keeping the withdrawl away at 10mg 4x a day. Plus, the longest it seems to work is 1-2hours. After a week he added fentanyl 25mcg/hr, which helped a bit more but the longest it seems to work is 11/2 day at the most and come 38 hours I start feeling sick.

A week later and while on Percocet 10mg 4x a day and fentanyl 25mcg/hr I went into withdrawl so sever that I had to go to the ER and almost needed to be admitted do to my heart racing at 180bpm. Then hospital ran a UDT and found nothing in my system, so they stableized me on dilaudid, and said that I was in withdrawl.

Then next day I went back to my doctor and got another UDT which is very specific and it showed that I had a 30x more norafentanyl which is the main metabolite of fentanyl. The normal ratio should only have 3-4 x more norafentanyl to fentanyl. I also had no oxycodone in my system but did test positive for the metabolite in very small amounts.

This prompted my doctor to consider testing me for genetic drug/enzyme metabolism. I still do not now the results of this, but since I have had the test done the test seems to have went from only taking 5-7 days to over 2 1/2 weeks.

During this time, my doctor won't raise the medication, in fact he wants me back on suboxone, even though I do feel pain relief if only for a brief time. Nothing is getting better with my pain, and nothing can be done. The fusion has caused the rest of my disc to develop problems, and I am having issues with my shoulder. The shoulder issues that are not even addressed yet and may be a freezing shoulder or impingment.

I don't know what to do, I can barely function right now, and if I was to go on suboxone I can't imagine how much worse I would be. I never failed a drug test, and while on suboxone I only took it every other day, so I am not sure why he is treating me like that. I really like the doctor and his personality but I feel like he is fearing something that is not even an issue, while I am fearing the pain.

I don't really know what I am asking, but I guess your advise, maybe a look from a different point or perspective. Anything really I am so scared, frustrated, and hopeless. I don't know why everything seems to go wrong all the time.

Thanks for reading,
2 Responses
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Avatar universal
MEDICAL PROFESSIONAL
Hello and hope you are doing well.

Understand your predicament. Chronic pain is responsive to oxycodone, but your doctor believes you may be abusing the medication. To provide a concrete evidence for this you can have a urine drug screen done. In regular users this screen should remain positive for two days. Also please ask your doctor or enquire at the lab, if they are using a oxycodone specific product for screening, as the more common opioid screening for morphiods does not detect oxycodone presence. Emphasize for the specific test.  

Hope this helped and do keep us posted.
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Avatar universal
Its possible that your body may have absorbed the fentnyl all at once. I read that your supposed to be very careful not to get hot, use heating pads, hot baths etc. Also, taking things with the suboxone still in your system is like a recipe for disaster, I don't know if that's the case, though. I just wanted to reply because of the poster above me saying your doctor thinks you are abusing your meds, don't let that comment keep you from posting here and seeking advice or support, have you and your doctor considered methadone for pain management? Anyway, take care and update us if you will.
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