This morning when I went in to see my doctor he showed me a print out from the drug screening they gave me last time, the kind you send out to a lab not process in house. It had a long list of substances listed with several areas highlighted representing medications I was currently on. He then told me that "there is a problem" because the test results show that I had large amount of Dilaudid (Hydromorphone) in my system and I am not prescribed Dilaudid so it was an abuse of a drug.
I tried nicely at first to explain to him that I not only don't take Dilaudid and have not before but that I wouldn't even know where to get it short of stabbing myself and driving into the ER.
I do however take MS Contin ER 30mg 1/day and Norco 10mg 3/day, which are both are prescribed by him and monitored by him obviously. I also take several other medications prescribed by other doctors that related to my disease but none of them are controlled medications or restricted in anyway.
I told him that it had to be some kind of false positive and was there any way one of the other drugs I was on threw the result but he assured me that those kind of things rarely happen and kept saying that he had to go by what the test said.
After some arguing with him I realized it wasn't going to matter what I said he probably gets people who lie to him all the time. He basically ended up telling me that he has to restrict my medication and start reducing it in addition to having me keep a pain journal and some other crap that sounded like high school homework in order for us to move forward because the government will crack down on him.
While that seems like crap to me I really don't care as much about the reduction in meds and the fact that I have to keep a lame journal now as much as I do that they have accused me of doing something I flat out didn't do and are not only adding it to my file as a "strike" but restricting me now because of it without me being able to say or do anything about it.
So while I can't prove what caused the false positive I know I didn't take Dilaudid or anything else you call Hydromorphone.
II would really like to know if anyone knows someone or somewhere I can go to that might help me get any kind of documentation related to this issue. If it's happened to me I know its going on in other places and I'm sure somewhere there is a study or some scientific information that I can bring with me when I go next.
I have been searching google for a few hours and I keep finding stuff about false positives as it relates to drug tests in general but nothing talking about exactly what happen to me.
Thank you for your time and anything you are willing to share.
Last edited by Administrator; 04-12-2013 at 07:36 PM.
The following user gives a hug of support to Lambent: janiee08 (07-27-2011)
Hi Lambent. Sorry to hear of the messed up drug screen. All I can say from what I read in the past is that when hydrocodone breaks down it produces hydromorphone in your system. And hydromorphone is not on your normal drug test. And why would your dr special order that test which is not routine. Get a copy of your test and get going on the computer. If there was a large amount, how large is large? Have him retest you. Why is he now going to tapper away your meds? Is he stopping them? I know how you feel about being blamed for something that you didn't do. I also believe that most prescription pain meds are largely passed thru urine during the first 8 hrs then completely gone in 24-48 hrs. Did you know you were going to be tested. And why? Anyway I figure if all this were to be true, you'd be totally ripped on test day. I'll do some checking myself and get back with you if I find out anything. Keep us posted
False positives do happen, now they are said to not happen very often but sometimes for whatever reason they do happen and more often then people think. I've heard if the drugs you are taking are similiar in chemical structure like most of opiates, then sometimes they show up as another opiate, like possibly Hydromorphone (Dilaudid) like you said happened to you. I guess benzodiazepines like Valium, Xanax, Ativan, there are alot of them and most are very similiar in chemical structure which I heard can lead to False Positives quite often so. I would ask if you can take another one right away to clear this up. I understand what you said that your doctor probably gets all kinds of stories from patients lieing about not taking substances that show up in your urine. But if your records with him are good then he should atleast let you take aniother test right away to clear this up.
Lambent- There is a GOOD reason you showed positive for hydromorphone in your system. It's because the Norco you take. The hydrocodone in the Norco breaks down to hydromorphone. This is where SO MANY uneducated PM doctors make HUGE mistakes which cause us PM'ers problems.
It is so VERY important for these doctors to be educated & knowledgable about medications they prescribe & just how & what chemicals they break down into once ingested. It's their job to know this, and I'm sure you weren't aware of it, I mean why should you be? You pay him big bucks to be the educated professional.
I am so sorry your doctor is doing this to you, but maybe if you do some research, you can print it out, get back in with him & show him proof that you are NOT taking anything not prescribed by him.
The reason I know this is because one of my previous PM doctors was going to switch me from Vicodin to hydromorphone and he said it would be a good match for me since they break both break down into the same chemical compound & my body did well with the hydrocodone.
Please, please find & print some proof & put that doctor "in-the-know" so you can clear your name & show him the error of his ways.
The other folks have given you great advice and many ways to "prove" your innocence, I would definitely get started on that research today. The one error that you did make was, you should have demanded a urine test their on the spot at your docs office. Now that you've left the office, if you ask for a new test, they'll just figure, "oh well yeah he was taking this stuff and we caught him so he'll stop and his urine will be fine." If your appt. was today, I would go in tomorrow and take a new urine test, because if they're saying that you have this huge amount of dilaudid in your system, you wouldn't have been able to clear it out overnight.
