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Old 11-30-2007, 08:21 PM   #1
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Pain management -- levels of narcotics

I am a stage 4 lung cancer patient. I am presently prescribed oxycodone 20 mg 4 times a day and also msir (morphine) 30 mg 6 times a day. Yesterday when I went to pain management they wanted to do a urine test for my levels. I haven't been taking that much medication but I don't want to lose my scripts because there are some days that I need them. How many would I have to take before my next appointment to have the right level in my system so the doctor will be satisfied.

 
Old 11-30-2007, 10:06 PM   #2
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Re: Pain management -- levels of narcotics

Hi Sun,

First of all, welcome to the pain boards, I am sorry to hear about your illness.
Do you discuss with your doctor the way you take your meds? as long as he knows you dont take them everyday, the levels should be okay, at stage 4, they arent going to be concerned about addiction, physical or phychological or both, that can be dealt with when you recover.

If you have been taking these meds on any kind of a regular basis, trust me, they will show up in your tests.

If for some reason, diversion is what they are concerned about, but I cannot imagine someone with stage 4 cancer diverting (selling) their meds, and I'm sure you arent doing that, they may question you about levels, but like I said, even if you take them every other day, it will show up.

Please dont take offense, but I have to ask, is the reason you are concerned because you are diverting your meds in order to obtain something illegal? If so, honesty is the only policy with your doctor here. tell him before he tells you, and with the seriousness of your condition, he should be open to discussion.

I have made no conclusions about you personally, I have just given open ended advice here based on what little I know, any additional info you could give us would help.

Again, welcome to the boards!
Your Friend, Fabby

 
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Old 11-30-2007, 11:11 PM   #3
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Re: Pain management -- levels of narcotics

How can they detect levels? Can they tell how many pills you take in a week or month? I just thought urine tests tested for the presense of a certain drug.

 
Old 12-01-2007, 04:16 AM   #4
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badoldback HB User
Re: Pain management -- levels of narcotics

If you take them as prescribed for a day or two before the test you should be OK.

 
Old 12-01-2007, 04:39 AM   #5
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Re: Pain management -- levels of narcotics

for a urine test, yes, for a blood test, no. liver levels need weeks to build up to where they should be, depends on the kind of test.

My issue is that if you are going far off what is being prescribed, you need to be honest about that or we (and your health care providers) cant help you.

 
Old 12-01-2007, 10:18 AM   #6
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Re: Pain management -- levels of narcotics

Urine tests can only detect if you have recently ingested the drug the test is looking for. A single urine test can not tell a health care provider anything about the dose of a drug that was consumed or when exactly the drug was consumed. Usually, the urine tests that pain management clinics require of their patients are screening tests for drugs of abuse. When a health care provider needs specific information about drug levels, blood tests are used.

I honestly don't think you need to be afraid of telling the doctor that you have good days when you don't need to use much medication and that you have more difficult days when the medication is very important to your comfort and well being. In fact, since your pain levels fluctuate on a day to day basis, sharing that information may allow your health care provider to tailor your drug therapy to better fit your fluctuating needs.

Let us know how your appointment goes and good luck!
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Old 12-01-2007, 07:40 PM   #7
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Re: Pain management -- levels of narcotics

just be honest about how your pain has been but you still need to have them when things hit the fan.if they suspect a possible diversion just bring all of your unused meds with you and show them that you DO have them but the pain hasn't been too bad lately.pretty simple to prove non diversion.if you are not taking them and not diverting them you should still have the extra.this would prove alot and show that you are trustworthy and honest with them,and that goes a very long way in the PM world.you should be fine if you just bring them with you.good luck,Marcia
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Old 12-03-2007, 06:43 PM   #8
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Re: Pain management -- levels of narcotics

No I am not taking any illegal narcotics....that is not why I'm asking. I was told that if they doctor doesn't think I need that much pain medication and that milligram that he will either cut me off or cut me down. I don't want there to be any problems. Once it's lowered or cut down it's hard to get back where you need to be if my pain gets worse. I've talked to people in my situation who thought they could do without it or cut way back and then when they did need it the doctor didn't want to give it back. Why would you go to "illegal" or "selling" them like that from what I said. I'm concerned about my levels in MY system. My husband is a commercial electrician and I have two checks a month coming in plus I make a little here and then off of the computer and I do office work/clean up for a friend of mine who owns a business. our home is paid for....our vehicles are paid for so why would I be trying to sell anything....that's illegal....I just was curious to as to how the level thing and narcotic works because I've never been in this situation before. I appreciate you speaking your mind...I know there are people out there selling just about anything...we have a crime watch for our county too so I've read that.....Thanks....T

 
Old 12-03-2007, 09:18 PM   #9
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Re: Pain management -- levels of narcotics

Hi Sun,

When we give advice, we try and think like the doctor is thinking, and from all of us being in pain management for many years and discussing it here, we know doctors have two big concerns, addiction, and diversion.

No one here can read your mind and I am so so sorry if you were offended, I can assure you neither I nor anyone I know well on these boards would ever want to do that.

We said that is what the doctor would think, not that that's what we think, although its a possiblity with anyone you dont know, so thats always going to be part of the advice too if we arent sure.

I am glad to hear that you are having some good days, and you may be right about them cutting back if they know you arent taking the max allowed. Like everyone said, if its a urine test, a few days should be all you need.

But also remember that you have a very serious illness, there is nothing wrong with needing an increase at a later point, in fact your doctor is probably expecting it.

I hope you come back and post often, and I'm sorry, we can only work with the info we're given, Glad to find out more about you and look forward to getting to know you.

Your Friend, Fabby

 
Old 12-04-2007, 08:27 AM   #10
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Re: Pain management -- levels of narcotics

ditto on what fabby said(hi fabby).you always have to think from the docs point of view.it was not intended to offend,just what they may think,good luck with this,marcia
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Old 12-05-2007, 08:01 AM   #11
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Re: Pain management -- levels of narcotics

fabby you did great. I didn't feel your post was a bit out of line and in fact I was thinking the same thing. Dr's will suspct this so she was only being honest and was not accusing you of anything illegal please don't take it personally and get upset with fabby. fabby is the best.

SS

 
Old 12-05-2007, 08:50 PM   #12
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Re: Pain management -- levels of narcotics

I think I am a bit confused here..(not surprising..) Is Oxycodone the same as Oxycontin? If it is then it's my understanding that Oxycontin is not an "as needed" medication but on that needs to be taken on a scheduled basis? Like as a preemptive measure? It's always great to not be in pain and as a result not need painkillers,but I fear that with such potent base meds not taken as prescribed could be making the pain worse in the long run because it's not in your system to beat the pain to the punch...am I making sense? I am sorry for your illness and I would hope you have no worries about your doctor taking away your medication if you're honest with him about the amount you are taking, maybe just a little tweaking needs to be done so you're getting what you need when you need it.

 
Old 12-06-2007, 06:18 AM   #13
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Re: Pain management -- levels of narcotics

Hey sun,
I agree with you it is better to be in a position where you can save some meds for a rainy day, rather than have to convince your Doc to raise your prescription.

 
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