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Broad spectrum urine drug test


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Old 06-16-2017, 09:37 PM   #1
Dtrace
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Broad spectrum urine drug test

Hello everyone. I'm trying to get some information. I have had the same doctor for 30yrs since married and 3 children while under her care. I have had various back joint problems but was very well for many years until the last 2years started with terrible periods (like labour pain) and back pain leg pain hips..I have my own business and I have to stand on my feet all day sometime without a break. My PM doc, suggested tyenol 3 after a year or so it just wasn't working so I tried one of my hubby 5mg oxycodone tabs he uses for his back pain. (same doctor) anyway I asked about switching and she said sure and put me on 100 tabs a month. Mean while hips were getting worse and so she sent for x-rays to confirm arthritis in both joints due to my job. My one leg has been so bad it is waking me up in the night lately and my toes are painful and ankle. So I had to go in for my pap physical 3yr they asked for urine I thought nothing of it and I already went and had my blood work done. During the appointment she suddenly said as I was asking about my leg pain (going for more xrays) you can't stay on narcotics forever. I said ok well what will I take she said naproxen etc..they really bother my stomach and don't work that well..I told her I stand all day 8 hrrs a day..she said no more and on I went ...So I look at my results on line and she has ordered a broad spectrum drug screen...I never take more than 1 or 1 and half pills at a time and only 5 hrs aprt..I have had to take in the night now so I was running out and taking some of hubbys pretty reg. I also took Tylenol with codeine the day before because it was a none work day and I was trying to take that instead of the 5mg tab ..Question is what is she looking for amounts in urine I would guess?? I only took 1 tab that morning early and 1.5 about an hour before test. I was prob taking more like 35-40 in total a week instead of 25. but as directed. That weekend I took less though because I wasn't working. I would really like to taper down anyway..as they really don't work as well use to last 6-8hrs and year later I'm taking them every 5hrs. Sometimes one in early morning 4am ...What will show in this test I wonder. I don't drink smoke or use any drugs other then what I stated. I had blood in urine so she is sending me for ultrasound. Any thoughts. I think I am dependant to some degree but I def do not get buzzy or feel anything but normal when I take. When I don't take over 7 hour period I feel crappy. Thanks for any insight. New to this. We went on a cruise just before this and I ordered 4 days early..and was suprised when pharmacy said doc wants you to only order exactly 30 days after this. So I knew she was concerned about something ..She has never in 30 yrs questioned us about anything. I'm rather horrified by it all. How would you suggest I get off of this med and go back on over counter meds? Thanks again.

 
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Old 06-17-2017, 09:47 AM   #2
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Re: Broad spectrum urine drug test

Welcome! Sorry you are dealing with this. Typically with a urine drug test of a pain patient they check if the prescribed medication is present in the prescribed amount and if anything not prescribed is present. What they are looking for also depends how the opioid is prescribed. If it says "as needed" on the bottle, there is more leeway as far as not having as much med in your system (possibly even none). If the bottle says to take it every X hours, then you are expected to have that amount. When my pain doc's office does urine screens, they ask me when I last took each of my meds. You shouldn't ever have more than prescribed in your system though. Also, with a short acting med, they wear off very quickly, so the look back period isn't far at all.

You could get yourself in some big trouble for having extra in your system and/or having something non prescribed in your system, a note in your file can red flag you indefinitely from ever getting opioids again.

If you didn't sign a pain contract, were never notified of the rules and that you would be drug tested at random and such, and weren't asked when you last took the Oxycodone, you could try to use that with your doctor as justification for your behavior. Most of us sign a contract which says what rules we are expected to follow, like no early fills (we'd talk to our doctor ahead of time if we needed them early for a trip for example, and if the meds are stolen, we won't get a replacement), no taking extra, no taking anything else, random urine drug tests, using only one pharmacy, that we can be cut off at any time at our doctor's discretion, etc.

With that contract and discussions with our doctor we are made to understand that although taking an extra pill may help in the short term, it doesn't in the long term, as running out early just puts us in more pain than when taking the baseline dose (and possibly withdrawal), and it can even jeopardize our ability to be prescribed pain meds in the future. It sounds like your doctor didn't make that clear to you. However, you don't want to try to make excuses or be argumentative, as that could make things worse. Just if it ends up being a problem, bring up your concerns of what you weren't made away of. Just keep in mind that doctors are under a lot of pressure not to prescribe these meds, and can stop prescribing them at any time even if the patient doesn't screw things up.

Whether you are forced off these meds or want to get off of them, I'd work with your doctor on a taper plan. Typically you reduce the dose by a certain percentage every certain number of days. Not a certain number of milligrams, as then it would get more difficult at the end - for example going from 4 to 3 to 2 to 1 pills a day has a bigger percentage reduction at the end, the time when it is more difficult anyways.

It sounds like you are physically dependent (not feeling well when you wait longer between dosages), as expected taking an opioid around the clock long term. Your dose is low, so you will likely end up taking fractions of a pill at a time, as well as extending the amount of time between pills. Some folks find tapering easy, and some difficult. I also suggest seeing a pain management specialist, as they are the best suited to treat pain. There should be many other treatment options available to you, and possibly more tests to be done. Often a combination of medications, alternative therapies, and lifestyle changes is used. We are expected to make any necessary lifestyle changes which will help our pain, even changing careers if necessary to get off our feet for example.

