false negative for morphine but false positive for vicodin!!

[precious_woman]

I am really glad that I found this forum...I am currently in as state of shock over what just took place at my own pain management doctors office. I have herniated lumbar discs which have also caused nerve damage, degenerative disc disease and buldging cervical discs. I have been on morphine for about 4 years, extended release and instant release. Last month the doctor gave ALL patients a urine test and when I got there today he said "we have a problem"...I was shocked and asked "what?" He said "the results of your urinalysis are in and they came back negative for morphine and positive for vicodin, I can only write you one months prescription and you will have to find another pain management doctor"... I was shocked!! I said "No way.. there is a mistake!!! I take my morphine like clockwork!! Every 12 hours!! I get home from filling my prescriptions and I take out 4 seven day pill containers and label them with each date... I put each days dose in each date and they go into a lockbox. I have not and did not take any vicodin!!" I insisted he retest me. I know there is a mistake. He said "no, it's a $900 test" he also added "the problem is not with finding the vicodin but with the morphine coming back negative"... HOW?? I insisted to him that the lab must have transposed the two drugs... but he refused to retest me and has now released me from his care!!! Does anyone know how this could happen?? I always, always take my morphine as prescribed!! I did NOT take any vicodin because it violates my contract that I have with him!! (as well as I don't have it nor do I like it!!) I don't know what to do! I even had a tooth extracted a week before that urinalysis and did NOT accept any pain meds from the dentist because it would have violated my contract with him!! The only other things I have taken are fioricet which is prescribed by him for migraines,  "benadryl" which he told me to take every night because I never get a full nights sleep due to the pain. Also "Orajel and anbesol" for the tooth extraction pain. I am also a large coca-cola drinker!! I am literally in a state of shock because I know these results are wrong!! any help would greatly be appreciated!!!

[TrayCee]

SO SORRY for your situation...unfortunately this happens all the time.  The only advise I can offer is to start looking for a new PM Dr.

Maybe your Dr. was just looking to release some patients, maybe human error.  You may never know the truth.  UA's are not 100%.  They dont always work the ay theyre suppose to.

Again, so sorry.  And Good Luck in your Dr. search

[troubleinohio]

this happens WAYYYYYYY TOO MUCH...is it time yet to get a Patient Advocate Group formed and get legislation up for consideration to ban this type of testing ? this has got to stop!

[precious_woman]

Thank you both so much!! I do agree with the fact that maybe it is time for a patient advocate group! All I did was type in "false negative on urinalysis" and I was completely shocked at the amount of "hits" that I got! He gave me the labs phone number, I called them and they refused to talk to me until they have a release from him, which will be on thursday. I was a veternary technician for 12 years until I became disabled due to this medical and I know for a fact that these tests are not 100% and there is ALWAYS room for human error, let alone mechanical error. If those machines are not calibrated properly then there will be an error. The one thing that I do not want is to be "red flagged" on my medical chart for something that I didn't do wrong! Like I told my doctor.... I can't walk let alone function OFF my morphine due to the excessive pain level. and If I were to ever stop taking it then I know I would be deathly sick!!

[RunningMom]

It sounds like the test was switched with someone else.  When I did the drug screen, the nurse wouldn't let me take my eyes off of her pour the sample into the container and put the correct label on before they sent it away.

This is unfair and I believe you should of been retested.  He doesn't pay for the drug screen.  You do with or without your insurance.  

[precious_woman]

I said the exact same thing to him RunningMom!! They test EVERY patient on the same day!! You are given the cup and asked to "pee" into it and "leave it in the box in the bathroom" I didnt even see them get the cup FROM the bathroom!! I am really and truly still in a state of shock!

[RunningMom]

I wonder if the pm doc is using this as an excuse to downsize on his patients.  Surely he knows that this is bound to happen with their system.  I'm so sorry this happened to you.  I was dropped from pm just by getting a second opinion.  I'd make an appointment with your PCP and let them know what is happening.  Most likely they will prescribe your meds until you can find a new PM.  Good luck.

[Tuckamore]

Hello Precious,

Welcome to the Pain Mangement Forum. I am so sorry that this has happened to you. Unfortunately it happens much to often. As said vefore you will never know why this happen. There are stastics that say these drug screens are wrong up to 60% or more of the time. All you have to do is be on this forum for awhile and you will see numerous posts like yours. It's always sad.