A hint of advice and a word of warning....even though you have been wronged, and you certainly have, and I'm sure your humiliated, angry, embarrased and a whole bunch of other adjectives. When you go to your docs office keep it professional. Do not march in their with a ticked off attitude and the "i'm here to show you idiots how wrong you are" speech....this kind of behavior will get you nowhere, except perhaps escorted to the door. I know it's not fair that we have to put up with all the bull, and act like the bigger person when trying to prove our innocence, but please trust me on this, acting angry, mad, accusingly, etc. will just make the problem worse.
So gather your research, which shouldn't be too hard to find over the internet, put on your professional contentment face, and go back and ask for another UA, and give the doc your paperwork. Don't give it to a nurse, you need to do this face to face with your doc, show him what you found and explain to him this is what you think must have happened. And be cordial about it. We have to realize Dr.'s are people too, they do make mistakes sometimes...the important thing is once the mistake is called to their attention that they fix it.
So good luck, take care and let us know how you do.
i find it so un-nerving that your pm doesnt evan know-not aware that hydrocodone metabolizes to hydromorphone. evan most pm pt's know this. if this happened to me i think i would call the hospital and ask to speak with a laboratory supervisor and ask if they can confirm that if one takes Norco(hydrocodone) and is urine drug tested, does it show up positive for hydromorphone-after they confirm this, ask if they could please put this information in writing, as my doctor and i were discussing this i would like to show him the information and have it added to my medical record. that's what i think i would do. good luck, and you SHOULD have NO problem clearing this up.
ps- not only would you be positive for hydromorphone-the QUANTITY of hydromorphone can exceed the quantity of hydrocodone present in urine. i take oxycodone-so OXYMORPHONE also shows up in my results. thank goodness my doctor knows this. we certainly seem to have to always be on guard about something in PM treatment.
I agree BB! I have found that my only choice is to do as much research as I can on my conditions as well as any treatments/meds, etc. I am dealing with.
So many of us have come to realize & understand that as we travel this road of chronic pain, we MUST be our own best advocate. We have to be educated to the point where we can be equipped to handle anything that comes our way during this journey, ya know?
These PM doctors are truly irresponsible when they don't know things like hydrocodone metabolizing into the same chemical compound as hydromorphone in the body.
I've seen too many stories about false positives & false negatives all because some doctors don't know all the details, therefore the PM patient suffers and can't clear their name, then end up being black listed or red-flagged.
If we defend ourselves too vigorously, we appear to be drug seekers, yet we DO have a right to speak up and defend ourselves when we know for a fact we are following doctor's orders to the letter. We are forced to be submissive for fear of being "fired" from treatment, therefore going back to a life of unmanaged pain and diminished physical capacity.
If these doctors are going to help us, they need to be thoroughly educated in this type of thing so they don't end up releasing innocent people from their practices. It's such a scary situation for all of us indeed.
Lambent- Let us know if you were able to get the information that will clear your name, ok?
she could evan ask the pharmacist for an insert from a bottle of norco-and this info is there! if this pm doctor doesnt understand/ignorant to correct interpretation of a UDT-
i gonna wonder what else he is missing in regards to my treatment. scary.
I'm so sorry for the difficulties you are having with your "uneducated" PM doc. After reading your post I dug out an old copy of my results from a drug screen performed by Ameritox that my PM uses. I am perscribed oxycontin and oxycodone for my pain issues. At the time of the test I also had taken Lortab for 2-3 days which had been prescribed by the endodontist for root canals which I had 3 days prior to the drug screen. Per my pain contract with the PM doc I brought in a copy of the perscription for the Lortab which was placed in my medical records.
When I had my next visit to the PM doc the next month I was provided a copy of the Ameritox results from the drug screen as an "FYI" copy. The results showed that the sample was positive for oxycodone along with positives for the hydrocodone and hydromorphone. I had not taken any hydromorphone. My doc explained to me that these positive results were to be expected as hydromorphone is a metabolite of hydrocodone and therefore would correctly be reported as a positive result on the test because I had taken the Lortab for the additional acute pain from the root canal work. He also explained that the reverse (taking hydromophone) would NOT result in positive finding for hydrocodone.
Ameritox is considered to be the most accurate and comprehensive drug screen available and are outrageously expensive (@1500). The report included a comment explaining the positive result and the correlation of the hydromorphone/hydrocodone issue. Perhaps you can research/contact Ameritox to obtain evidence to provide to your PM doc.
I feel so fortunate to have such a knowlegable, compassionate PM doc. I hope you are able to resolve the situation. Good luck.