Opioids are a last resort, and most of us go through many years of diagnoses exploration and treatment trial & error before possibly getting opioids as a treatment option. If a chronic pain patient is on opioids, typically the preferred way is a long acting opioid on a set schedule, so we have a constant level of medication in our system instead of the ups & downs of the short acting ones (and often short acting opioids are used on top of long acting as needed).

However, the pain management climate is moving away using any opioids for noncancer chronic pain. We hear of many folks being cut off or having their dosages reduced (mine was reduced by 2/3 a couple years ago for example). Most primary docs won't even prescribe opioids anymore, and use other methods for acute pain, and refer to a pain management specialist for chronic pain. Best wishes.
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Old 06-17-2017, 11:45 AM   #3
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Re: Broad spectrum urine drug test

Thank you for your advice.
No I did not have any formal contract or even discussion. It was like no big deal here they are take as needed 1-2 every 6hrs.
Now she seems concerned a year later. There has been a lot of gov and warning's about opiates etc in the news lately so I'm wondering if it has to do with the all the discussion of doctors over prescribing. I'm wondering if she may of run this test to see levels of toxin urine because of the blood showing up.?? Do you think this is a possibility? Or it's to check on how much I'm taking I just don't know. I will have my ultrasound on kidneys bladder next week. I def want to cut way back and eliminate the daily taking. Just taking something now and then when it's really bad. (trying to work) or eliminate ll together and try just Tylenol 3. I don't want to have to worry about taking it to elevate withdrawal symptoms...So I'm going to taper off and hope she wlll agree to help. I do not want to be dependent on it. Thanks again.

 
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Old 06-17-2017, 09:06 PM   #4
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Re: Broad spectrum urine drug test

I want to make sure I am not misunderstanding. You were prescribed Tylenol #3, but switched to oxycodone after taking your husband's prescription. Its a bit unclear what your actual dosing instructions are on your bottle but you said you should be using about 25 tablets a week, yet are taking 35-40, almost double what you are prescribed, then taking your husband's when you run out? Then you took tylenol#3 , from an old prescription? Filled an oxycodone prescription early? Is this the first time you have done that?
Not lecturing you, but trying to educate you and anyone else who might consider doing anything similar...all of the things you did, are considered misuse, abuse, and self medicating. It is illegal to take someone else's prescribed medications, even a spouses, and could potentially result in both of you being refused opiates in the future. Once your Dr. changed your medication to oxycodone, you should NOT be taking ANY Tylenol #3, without your dr.'s permission ahead of time.In fact, you are supposed to properly dispose of old medications.
You also should never change the dosing directions or frequency of doses without clearing it with your Dr. first. The things I asked about are called red flags, and typically result in patients loosing access to prescribed opiates, and often great difficulty in finding another Dr. willing to prescribe opiates elsewhere. There is also a danger of accidental overdose.
As others explained urine compliance testing is done to ensure you are taking meds, exactly as prescribed, not taking more than prescribed, not taking anything not currently being prescribed, and not using illegal or illicit drugs. It checks the actual levels of the metabolites circulating in your system, and tests used today are highly accurate.
I wouldn't be surprised if the doctor determines that opiates aren't in your best interest right now, and you may want to prepare yourself, and think about finding out exactly what may be going on with your back and hips through further testing. Xrays can show arthritis, or fractures, but are not very helpful in diagnosing spine issues.
If you aren't dismissed and cut off immediately, I think tapering is a good idea, assuming your Dr.is willing to work with you on that. I am concerned though, given what you have said, that may not be an option. There are meds that can be prescribed to ease the symptoms of withdrawal if she is willing to work with you.
In today's environment, Dr's are holding patients to strict adherence, and enforcing the rules, so I hope you get this worked out.
Good luck.

 
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Old 06-18-2017, 08:14 AM   #5
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Re: Broad spectrum urine drug test

Yes, things have really changed in the last couple years, and doctors have a lot of pressure from all sides not to prescribe opioids. Even for patients who have done well on them, who have trial & failed years of other treatments, etc. So it is possible things may change by no fault of your own. But you definitely should only take your own meds as prescribed, nothing extra. It'll just create problems. If your pain isn't controlled, it is something to ask your doctor about. However, it is important to have reasonable goals. 50% relief is a common pain management goal.