Unfortunately you have no recourse. There is no protection for the PM patient, no second chance. One failed drug screen gets you booted out the door of the PM Clinic. The lab eill only give you the number results. They will not admit there could have been an error.

I know this is difficult but please don't waste any time, you need to begin looking for a new PMP.  My heart goes out to you. Please keep in touch and let us know how you are doing.

Take Care,
Tuck

[precious_woman]

Thank you all so very much for your support. It's greatly appreciated. The biggest problem here is that I am in the process of trying to find a primary care doctor. Since I moved back here I saw one doctor whom I did not like for two reasons...#1) he answered his cell phone during the appointment and continued to carry on a conversation in arabic for 5 minutes IN the room!! (he could have said "excuse me" and left the room for that) and #2) he said "do you think with all the surgeries you have had in the past you are addicted to narcotics" ... I was so shocked at that comment. But I felt I handled it appropriately by telling him "no, I am permanently disabled. I only take what is prescribed by pain management and I have a contract with my pain management doctor that states I am not allowed to accept ANY prescriptions for any pain medications at all from any doctor other than him. I ONLY take what is prescribed to me and I take it exactly as it is prescribed".. This "new primary care" doctor was supposed to set me up with "pain management" here in Massachusetts but when I checked the doctor out that he referred me to online, it turns out to be "physiatry" (been there, done that when I was first injured) it wasn't until the physiatrist sent me to pain management that they put me on time released meds that actually helped relieve the pain. Like my doctor says, I will "never be pain free, they can only do the best they can to help make it tolerable"
I am going to call my pain management doctor back tomorrow and ask to speak to him directly. After researching on the internet and seeing that a urinalysis is not even 60% accurate, I was not there to witness my own urine sample collected or marked with my name (they had me "leave it in a box in the bathroom" and also from what I can tell I am entitled to request a second test OR a blood test and I was denied both! I doubt he will comply but I guess it's at least worth the phone call. I will also call the pain management clinic he has referred me to. I don't know, I am still very, very upset and being disabled it's not easy to fight a fight thats all due to some sort of mistake or error!! Again,  thank you all so much. It helps to know there are people out there who have been through the same thing and/or understand.  

[TrayCee]

Sorry to say but...IMO youre wasting your time calling the Dr that discharged you. Also sorry to say that your not "entitled to request" another UA.  As long as he gave you a "legitimate" (I use that term loosely) reason and 30days of meds hes well within his rights.

Put this mess behind you and look for a better Dr. BEFORE your meds run out.  You may want to consider weaning yourself off the meds with this last script incase you dont get new Dr. before the meds run out.

I sincerely hope everything works out for you.   I dont know what your religious beliefs are but...Never underesitmate the power of prayer

[Tuckamore]

If it makes you feel better to call your PMP than do it. Don't be surprised is he refuses to even take your call, It happens all the time and unfortunately that is the usual procedure.

And think about it? Do you really want a PMP that no longer trusts you and that apparently uses faulty procedures to collect urine samples for drug screens? I certainly would not.

You are correct there are some statistics that say that urine drug screening can be as high as 80% but you will never get a PM Clinic to admit to that. They have to rely on something. They are monitored by the DEA. If they continue to prescribe narcotics to someone that fails a drug screen they risk losing their license. Please do not think that I am standing up for the PM clinics, I'm not. These are just the facts as tough as they may be to swallow. I am sincerely sorry that this has happened to you.

I encourage you to also look for another PCP. In my opinion you ran into a very uneducated and unprofessional physician. There are good ones out there.

Again best of luck and please keep in touch.

[precious_woman]

Thanks guys. I am not so sure it will make me feel better to call him... but I am going to anyway. If for no other reason than to point out the collection procedure they used that day. I have been suffering from a severe migraine all night and regardless of what I try I can't seem to relieve the pain and nauseau (sp). I have that appointment with physiatry next week and I have the number to the pain management clinic that my old pain management doctor gave me. I don't know..... I am still shell shocked. I honestly thought I read somewhere that I had the right to request a second urinalysis and/or blood draw. Does anyone know if a problematic gall bladder would cause false negatives or false positives? about 6 months ago they went in and looked at my gall bladder and said there was a problem with the bile duct that leads from the gall bladder to the liver. (I think that's what it was). But after reading the post above about how he was "within his rights" I am feeling discouraged.  Because even if I were to "wean myself off my meds" then I would be 100% bedridden and in excrutiating pain!!

