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Old 05-03-2011, 10:42 AM   #1
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Nervous wreck about urine drug test

Hi Guys,
I've been in PM for back pain for about a year now. I take 2 Tramadol 3 times a day and 30 Percocets per month as needed for breakthrough pain. Last week I was asked to give a urine sample for the first time. No big deal, or so I thought. Yesterday I got a call from my PM office saying that the doctor wants me to come in and see him this Thursday. I asked why and the receptionist said that he wants to "follow up with me on something". She wouldn't give me any more information. Keep in mind I already have my monthly appointment booked for May 26, so for some reason my doc wants to see me sooner than the usual 30 days. I have to assume that this has something to do with the results of my urine test. I have NO idea what could possibly be wrong. I take all my meds as directed. In fact, on the day I went for the urine test, I hadn't taken any Percocets in at least 4 or 5 days, so I would be surprised if any narcotics showed up in my system at all (I read online that they only stay in your urine for 2 or 3 days). In any case, since the Percocets were prescribed as needed there shouldn't be an issue with no narcotics showing up in my urine, correct? But what else could be wrong? Is is possible to have false positives with these types of test? I've heard of poppy seeds causing false positives, but I don't think I ingested any poppy seeds recently. I do take lots of supplements and vitamins. Has anyone heard of things like that causing a false positive? I'm a nervous wreck about this now. It has taken me years to get where I am in PM and now I'm afraid some mistake has been made and I'm going to be falsely accused of breaking my PM contract and then I'll be dismissed with a big black mark on my record. Please, if anyone can think of any reason why my urine test could result in a false positive, let me know. I'll be seeing the doctor on Thursday and want to be prepared to defend myself.

Thanks,
Steve

 
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Old 05-03-2011, 01:10 PM   #2
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Re: Nervous wreck about urine drug test

I'm wondering if the call in could be in relation to not finding any opiates in you system at all. This could also send up a red flag. Please keep in mind that I am not accusing you of anything. Some doctors get worried when they have prescribed you opiates and you test completely negative. This could be a sign to them that you are not taking your meds at all and are in fact selling them on the street. Again, I'm not accusing you just bringing it up.

I would suggest that when you go to the doc for the call in, take your bottle with you so that you can show him that you have the proper amount left. You could simply explain to him that you had several good days where the meds were not needed. Give them a logical explanation and back it up with fact (I.E. the remainder of your pills) and you should be fine.

Good luck, I hope this helps,
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Old 05-03-2011, 03:34 PM   #3
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Re: Nervous wreck about urine drug test

I agree...I wouldn't worry too much as you have done nothing wrong..

I assume that you filled out information along with the test as in the vitamins and supplements you take...as well as the last time you took each medicine...

I think it's a great idea to bring in that list of items, as well as your bottles of medicine for this appt.

You can only work with what takes place...borrowing trouble for tomorrow only causes you grief...

There are rare cases of false positives with certain items....

I am friends with my PM...and he said that this doesn't happen except maybe
less than 1% of the time for tests...

It certainly is possible that no medicine showed up in your system...that is when you can show him your bottles...and explain the time frame of when you took the medicine...either the night before...or before you went on the appt..

Good luck and keep us posted..

 
Old 05-03-2011, 10:55 PM   #4
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Re: Nervous wreck about urine drug test

Well, wouldn't your Doctor wonder why the pain medications he is prescribing you aren't showing up in your system? False negatives can be just as big of an issue of Doctors as False Positives as they want to make sure the patient they are prescribing the narcotic medication to are actually taking the narcotic medication. So, maybe that is the issue. Maybe your Doctor wants to talk to you regarding the medication not showing up in your system?


Just a thought

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Old 05-04-2011, 05:54 AM   #5
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Re: Nervous wreck about urine drug test

If you told the Doc when the last time it was when you took a Percocet then he should be aware of the negative show. But your Tramadol should show positive.That is a good thing
I have had tests come back where the Doc questioned my usage but i was never called to come in early. It was addressed at next monthly appointment. He told me if I am off on the last time I took a med it can effect the results.. ie I took it at 11 pm they test and it shows HIGH levels I took it much later and vice versa. It is important they know when the last time it was you took your med.
bring your bottle os unused meds to show you still have them and have NOT been diverting them and you should be fine.
keep us posted....

