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-   -   Percocet/Fentanyl False Negative (http://www.healthboards.com/boards/pain-management/935833-percocet-fentanyl-false-negative.html)

mitchmer 01-18-2013 04:52 PM

Percocet/Fentanyl False Negative
 
First time poster here. A little info about myself. I have been on bloodthinners for 13 yrs now. I am also on Cymbalta, Trazadone, Percocet, 75 mcg Fentanyl patch and I have been taking otc antihistamine lately. I lost my insurance Oct. 1st. My PMP won't see me w/o insurance or cash payment for visit. So I went to my pcp to see if she would see me until I get my insurance back. Saw her and she ordered urine test to check my levels and it came back at 0. Now I'm being accused of selling my percocet and fentanyl. I don't understand how this could happen. I don't know what to do. I'm terrified of going through withdraws. I have been taking 4-6 percocet daily and changing my patch's every 3 days. Can someone please help. Thanks.

ferd144 01-18-2013 05:34 PM

Re: Percocet/Fentanyl False Negative
 
I pray that you get through this :(

1) How old are you?

2) What is the primary illness ,treatment, or diagnosis going forward?

3) In your *honest opinion*...why would your PCP be suspect,or think that you are selling your scripts/narcotics?

These are SERIOUS accusations and if you are *innocent*....its a travesty.But unless you provide further info/stats,there seems to be questions?

~ferd

tortoisegirl 01-18-2013 05:50 PM

Re: Percocet/Fentanyl False Negative
 
What type of test? If its a simple (cheap) in office dip stick test, those are notorious for being inaccurate, as well as sometimes being mis-read (the test doesn't show the meds in your urine, as much as the metabolites from the meds). Plus sometimes other meds and even foods can mess with the results. If it was an in office test, ask for them to send the sample out to a lab which does gas chromatography/mass spectrometry.

Fyi these tests are in the realm of $1,000, but some doctors have deals such that the patient doesn't pay out of pocket if their insurance doesn't cover it all). Also, ask for your medical records so you can see what they have documented.

You say they have accused you of selling your meds. Have they said they will stop prescribing, or that the prescriptions you just got were the last, etc? Sorry you are having to go through this. If you are on the patches as well as taking the Percocet around the clock, both should show up (in contrast to if you were only taking the Percocet as needed, then it may have not been expected to show up).

If its a reasonable doctor, even if worst case you can't get this straightened out, I'd hope they give you a month's of meds to taper down from (which may be the ones you have now, if they aren't currently planning to continue prescribing). However, I'd do everything in your power to try to clear this up.

I'd make an appointment to talk with the doctor, not try to do this over the phone or through the staff. You want to get another urine sample in asap so when that one shows the meds, they can't then say you had enough time to start taking them again. I'm guess that if they did an in office test, they wouldn't have saved the original sample (sending that out to the lab is what they should have done when the test came back at 0). Unfortunately this is one of the problems that is more likely to occur when you aren't seeing a pain specialist. Really hope you can get this sorted out. Best wishes.

mitchmer 01-18-2013 08:27 PM

Re: Percocet/Fentanyl False Negative
 
I'm 43 yrs old. I lost a big portion of my abdomen from having the internal bleeding after my gallbladder was removed. I was in the hospital for 2 1/2 months and then in a nursing home for a month. Then over the course of the next 6 months I was in the hospital more than at home. I had 15-17 surgeries in 21 days and had to have a mesh put in to hold my insides together while a vac dressing was being used to close the wound. I used the vac for at least 6 months. I also have permanent nerve damage in my left leg from my groin to my knee from all the surgeries along with nuropathy in my hands and feet. Along with having Protein-C deficiency that I have had for 13 years and have been on Coumiden. I have no idea what is going to happen next. I asked to be retested but was told no because it is not a random test. My pcp is at a local office and the test was sent to the main hospital 30 miles away. I am totally dumbfounded. The only thing that I can think is that there might have been contamination. Reason for this is that the urine sample I gave was not labeled with my name when I took it. When I was done the lab tech was not around and the directions on the wall said to leave in a basket on the shelf. I even waited for the tech to come back for 2-3 minutes. I only have 2 patches (6days worth) left and 11 percocets (2-3 days worth).

mitchmer 01-18-2013 08:32 PM

Re: Percocet/Fentanyl False Negative
 
The only reason my pcp brought up selling is because everything came back 0. I have been prescribed 180 pills/ 30 day supply. Which I have been taking 6 a day on most days. She did call me after hours tonight. I asked her about a blood test and the cost. She did say she would get more information for me. From things that I have read the tests are different for the fentanyl and the percocet.

gmak 01-18-2013 10:23 PM

Re: Percocet/Fentanyl False Negative
 
[QUOTE=mitchmer;5119447]The only reason my pcp brought up selling is because everything came back 0. I have been prescribed 180 pills/ 30 day supply. Which I have been taking 6 a day on most days. She did call me after hours tonight. I asked her about a blood test and the cost. She did say she would get more information for me. From things that I have read the tests are different for the fentanyl and the percocet.[/QUOTE]

Dear mitchmer, Did she say she would do the blood tests or help you with the medication? You mentiom all the surgeries & i wonder if possibly one or more of the surgeons could help you. Certainly they must be aware of your pain, history etc yes?

ferd144 01-19-2013 09:04 AM

Re: Percocet/Fentanyl False Negative
 
[QUOTE=gmak;5119476]Dear mitchmer, Did she say she would do the blood tests or help you with the medication? You mentiom all the surgeries & i wonder if possibly one or more of the surgeons could help you. Certainly they must be aware of your pain, history etc yes?[/QUOTE]

