When the sample is sent to THE LAB, do they test for specific drugs--- 1) Percocet ( Oxycodone ) 2) MS Contin ( Morphine) 3) Klonopin or do they do the dip stick where it shows positive for Opiates ( Or Benzos if the case may be )
I only ask because I have heard if they send to the lab they can narrow down to THE Drug. If I have to drive myself to PM I will not take a morning dose of the MS Contin until later or NOT take a Soma with it depending on how I feel. I don't want NOTHING to show up but then again I want to make sure they KNOW I am taking MY Meds and no one elses.. LOL
Also,, I had an endoscopy done last week and they used Versed and Dilaudid. Is THAT going to show up as a Benzo ( Versed ) and Dilaudid as a not presribed narcotic ?
Most docs order an abuse panel to be done. The actual drug isn't listed to my knowledge. It comes up as, opiates, benzos and so on. I was amazed to learn that my percocet was not showing up in my urine screens, nor was my duragesic patch. My pain doctor was good enough to specifically order those drugs be checked at my request, and both showed up, no problem. He told me that they don't routinely check for fentanyl because it's a very expensive test, and unless requested, it's not on the abuse panel. My doc also told me that percocett frequently does not show up in routine drug screens. Benzo's on the other hand, stay in your system for a long period of time. If you get it IV, I don't know how it is metabolized. I have wondered that myself, when I have had oral surgery and versed was used. I do know that most pm clinics require you to let them know when you have ANY narcotics prescribed or used by anyone else. Some even make you sign a contract stating that you will NOT receive narcotics from anyone else. Might want to check and see what your contract says, and maybe let them know ahead, instead of them finding it in your urine. I would like to see some further posts on this. Thanks for bringing it up.
everytime I go to my PM Dr I am asked to fill out 5 pages of info, in that paper work it does ask me if I have seen any other Dr's in the past month. I am sure yours does to, just put down on the paper who you saw and what you were given med wise as you are disclosing all info to him, as it will ask what meds were you given at this Dr's office so you should be fine there.
My PM Dr sends the UA'S off to a lab using a very high end lab that tells every medication you have taken and it also measures the levels of each drug in your urine its called " quantitie" . You should no by now what method your PM DR uses unless you have not had a UA yet. you can tell if its done in house as a dip stick or sent off to a lab, and if you don't know ask the nurse or the receptionist. I hope your Dr does not use the in house method as its not as relaiable.. especailly if your on a low dose of narcotics. they ask me to tape my own sample down so I know it has not been tampered with.
How long have you beed taking your morphine as I am surprised you don't take it before you drive. I don't even feel mine at all I feel nothing but pain releif, so I am thinking maybe your on to high of a dose or something. Do you have a long drive to the Dr? if so than I can understand your not taking your meds. also when ever you get a UA the Dr will usually ask you when you took your last pill so you could say last night and they will note that. the test that are sent off are very good and thorough so it will show if you took your meds the day before.
Just be sure to tell your DR That you did not take your morning dose if you get tested. from the sound of things you have never had a UA. It will happen at some point I am sure and I am surprised if it hasn't happened yet. I feel safe with the fact my Dr does do them as it keeps people honest. Not that I like it but I know its the right thing to do.
In order to find out exactly how much of something you take, I think they need to do a blood test for it. When I was with my first PM a few years ago, his patients were used in a study to look at blood levels of the pain meds and how we said they were working. We gave blood every month and I still have my records. What's interesting to me is I am on the patch and change it at the same time yet my blood levels of fentenyl were different every month.
Most PM UAs are fairly sophisticated and will report back the active ingredient....Hydrocodone, Oxycodone and etc. They will also report back a level, and it must be above a certain threshold to test "positive."
Dip stick tests are the least reliable and are done in the office...If there is a problem, they usually then send it to lab for follow up testing. Dip stick testing usually just tests the absolute basics...Opiates, illegals and etc. It's used because it's cheap.
When you are selected for a UA, PM protocol calls for the nurse to ask you to list every drug that you've taken and when the last time you took it. This way, they can acct for metabolism and etc. If you had an endoscopy last week, you just tell them what they gave you in case it shows up. Surprisingly, most of the UAs today...Even sophisticated ones, have fairly narrow windows....24-36 hours, especially if there is a threshold. So, if you haven't taken your meds, they won't show up. Some illegal drugs are the exception...They stay in your system for a while. Most Benzos hang around for a while as well.
To most PM Docs, the absence of meds is just as bad as meds that aren't supposed to be there. PM Docs will dismiss patients for "negative" UAs....Due to diversion and etc.
The only real negative of UAs is if they use a "threshold" test. Most labs run the same UA analysis as they use for prospective employees....Rather than falsely accuse someone of something, they set "threshold" levels off the floor so you must have a reasonable amt in your system to test positive...I.e. no chance of testing positive for second hand smoke or poppy seeds on your hamburger bun....That type of thing.
However, in PM, one can get what they call a "false negative"....The med is there, but below the threshold. Therefore, you may want to ask if they use "no threshold" tests.
Personally, I think it's always best to have taken your meds before you go in...That way, there is no chance of a problem. If one fails a UA, many Docs don't give you a chance to explain....Kinda scary.
Lastly, if you can't provide a "sample", then they send you to get a blood test and they take you straight there....You can't leave the office and etc. Abusers and diverters use lots of tricks so the Docs have responded with pretty strict standards for UAs....Which is good...It ensures we all still have reasonable access to good PM care.
I have NEVER had a UA test at my current PM and I have been going there for almost a year. My Soma's make me sleepy, the MS Contin can hit me with a drowsy feeling a few hours after I take it, the Percocets for the BT may not need to be taken late morning early afternoon. the MS Contin is 30 mg taken 2x a day. the Soma 3x a day as needed and the percs up to 4x a day if needed. I am not worried that they will find Hydrocodone instead of Oxycodone as I never have anything other than what THEY presribe. Just want to make sure they find WHAT they presribe. Thanks for all the info. I have no idea of how they test the patients and have no idea why they have never tested me
Last edited by katlovesdogs; 03-20-2009 at 07:23 AM.