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Old 04-03-2009, 01:38 PM   #1
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False negative urine test

Can someone tell me why my urine test comes back negative. I'm on Duragesic patches, Lortab and Soma. My spouse religiously applies my Duragesic patch every 3 days. My doctor ordered urine test, comes in the exam room and informs me I failed the drug test. Nothing shows. Now I feel accused of selling my Duragesic patches and my oral meds. It makes me feel like I'm dirty and trying to pull a scam. Some answers? Anyone? Help.

Last edited by accused; 04-03-2009 at 01:39 PM.

 
Old 04-03-2009, 02:38 PM   #2
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Re: False negative urine test

Did your DR Dismiss you? are you in trouble for this I am just curious. Does your DR do a in house dip stick type of UA? Vs sending it off to the lab? that is a big problem with the in house test, this is common. I feel so bad for you I hope your DR will order a blood test or a more sophisticated test that is more accurate. you can't trust the in house UA'S there just not reliable.

Let us know what happened! I would ask for a repeat and do a blood test. when did you apply your patch vs your test? was it 3 prior to be tested? I wonder if that is why. I really hope you weren't let go from your pain management. did you just have a random UA or was your Dr suspicious about something?

 
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Old 04-03-2009, 03:40 PM   #3
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Re: False negative urine test

I asked for a blood test and it was given but, the local hospital had to call the Dr 3 times to ask what he wanted. Now I'm not so sure they even know what to do. I told the Dr my patch was due that evening and I asked if that could have anything to do with it. He said, " no ". No I was not dismissed. I went home and got all my meds to show him I had them.

 
Old 04-03-2009, 07:54 PM   #4
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Re: False negative urine test

Sorry to hear about your problem. "False negatives" are more common in PM than many realize. Here is the problem:

Local labs doing UAs use the same process for all their UAs, whether it be a PM Doc office or a pre-employment screen. These tests commonly use "thresholds"....One needs a med detection level above this threshold to test positive. This prevents someone from being falsely accused. Thus, one can't test positive for second hand smoke or eating poppy seeds on a hamburger bun. The rationale of thresholds is that it's better to let a few people get by who have low levels than to falsely accuse someone of drugs.

This theory works well for pre-employment screens, but for PM, it's very problematic. This is the main cause of "false negatives"....The med is there, but below the threshold. As a reslut, some PM Docs now use "no threshold" tests, but they are much more expensive.

Further complicating the situation is that for those on narcotics, one's metabolism clears your system very quickly of meds...Much faster than those who aren't chronic users. The exception is THC, which actually stays longer in chronic users.

Additionally, the "window" of detection time in most UAs is very small...According to some very reputable resources I've seen, Oxycodone for example, only has a detection time of 8-24 hours (as a range). Thus, the med in some people may only show up 8 hours after taking it. Very few still have it in their system 24 hours after digestion. Again, very problematic for PM patients. If you do some research, you can find charts that list the average detection times of commonly used pain mgt meds. We can't post links, or I'd give you some of my resources.

This is why PM UA protocol calls for the nurses to ask patients the exact time one last took their meds....So the Doc can coordinate the test results with the information you provide. For example, if you are tested at your 2PM appointment and you inform the nurse that the last time you took your Oxy was the night before, then that may very well explain it's absence. However, if at your 2PM appointment, you tell them you took it with breakfast, then it should show up in your UA.

So, if you couple the three related factors together.....thresholds, small detection time windows, and fast metabolizing, false negatives can happen quite a bit in PM. In fact, they are a major threat to PM patients. I would do some research on the subject, and then talk to your Doc. It sounds as if he probably knows these things....And you've probably got a good reputation as a patient there, or he would have dismissed you. I can't tell you how many stories I've read from people who have almost identical experiences to you, yet are dismissed without so much as a follow up appointment.

Please let me know if I can help further.

Regards,

Ex

 
Old 03-14-2012, 08:44 PM   #5
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Re: False negative urine test

Last month when the test came back negative it was don't worry, today the test was negative and we were treated like criminals my husband takes 120 pills a month so he can work. We were shocked, scared not knowing what test to take to show he is taking the meds.