[JoshuaY46013]

If you call him, what are you going to say?  That your test was wrong?  The doctor doesn't have to give a client a second chance, if he even suspects you're using the medicines in the wrong way he can discharge you, no questions asked.  His ONLY obligation is to supply you with 30 days of medication.  I suggest you call another pain management facility instead of the discharged facility and schedule an apt.  They will not prescribe you anymore medication nor will they take you back because of stuff you read from the internet.  

I don't agree with the way these tests are collected, but this is the way of THAT doctors office.  If you're not careful, you'll add more information to your file and no doctor will want to take you.

I'm so sorry and I hope you get this sorted out, good luck to you.

[Tuckamore]

I still think you should call if it will make you feel better.

And I disagree that you will add more information to your file that would stop another PMP from taking you. That is unless you would be unruly, rude or untruthful.

We all have to look out for our own best interest. I don't believe that your PMP is going to take you back for anything and I think you have nothing to gain by calling him. But again if it makes you feel better, call. Just don't let the results of the conversation upset you any more than this incident already has.

I can't stress this enough, call another PMP and get on the appointment list. It will take time to get an appointment, especially with the holidays up on us. My heart goes out to you.

[precious_woman]

Thanks Tuck, (and Joshua .. it's kind of funny that you have my PM's name, call me paranoid but at this point I guess anything is possible!!). All I wanted to accomplish with the call was to ask if he was even aware of how the specimen was collected! I pee'd in a cup and left it in a box in the bathroom, I have no clue what happened to it from there!! I honestly didn't consider that stupidity on my part until this whole incident. I never in a million years would have expected this to happen to me. From what I am reading morphine stays in your system for 3-4 days, so IF I had run out of my meds then I would have been visibly detoxing right in front of him! This wouldn't be the first mistake at that office, one of which his assistant input all my medical information in another patients chart on the computer... which he caught and corrected in front of me! I guess it is a matter of principle., I don't like my reputation being scarred for something that I didn't do wrong! I have two appointments set up., one is with physiatry (maybe that has changed since 5 years ago)., that new primary (the one who answered his cell phone during my appointment and continued with a conversation in arabic for 5 minutes) is the one who set me up with them as pain management.. the second appointment is with a new primary. One who has a better rating and hopefully will treat me with a little more respect. It's hard enough to move from one state to another but being disabled makes it a bit difficult to find a primary care doctor. I kept my pain management doctor because I trusted him with my care. He WAS very understanding that all they could do was try to keep me comfortable. So the step after that is to call the pain management clinic that he referred me to. I honestly think that he does believe me that an error was made, but where he is a NP and ARNP he is concerned the DEA will audit him and he will lose his liceance. I can only hope this was a "blessing in disguise" because he was an hour and a half away and my older son would drive me to my appointments with him every month! I am unable to do that drive. I am still very stressed out about the whole scenario & I am also still nursing a migraine... but what more can I do?

[ckaye582]

A couple of years ago I had a hospital run a drug test on me and come up positive for crystal meth!  I am a 50 year old highly responsible woman whose vices are cigarettes and coffee.  Admittedly they were kind of astonished too, because looking at me you would find that I am very healthy, work out, well hydrated, etc.  Anyway, I did the research and found that this cold medicine I had been taking for 3 or 4 days in a row had something in it called psuedoephedrine in it, which tests out positive for crystal meth ALL OF THE TIME.  I don't know if they ever corrected it, but I sure as hell hate having that on my medical history.

[PattiKD]

WOW! Unbelievable!! I'm sorry that happened to you. At the same time..the labs should be aware of such compromises and either have a way to second test or determine a difference! That little mistake could send people to prison if they are testing for a state official or NOT using drugs illegally! Not everyone has a pristine history or reputation.