I think you'll have to wait and see why your doctor ordered the test. They are very typically ordered for patients on opioids, as recommended by opioid prescribing guidelines.
If you want to taper, please work with your doctor. You should discuss the plan for during and afterwards to make sure you are on the same page. Its still not a bad idea to see a pain management specialist, to open up more options. Best wishes.
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Old 06-18-2017, 11:17 AM   #6
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Re: Broad spectrum urine drug test

Sounds bad put like that.but .I told my doctor when they pain got very unbearable 2 periods a month etc...that I took one of husbands tablet and how much better it worked. She was fine with this and then changed my Tylenol prescription to oxycodone. 100 tabs per month 5mg 1or 2 as needed every 5-6 hours. The hip problems started during this period and got worse..she sent me for x-rays confirming arthritis in both hips and some toes. When this started I eventually went from filling it once every 6weks to every 30 days then of course they weren't working as well so I was taking it more regularly not more per dose. Yes I should not have taken any of hubbys and now I've already started tapering off them . I have made the decision to get off the oxy 5mg and try tyenol advil as needed but not on reg schedule. I didn't realize how much body was becoming dependant. I do now. She would not mind if I took tyenol instead of the oxy...she just would not want me taking it with it. Thanks for your thoughts.

 
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Old 06-18-2017, 11:23 AM   #7
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Re: Broad spectrum urine drug test

Yes I will go and see her and tell her I've decided to get off them and just use tyenol and advil as needed. Do you think I'll have much trouble tapering off...I'm on3rd day of 20 mg over 24 hours..Sometimes I seem to be tolerating and thenother times it bothers me a lot. Back is aching and really jumpy anxious feeling ,,I'm not sick though. Bowels are cleaning out though. Thanks for your response. I appreciate it.

 
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Old 06-18-2017, 01:45 PM   #8
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Re: Broad spectrum urine drug test

I can't give medical advice or guess how you will do with a taper as everyone is different. However, I encourage you to talk to your doctor before making any changes to your medication regimen. The symptoms you describe could be mild withdrawal.
Best wishes.
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Old 07-07-2017, 01:25 PM   #9
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Re: Broad spectrum urine drug test

If your Dr. RX'd you 100 pills per month, that's roughly 3.5 pills allowed per day. If you're taking 1 every 5 hours then your taking 5 a day....your overtaking your meds. You also said you had taken some of the old Tylenol 3/codeine. When she did your drug screen it most likely showed to high of an amount of narcotics in your system, that is one of the things they look for;

too much
not enough
different kinds

With the way things are today with Narcotic dependence and random overdosing, Dr.'s are being extremely cautious. She didn't have you sign a Contract so she can't really dismiss you for breaking that Contract, but she can refuse to give you anymore Narcotics because your abusing them by taking too many and also taking the codeine ones as well....those are both big "no-no's".

So at this point you need to taper off the meds safely and you need to find out what your diagnosis is and what the treatment is. You'll probably have to go to a Specialist for that.

 
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Old 07-07-2017, 02:27 PM   #10
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Re: Broad spectrum urine drug test

Hi .I'm already off the medication..She never has mentioned anything to me about the results of my test. ..I'm taking oc tyenol and Advil for pain. I have been diagnosed with arthritis in my hips my career aggravates it by standing all day long in one spot. ..I have never re filled my last prescription since May. I would like to be able to take it when it's a particularly hard day but I don't know if that would start my body feeling worse again when I don't take it? I don't know whether she would have a problem prescribing it on a much less regular basis or not.

 
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Old 07-07-2017, 10:42 PM   #11
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Re: Broad spectrum urine drug test

Have you ever discussed with your dr. about using meds like Cymbalta, Neurontin or Lyrica off label for your pain? Some people have quite a bit of luck.

 
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Old 07-08-2017, 02:18 PM   #12
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Re: Broad spectrum urine drug test

Quote:
Originally Posted by Dtrace View Post
I would like to be able to take it when it's a particularly hard day but I don't know if that would start my body feeling worse again when I don't take it? I don't know whether she would have a problem prescribing it on a much less regular basis or not.
Typically patients don't become physically dependent unless they are taking an opioid medication around the clock for a couple weeks or so. One dose per day, or a few doses a day but then skipping some days wouldn't usually create an issue with "skipping" it and having withdrawal symptoms.

I'd recommend having a chat with your doctor. Bring her up to date on what you are currently doing, your pain levels, and what your greatest issues currently are (such as specific activities you are prevented from doing). You could ask if there is something more effective than the Tylenol and/or Advil you are taking that you could take as needed but not everyday. That may be a way to broach the subject without specifically asking for opioids (which is typically a no-no).

I'd also discuss your regular use of Tylenol and/or Advil, as that isn't so great for your system (liver) to take those daily long term, especially for folks with certain conditions. There should be a multitude of other options to treat your pain and cut down on the otc painkiller use. For example, the adjunct prescription medications already suggested (Cymbalta, Neurontin, or Lyrica), muscle relaxers, physical and/or massage therapy, ice/heat, TENs device, etc, as well as lifestyle changes (possibly a career change or accommodations, resting more, a targeted exercise regimen designed for a chronic pain patient - like water aerobics / swimming).

Opioids are usually a last resort after failing all other options. I'm glad things worked out ok with the urine drug test. In the long term however, I recommend you seek out a pain management specialist. They are the best suited to treat chronic pain and should be able to offer you the most options. Most folks combine a number of treatment methods to obtain significant relief. Transferring my pain treatment from my primary doctor to a pain clinic was the best decision I ever made for treating my chronic pain. Best wishes.
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