It really depends on the type of test you were given and also the results coming back negative twice is cause for alarm. I would make SURE you get the blood serum test as soon as possible so that the results can be put in your file and the doctor then can say okay we have proof so lets find out why your urine test are testing negative.
We have seen alot of this happening here and it is very hard to find a new doctor that will prescibe these meds for you after a negative test result and you have two so it is very very important you get this blood work done pronto!
Mollyrae has an article in her journal about this take a look at it too.
There are reasons your test could have come up negative such as mistakes at the office or lab but with two thats a rare occurrence to have happen twice. There are 13 drugs that will interfere with these test and I have posted them many times , I will find them again and post them for you too.
Normally i would doubt you were even taking your meds with a negative test result twice but with having the patch on and showing the doctor and I tend to believe you I think you may have some problem that your meds just are not showing up.
Did you ask the doctor for reasons he/she thinks this could happen?
Please get the blood work soon and I also think with the doc giving you a second test which is really never done and then ordering blood work I think the doctor believes your taking your meds too. There is also a hair follicle test you can buy online that will show the drugs you have taken in the last 90 days you can look in to.
I am sorry this is happening to you.
Get the blood work and then ask the doc if he will refer you to another PM doctor since I am assuming it will show your meds. If it is not in the blood work then your not taking the medications. I am not accusing you of anything mind you I am just saying there is no mistaken what drugs are in your blood work.
It is in your best interest to have this blood work done immediately and then get with your doctor about what options he can offer you at that point.
Let us know how it goes:)
During the visit he told me that this urine test goes back 30 days so if i had taken it the last 30 days it would have showed up. Is this true b/c from what I understand most drugs are out of your urine in 72 hours. Also if I am taking the smallest dose available for fentanyl that should still show up in my blood? I placed my last patch on , on tuesday june 9 and I did get the blood test done on friday june 12, I should have nothing to worry about? I also took a 5mg oxcodone that morning at 8:45am I saw him at 9:30am took the urine test somewhere between 10:00 - 10:30am. They then told me it was negative and tried to find a place that would do a blood test. I cried and had to blow my nose from the time he told me it was negative until 11:15am when I left and then it continued almost all day until my head started to hurt and my vision got blurry then after that i woke up about every hour during the night and could not sleep. Before I left they could not find a place that would do the blood test and the nurse told me they would continue to see me and do the injections but would not prescribe anything. I then called them back to schedule my next vist and she told me they found a place that would do it. the nurse said that they would contact me to set the test up. I then asked her if they would do it today because next week ther would be even less of a chance it would show up. She then called me back and said I could go now. It was almost an hour drive but hopefully it was worth it. I am also taking seroquel 25mg, Lamictal(lamotrigine) 250mg, alprazolam .5mg 1-3 a day, bupropion 300mg plus the pain meds. Also I have been given vicodin percocet narco darvocet oxycontin and fentanyl 25mcg per hour which all of them made me sick and called them and asked for something different b/c they made me sick . Also the first couple of days of the 12mcg/hour patch i was also sick but rested and got through it b/c that one did help the pain and those symptoms stopped. I do get very costipated on these patches and some is probably due to the oxycodone too. Also when i went to pick up the script for the lower dose , the nurse asked for the 25mcg patch's so I went out to my car and got them and gave them to her. as far as the rest that I never used I dissolved in water and poured that into a little ziplok bag of cat litter, which I learned is the best way from working for hospice. These doctors have told me how strong these meds are yet I take them and they do not show up in my urine? I thought I had nothing to worry about so I signed the paper and gave them a sample and now I have no faith in the health care system. I did ask him why and he said the test goes back 30 days so I must not be taking them. This is th worst month I have ever gone through, being on short term disabilty and finding out june 15 it was going to go to long term disability and I will lose my 24 hour a week status and go to casual position and not knowing if I will have a job if i do get better and now this. sorry this is so long but maybe writing my thoughts down will help me sleep better tonight although my back hurts pretty bad right now.
I do not know what your doctor is saying when he states that the urine test goes back 30 days. There's no urine test that I am aware of that will show these medications after 30 days. The oxycodone will show show up depending on your metabolism anywhere from 24 to 72 hours after taking the pill. the fentanyl will show up considerably longer.
Are you sure he was not referring to the blood serum test? Even then the short acting oxycodone would not show up after 30 days.
It does not matter what amount of the fentanyl that your on it will show up in your blood work if your using it. When you had the test done had you taken any oxycodone within 3 days?
I assume you have not gotten the results back yet for the blood work.
Ask the doctor what he meant by the test goes back 0 days because that is not possible with a urine test.
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
.‘Result of Urine Toxicology in VA Patients Treated In a Pain Clinic’
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.
These are the drugs known to 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.
I copied the above from an old post when a member had the same problem your having.
When you do speak to the doctor ask him about the 30 days and also if he is aware that some medications will cause a false negative.
Did you sign a contract with your doctor?
Your doctor ( according to your state laws) has to treat you for thirty days or until you can find a replacement doctor. this means treating you with the medications he has been treating you with. You can sue him for patient abandonment. Unless you signed a contract with him of course..
I am so sorry for all you have had to endure with these false drug tests. I am not as familiar with these as my astute colleague Sandee. I hope to be up to speed soon.
I am about to take a continuing education course on opiates, addiction, chronic pain patients, drug screening, etc. My sister (also a nurse) is taking this course now. I have reviewed the information and accompanying workbook. I was extremely surprised at the percentage of false negative and positive drug screens and why and how they fail. There are several reasons that this occurs and in a small selection of patients they can not accurately explain the results.
Some things I do know. Such as unfortunately the general medical population has viewed and treated these tests as if they are basically infallible. As you know there are policies set forth in a PM Program. If you fail one of the drug screens you are dismissed from the 'opiates for pain control' portion of the program. It is out of the PMP hands to reinstate you.
I encourage you to begin looking for another PMP, asap. It will take you time to find another physician/clinic that will admit you to their program. You may want to consult with your PCP to see if he/she will prescribe for you until you are able to locate another PMP that will accept and treat you.
We are here to support you. You may vent or ask questions at any time. Sometimes just knowing that someone is listening, cares and understands can be helpful. We can offer you that and I hope you will take advantage of our comforting community.
Hang in there. Please keep us updated. We will look forward to hearing from you. I hope you will become an active member of our community.
Are they actually checking for Fentanyl? I've read that it won't show sometimes on a standard opiate test, but that could be wrong.
I had a test once where the doctor came in and goes "Well you tested positive for opiates, so we can't continue". I shook my head and said "Look at the paper where you asked me to write down what I took..." of course "Oh it says Percocet 5mg, I'm sorry about that".
Doctors are extremely fallible and seem to believe in these tests above all else, I believe you had the patch on and it should've came up. As sandee said maybe that's the issue or perhaps the test is wrong, I mean it must be. Keep trying, plead your case.
Because you were on the 12 mcg patch and you initially changed the Patch on the 9th and then had your test on the 11th, it's possible that the amount in your blood stream was too low to register. As you know, the 12mcg patch is the lowest available and with it needing to be changed the day you had the test, it's possible that there was not enough in your system.
As for the Oxycodone, I do not know why that wouldn't show up. When you have the blood test, it will show up and prove that it was in your system.
I have heard a lot of this going on too. I think it's because opiates are so widely used these days. Everyone's system is different and I think the way Doctor test for the drugs has to be changed. I'm not sure how but evidently it's not working for many ppl who are honest.
I feel for you and hope that with the blood test, everything gets straightened out. It's a crime to loose the one thing that helps many of us and Doctors are so hard to come by.
Please take care and good luck with the results.