[precious_woman]

Wow ckaye, thats unbelievable... but believable (of course). I think only those of us who this has happened to can understand a believe it!! I am EXTREMELY curious as to "which lab'" did the tests on the others who came back with false negatives! Does anyone know how I can start a poll??  My doctor gave me the name and phone number of the lab that had run mine (AIT Labs) and he also sent them over permission to talk to me about the results. The woman I spoke with said they could "do a re-test" but when she came back on the phone she said "oh, I'm sorry but we no longer have that sample, but you can have your doctor send in the rest of the sample or submit for another test" and amazingly enough my doctor "no longer" has that sample either!! and we all know that he is refusing to retest me!! So the woman at the labs said that I could "speak to a toxicologist" and put me through to a voice mail. I left my name, phone number and an explanation of why I was calling but of course they never bothered to call back.

[ckaye582]

You know, I'm even wondering if the doctor is in trouble.  Yes, it would be nice to talk to other patients at the clinic and find out if they had an experience similar to yours. If it came down to it maybe you could run an ad in your local free paper or newspaper or on bulletin boards or something and see how many respondents  you get - even a handful would statistically give you some kind of picture.  But what would you do with that information once you got it, and how would you go after the doc?  You say what the doctor did was within legal bounds in releasing you (though you challenge his reason). Maybe you could file a complaint with your state attorney general's office if you got enough people together.

[PattiKD]

Very GOOD idea! WHO do we have to report to when we have problems with pharmacists, labs, or even doctors that refuse to run a second test to exonerate someone's medical record? Thank you!

[Armistead1424]

More and more people are going through this. I almost lost my meds due to a drug test. It's strange I had been seeing her for for 6 years before my first drug test. I take methodone  and lyrica. I take lower doses than prescribed, so often call in weeks later after it's due. I called in for my meds and she was out of town. The Neuro there wouldn't write my meds until I took a drug test, so I took it. I walked in the place next door, was given a pee bottle, no paperwork, nothing. I even asked about it and was told just to pee. So I did and left. Course I asked for my meds 3 days later and failed the test. I told them I had just seen the dentist and had 5 root canals done. I was put to sleep and given Vicoden for pain. I told the nurse I expected to fill out paperwork and would have listed the meds. As an employer at the time, I tested my employees and they would fill out paperwork stating any meds, ect. Again, I was in an agreement not to take other meds without consent, but the tooth pain was bad. I  told  the Dentist and he said I would be fine and he wrote it for 3 days, course I didn't expect to get drug tested. Also, I was put to sleep. Didn't matter. I was told I should've refused the pills. I told her get 5 root canals done in one day and one extraction, I was in terrible pain. I argued, didn't matter. I actually got an attorney, after a letter they reinstated me. They followed improper protocol. Still, she has been a hassle ever since. They treat you like a drug addict when I in fact take less than prescribed.  If your concern is talking a red flag, a lawyer could get it off. They have a strict drug testing protocol in most states...almost always now they require you hand them the pee and watch them label it and I even now sign my labels. I would check the drug testing laws in your state and see if they followed proper protocol...sounds a little fishy to me and your bottle sounds like it mixed up with someone elses. Hard to believe you were taking morphine and it not show up. Also, that he lost the sample.
If you can't afford a lawyer, legal aid may help. It sort of depends, you can't force a Doctor to see you, but losing your sample, .....I would talk to legal aid.

[JoshuaY46013]

How long are they supposed to hold the samples?

[TrayCee]

your case is different... you actually DID break your PM contract.  You are suppose to refuse the pills from the Dentist.  The methadone should have taken care of your tooth pain.

[precious_woman]

To: Armistead1424,  I agree with TrayCee that your case is different, because you did break your PM contract. I had an extraction the week prior to my test and I refused the prescription because I knew it would violate my PM contract!! and the tooth was fused to the bone!!! It was excruciating, but that is why I used SO much orajel and anbesol! I numbed the heck out of the whole area for the full week.
To JoshuaY46013: Thats a good question the lab said they throw them out after 10 days.