 
Old 05-05-2011, 01:27 PM   #6
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Re: Nervous wreck about urine drug test

Hi Guys,
I just got back from the doctor. It was exactly what a few of you had predicted. My urine test came back showing no Percocet. I'm glad I posted here and was encouraged to bring my meds to the appointment, because when the receptionist called the other day to ask me to come in she never said anything about me bringing my meds in. But as soon as I checked in to the office today she said "Oh, you brought your meds, right?". Well I'm glad I had them. Anyway, the nurse came in and did a pill count and told me the count was right where it should be. Then the doctor came in almost apologetically and told me that he was sorry he had to ask me to come in like that but because my test showed no narcotics he had to make sure his documentation showed that he acted with due diligence to find out if there was any problem. He agreed that if a med says "as needed" then there should be no expectation for it to be in my system at any given time. It seemed as though it was all simply a matter of having some type of audit trail of documentation to cover himself in case he was invaded by the DEA. He started talking to me about colleagues of his being taken away in handcuffs for overprescribing meds and not having things documented well. He told me that he spends 2-3 hours a day doing all the paper work he needs to cover himself. He seems very nervous about the DEA and making sure he does everything by the book. I can't blame him. Oh well, hopefully I won't have to go through another one of these for a while! Thanks for all the advice guys. It really helped me to go into the office prepared for this.

Steve

 
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Old 05-05-2011, 02:59 PM   #7
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Re: Nervous wreck about urine drug test

Super Glad everything worked out well for you!
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Old 05-06-2011, 06:57 AM   #8
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Re: Nervous wreck about urine drug test

Quote:
Originally Posted by mju58 View Post
Super Glad everything worked out well for you!

Thanks MJU. It was all an eye opening experience for me. You have to wonder why any doctor would even want to go into pain management with the government making things so difficult for them. I really hope we don't end up with a shortage of PM docs in years to come because of fears of govt crackdown.

 
Old 05-06-2011, 07:16 AM   #9
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Re: Nervous wreck about urine drug test

I think PM docs do it because they recognize the need. If they do it right, it is a win win situation for everyone

 
Old 05-06-2011, 10:52 PM   #10
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Re: Nervous wreck about urine drug test

Steve,

I'm glad it went well for you! I hope that this is a doctor that you like and hope to stay with for a while. You just bought yourself a "whole bunch of trust" with this doctor. It may very well make things a little easier for you in the future. Especially when it comes time for a dose change. I have found that once the doctor realizes that you are not a pill popper, it just makes everything easier.

Again, I'm glad it was what I thought and went well for you.

Good luck,
"Joe"
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Old 05-07-2011, 09:49 AM   #11
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Re: Nervous wreck about urine drug test

I don't want to alarm you, but I am pretty sure people is wondering if you're selling your percs. A negative on a test like this-in this day ad age-czould raise a red flag. Depending on your relationship with the doctor, he might give u another chance

 
Old 05-09-2011, 06:01 AM   #12
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Re: Nervous wreck about urine drug test

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Originally Posted by erfan View Post
I don't want to alarm you, but I am pretty sure people is wondering if you're selling your percs. A negative on a test like this-in this day ad age-czould raise a red flag. Depending on your relationship with the doctor, he might give u another chance
Erfan,
Everything is ok now. I don't think my doc ever doubted my integrity. Like I said, it seems as though the only reason he asked me to come in was so he could do a pill count and document it in his records leaving a clean audit trail in case he should be investigated by the DEA. He agreed with me that "as needed" means just what is says, "as needed". I asked him point blank, "Should I just make sure I take one Percocet the day before an appointment so I don't get a negative test like this again?". His answer to me was "Absolutely not. If you don't need pain meds you should NOT take them". So if I have a very good week and don't need a Percocet for 7 days (a rare event I admit), then I will test negative on a urine test. My doc says that's fine with him as long as I'm willing to come in for a pill count so he can document that there is nothing fishy going on. The only other option is for me to intentionally take pain meds when I'm not in pain which would be breaking one of the cardinal rules of pain management.

 
Old 05-29-2012, 11:26 PM   #13
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Re: Nervous wreck about urine drug test

Quote:
Originally Posted by steve63 View Post
Erfan,
Everything is ok now. I don't think my doc ever doubted my integrity. Like I said, it seems as though the only reason he asked me to come in was so he could do a pill count and document it in his records leaving a clean audit trail in case he should be investigated by the DEA. He agreed with me that "as needed" means just what is says, "as needed". I asked him point blank, "Should I just make sure I take one Percocet the day before an appointment so I don't get a negative test like this again?". His answer to me was "Absolutely not. If you don't need pain meds you should NOT take them". So if I have a very good week and don't need a Percocet for 7 days (a rare event I admit), then I will test negative on a urine test. My doc says that's fine with him as long as I'm willing to come in for a pill count so he can document that there is nothing fishy going on. The only other option is for me to intentionally take pain meds when I'm not in pain which would be breaking one of the cardinal rules of pain management.


THat is exactly correct. If it says "as needed" that means just that. THe only way Your DR would have probably been worried had been if your script said take One everyday for pain then NONE showed up then that would have been a huge red flag...I was wondering the whole time I was reading through this thread was if he was wanting to see you for a pill count. I am glad you have found out now and can put it to rest

 
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