The Following User Says Thank You to konagirl222 For This Useful Post: dee088 (08-13-2011)
I just came from my PM doctor, who told me I took dilaudid when I didn't. I am prescribed MS Contin 60mg 2x/day and oxycodone 10-25 2-3x/day. What the heck happened?! I am not abusing drugs. I work as an addiction counselor for God's sake. I asked if the fact that I work at a methadone clinic (and am generally around methadone a lot) could have caused this. He said no. I asked if handling dilaudid (handing it to my grandmother after her surgery) could have caused it. He said no. I asked for a retest at my own expense of the SAME URINE FOR GOD'S SAKE! He said no. What do I do now?
Nevermind. I found a study in which it was found that in up to 2% of patients that are prescribed high levels of morphone sulfate, morphine sulfate will metabolize into hydromorphone at a detectable level. This is especially likely if the dosing schedule of the patient isn't followed perfectly. For example if 2 doses were taken too close together, etc.
I to just last thursday got a false positive for that dilaudid garbage.My doctor says he was going to try and figure out from the lab why i would test positive for that and show negitive for the loritabs i am currantly taking and show possitive for percacet as well in which i was not taking. He proceeded to tell me how if the lab cannot give him good reason for these results that i will no longer be able to recieve my prescription for loritab any longer.I proceeded to tell him he could have hair sample blood sample test me everytime i come to his office call me in for a suprise drug test he simply said it wasnt possible that it was out of his hands... I ll find out im sure on monday weather or not I have to live with my pain with over the counter drugs that have no impact at all. or tramidole which gives my bad headaches .Im not sure what route I can take if any if i do get cut off. I am just so angry that this can happen at absolutly no fault of my own and hope I do find some way to retake this drug test which someone in the lab must have made an incredible mistake with.If anyone else
knows of something I can do please let me know ASAP I go in on monday for final decision I guess
I am wondering if this is really true, that they are saying Dilaudid was found, could it be they (the Drs.) are lying so they don't have to dispence pain meds any longer? I know my PCP will NOT presribe pain meds to me any longer, but he was up front about the reason & it does have to due with patient med abuse, while I am disturbed by this, I do see his point of view. Anyway this is just a thought to consider.
Yes, it can happen this way, however, it also depends on the type of testing that is being done. If it is a standard in office urine screen and not sent out to a lab to be confirmed by gas chromatography mass spectrometry, then it depends on two things, the threshold set for the detection and the type of urine screen done in office. If it is sent out to a lab for confirmation, then the likelihood of a false positive, especially using gc/ms testing, the likelihood of a false positive is slim to none.
Any PM doctor who is unaware of the possibility of false positive/false negatives in in office urine screening is not worth having, and in fact, they are seldom unaware that there is a margin for error so those tests are the ones usually sent out to a lab for confirmation, at least now. All of my PM's office screens are sent out for confirmation- and there is little to no room for error when it is done that way. The posts were from some time ago , initially in this thread and nowa days most PM offices use gc/ms for all urine tests, which is why many will not prescribe right away for new patients, preferring to wait until the results come back for a patient.
Back surgery -Post op Cauda Equina Syndrome
Salvage 2nd Back Surgery
BMP - dura adhered to three levels in lumbar spine
Central canal stenosis, severe - dia. 3.44 mm
The Following User Says Thank You to backhurtz For This Useful Post: ferd144 (04-14-2013)
Lambent, I know exactly what you mean since it just happened to me the exact same problem. Only difference is that my Dr. just told me to ween myself off of them all together because he would not write me another script. This is some serious bull because my pain will not go away either. Thanks to all the dopers out there we have to put up with this crap. So off to find another Dr since I have so many reasons to live. GOOD LUCK! My dr wouldn't give me anything showing the results of the test but the bill was $400 so I'll guess they sent it out to a lab. I DO NOT DO ANYTHING THAT IS NOT OVER THE COUNTER OR PRESCRIBED BY A DR. and I only go to one pain management Dr.
Last edited by Administrator; 04-12-2013 at 07:46 PM.
The following user gives a hug of support to Twofold: backhurtz (04-15-2013)
Twofold: I would ask for your records from this doctor. You'll likely need them for any new pain clinic you go to. You may get lucky and have that test result in there. I would fight it if you know it is incorrect.
It seems like they would have to give you written proof of why they are dismissing you? To me, $400 seems between the cost of an in-office and gcms test (my gcms tests run more like $950 for example). Even if sent out to a lab, they or the doctor can misinterpret the results.
You may have a very hard time finding a doctor to prescribe again with this in your record, so it seems like you wouldn't have much to lose my fighting it. Ask for the proof, then decide where to go from there (see if you can find a fault in it). Sorry you are dealing with this. Best wishes.
constant head pain, fibro, and other fun!
chronic pain established in 2006
This is so scary for those of us that rely on the medicine for a functional life & i would want the record to check for errors & for examples of what the threshold is in case it is set too high or low for my dosage Im on. Also. It scares me bc im always taking as directed. Or if the test is marked as needed or as scheduled med on lab form. Im so sorry that this is happened to you!
Last edited by gmak; 04-14-2013 at 04:38 PM.