 
Old 12-12-2012, 12:50 PM   #6
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Re: False negative urine test

Hi:
I have been on Percoset Methadone and Ritalin for the past 13 years and my doctor of 10 years retired in June, I visit the new doctor at the same clinic on July and for the first time I had to take a Drug Test, My second visit was on October. My old doctor returned to work 2 days a week, so I decided to switch back and Yesterday was my visit with him and he discharged because I had failed the test back in July, Ritalin and Percoset did not appear at all, and he could not prescribe narcotics anymore.

Being the first test I take I did not bother to put attention to the results, I take my medication every day, why should I bother.

I asked him how come the new doctor never mentioned to me back in July, I could probably take another right away, and his answer was that the new doctor was afraid of me.

I am in a Panic and have done some research and it appears that for the Ritalin, there is a different drug test or it won't show, it has a 2 hour life.Endocet / Percoset, I am still searching.

The damage the Lab has done to my life is irreparable, I am in real trouble.

Any suggestions

Thank you

 
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Old 12-12-2012, 07:41 PM   #7
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Re: False negative urine test

Sorry you are having these issues. One thing I can add is that if the Percocet was prescribed as needed (for breakthrough pain), it should not have not have been required to show up in the test, as someone may not take it around the clock or even every day. Since you are on methadone as well, I assume the Percocet was as needed. Any chance the Ritalin is the same?

The time of day of the test vs. the time you last took the meds also really matters...they should have asked you what meds you took and at what time (and written it down to correlate with the results). Was this a cheap in office dip stick type of test, or a send it out comprehensive test (expensive, often ~ $1,000 +)? If its the simple test, they can be inaccurate. Even if its the expensive test, the results can be misinterpreted.

Also, depending on the dosing schedule as I discussed, its possible neither was supposed to show up. Supplements, meds, and even some foods can affect the test. They should have asked you for a complete list of meds and supplements.

Seems like something else is going on if they say you failed a test in July, but didn't tell you at the time, and now hold that against you. Maybe they are trying to dump patients for some other reason? Or, cannot prescribe narcotics because of some legal issue? Your doctor really said the new doctor was "afraid of you"? Wow. Ask for your complete medical records and the lab results. See what they say. If this doctor will not let you make an appointment to let you clear this up, then your best hope is to find a new doctor and bring in your records and explain the whole story.

Best case they accept you on a short leash. Worse case you won't be able to find anyone to prescribe. Do you have any meds to taper down with? Especially the methadone. Although there isn't a norm, it would be expected that a doctor wouldn't cut you off of these types of meds abruptly as that can put your health in danger (or at a minimum, make you very uncomfortable with withdrawal). Best wishes.
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Old 12-16-2012, 08:23 AM   #8
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Re: False negative urine test

Quote:
Originally Posted by slipperyslope View Post
Did your DR Dismiss you? are you in trouble for this I am just curious. Does your DR do a in house dip stick type of UA? Vs sending it off to the lab? that is a big problem with the in house test, this is common. I feel so bad for you I hope your DR will order a blood test or a more sophisticated test that is more accurate. you can't trust the in house UA'S there just not reliable.
Let us know what happened! I would ask for a repeat and do a blood test. when did you apply your patch vs your test? was it 3 prior to be tested? I wonder if that is why. I really hope you weren't let go from your pain management. did you just have a random UA or was your Dr suspicious about something?


Hi accused, Im so sorry that this happened! Idk if this will help you but i thought i would share it with you. I had to see a new PM for a couple of months b/c my dr left to do only rehab in hosp. I had to have a urine toxicology screen on the 1st OV. It cost $2500. Out of network for my insurance. While speaking with ins co, labs, PM's office I was informed that fentanyl is not included in a routine drug screen, but was included on a urine toxicology @ the lab the PM used. To the best of my understanding, it is a separate test, & different labs have different groups of drugs that are tested for under different names & order numbers & fentanyl was not included on any of the drug screens that could be ordered @ the in network lab i spoke with, that my PM's staff knew very little about the individual lab tests for duragesic/fentanyl. Even the head of the lab in network for my insurance company told me that one test was done in one division of lab & the fentanyl in another & that the $2500 test is like the test that they use in hospitals & autopsies & those toxicologies go to pathology & drug screens to industrial, as I understood it. I had virtually no success in finding a way for it to be done in network b/c the PM office did the testing at one lab one way and i never could get them even to fully listen to my problem or help me find a solution. Thankfully, my old pm took me again as a pain patient. I hope this helps you & again Im so sorry that this happened.

Last edited by gmak; 12-16-2012 at 08:50 AM. Reason: more accurate

 
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