To Group: I have been researching the whole situation ever since I got home that fateful day and I have discovered so many areas for questioning. Not only was I not present when they picked up my sample and labeled and packaged it, BUT I DID NOT even see the form that they submit to the lab for testing which is supposed to list any and all meds taken and it's apparently supposed to be signed by me!! I had been to the emergency room two weeks prior to my appointment where I was diagnosed with pneumonia and bronchitis., I immediately let my PM doctor know that they had put me on pills for the cough, I even handed him the bottle!!  he said that it was fine for me to take them. (I have been wracking my brains trying to remember the name of that drug) benzotate (maybe??).. could that have showed up in a U/A as "vicodin" or could that have interfered with the morphine?? and here is the biggest question mark...
I was treated six months ago for abdominal pain, they did blood work and ended up bringing attention to my gall bladder. So they did an unltrasound on the gall bladder and also did the tube (where they put you under anesthesia) and it showed that my bile duct leading from the gall badder to the liver (or vise versa) was blocked. Can this interfere with my body's ability to process the morphine, thus resulting in a false negative??
There is also the question of which U/A test the lab performed.. if it was the ImmunoAssay test then that is extremely inaccurate (according to all the research I have done)... but if it was the Liquid Chromatography-Tandem Mass Spectrometry test (which i highly doubt) then it would mean that was not my sample that was tested.
I have an appointment tomorrow with a new primary (uggh) and on wednesday I have an appointment with Physiatry. I am not willing to just walk away from this without exhausting all means to prove my innocence!! Not when I take my medication every day and I can't walk without it!! Literally!! I am 80% bedridden WITH meds, but without them I am 100% bedridden.
So the sample could have been mixed up with someone elses. but my biggest issue is that I was not present during the labelling and packaging as well as I did not even see what was on the form that went with that urine sample. The toxicologist never called me back, so I am calling the lab again tomorrow, I want a copy of the report and my doctor already gave them permission to talk to me about it. I could barely "pee" when they tested me and I told his assistant as I was walking out the door that "I don't know if there is enough there to test, it didn't even go above the thing in the cup" and she said "that's ok"... if the reports states "how much" of the sample was recieved, I may be able to tell if that was my sample by the amount. I am also again going to contact his office however, I am getting together a letter stating all the facts, including the form that is submitted to the lab and the fact that I did not sign that form. I am under the impression that the form lists any and all meds taken and the patient is supposed to sign it stating that is the truth!  I will fax it to his office. I know alot of you think this is a waste of my time and it probably is, but I certainly don't want to be thrown into a group and labelled as something that I am not!! I have been going through my old records and reading "no abuse or misuse by patient" at every single visit. And there still is none of that!! I do not abuse or misuse my meds! I am adamant that I don't "violate" my contract by taking any meds from any doctors including the dentist!!

[TrayCee]

anything that even sound like "benzotate" would be a "Benzodiazepine" and would show up on a UA as just that.  Not an opiate. (Vicodin)

BUT.....I've never heard of a cough med containing a benzo.   Most cough med's DO contain opiates to suppress the cough.

[precious_woman]

I am finding myself extremely curious about the problem I had with my Gallbladder and the bile duct and IF that had anything to do with the false negative. As my PM doctor said he didn't have a problem with the vicodin in my system (which I didn't take any vicodin so I don't know how it came back that I did) he had a problem with the morphine not showing up! So I wonder if the problem with my gallbladder and the blocked bile duct has anything to do with the lacking morphine that I take everyday.

[Tuckamore]

As I said earlier gallbladder disease would interfere with the drug screen. If it was your urine that they tested and they used the correct test and their was no human error the morphine should have shown in your urine drug screen. I too have done extensive research on the reasons for false negative and positive drug screens over the past 18 months as we have so man questions on this issue. There is much information available on www and some of it is conflicting and difficult to understand.

The one fact that is undeniable is called the chain of custody. It has been protocol for years since the eighties when we required pre-employment drug screens. Chain of custody means proper documentation, confirmation and handling of the urine sample from the very get go.

I had to physically hand my urine sample to the technician, watch her label it, sign the label and the additional papers attesting to the fact that it was indeed my urine and that the proper protocol was used to obtain it as well as identify it. It also stated that it was my urine that in the container. That is the correct and legal protocol for collecting urine samples for drug testing, not placing your cup in a turn style and walking out of the facility. That is the part of your ordeal that I find so troubling.

UA's are not kept. Every lab has their time limits, some are 5 days, some 10 or 30. Due to the mere volume UA's cannot be kept indefinitely. In my opinion it is not suspicious that they no longer have your sample.