I completely agree.And based on your surgical history,I am sure there must be a surgeon,another doctor,hospital records,etc that can also confirm your pain issues

However something doesn't smell right though,and assume we are hearing the ENTIRE story.I would be appalled/livid if ever accused of selling my own meds

Hope you feel better :)

backhurtz 01-19-2013 11:15 AM

Re: Percocet/Fentanyl False Negative
 
The testing for fentanyl can not be done by an in office urine screen....it is a specific test that must be done in a lab and must be requesitioned on the form for the lab. I know this because I am currently on the fentanyl patches. Oxycodone ( the pain killer in percocet) however should have shown up if it is taken regularly and was properly listed on the paperwork..Because oxycodone (percocet/percodan etc.are synthetic opiates, the specific test must be requested just like for the fentanyl patches. The cut off is usually much lower for the detection levels but I would have to make sure if I were the orginal poster that both tests were specifically requested. If the doctor does not regularly perform drug tests, he or she may not have known that they need to specifically requests these two tests for those medications...

mitchmer 01-19-2013 11:41 AM

Re: Percocet/Fentanyl False Negative
 
:confused:
When I did speak to pcp last night I asked her to find out the cost of the blood test and the cost of doing another urine test. She said that she would check into. I last saw my surgeon in Nov. because I have more issues going on. He thinks that I now have a hernia and/or what abdomen muscles I do have remaining are breaking down. But until I get this insurance thing figured out we have to wait to do a CT. He said that if it gets to the point that I can not handle the pain to go to ER and then we will deal with it. He also said that what I am dealing with is very painful. The surgery to repair my abdomen is also very painful and recovery time is lengthy. I haven't contacted him yet. I guess I want to see what my pcp has to say. I just can't believe that this is going on. I still think that there is a possibility of contamination of my urine sample. Because of it being left in the open not labeled and the lab tech not being around. Another thing is that I have been having problems with this pcp since Sept. when I told her that the surgeon that did my gallbladder surgery messed up. The surgery should never been done as outpatient because of my blood disorder. Once I mentioned that her whole attitude changed. She also always compares my pain to the pain she deals with in her wrist. Also is always telling me that she still have 49 of 50 pain pills that she was given after her surgeries in her medicine cabinet. Up till all this I loved her as a pcp. Idk what is going on but it just puzzles. I have never lied or had anything to hide.

SoonerChris 01-25-2013 11:58 AM

Re: Percocet/Fentanyl False Negative
 
[QUOTE=backhurtz;5119681]The testing for fentanyl can not be done by an in office urine screen....it is a specific test that must be done in a lab and must be requesitioned on the form for the lab. I know this because I am currently on the fentanyl patches. [/QUOTE]

This is correct as I'm on the patch as well and was told the same thing by my PM doctor.

ctrue 01-25-2013 06:51 PM

Re: Percocet/Fentanyl False Negative
 
I wanted to say I would never leave my urine anywhere, without my name clearly stated on the label. I am always asked (in both my PCP and PM doctors offices) to either write my name on the cup with a permanant marker or sign a paper and a sticker from it is immediately placed on the urine cup. That is asking for mix ups and contamination and they should know better! Some other person may have gotten your results and be in trouble for having those meds in their urine. I also know that, like other have said, specialized tests are required for some meds and a simple dip test wont show them. I am assuming since they are a regular drs office, they dont do the higher priced test. She needed to ask for that test and if she didnt, thats her fault. Ask her what urine test was performed and ask to see the order and the results to verify she did the right one. You could also have her to call your other doctor. If you take urine tests with him and have never had any problems, that should prove it could be a mix up.
I would also stay on her about the specific test needed before your medications do run out. Either way she still should be willing to give you enough to taper, if nothing else. The only problem being she is not your regular prescriber so she doesnt have to. Have you tried asking the other doctor can he prescribe just a months worth of meds until you can get the insurance situation fixed? He may be willing to, depending on how long you have been seeing him and your relationship with him.
I hate a doctor who will "look down" on a patient for taking their pain medications. So what if she didnt take hers, everyone's pain is different. She of all people should know that. Good for her if she didnt need them, but some people can not live without them and that is not her place to point it out to you. all I can say is UGH! to that comment. She has no right to judge!
I wish you luck and hope you are able to get this resolved.

backhurtz 01-25-2013 10:31 PM

Re: Percocet/Fentanyl False Negative
 
Mitchmer,
I don't know if you didn't understand what I said but fentanyl and oxycodone are semi synthetic medications- which means that they must specifically request those tests to determine the levels if any of those particular drugs when requesting a drug screen. If they did not ask for those specific tests to be run, that would be why they didn't show up.....you need to find out if they requested those specific tests and if they didn't , that would explain the discrepancy....

gmak 01-26-2013 06:24 AM

Re: Percocet/Fentanyl False Negative
 
Dear mitchmer, What has happened, did you get the your patches & breakthrough medicine? Ive been concerned about you going thru withdrawal & if you are undergoing the very complicated abd surgery & wondered about how you are getting on. I Truly hope that all is working out b/c you have been through so much sickness.

mitchmer 01-29-2013 08:46 AM

Re: Percocet/Fentanyl False Negative
 
Well nothing has changed. I have been without my perc since1/24 and the patch since 1/25. PCP will not budge. I have contacted a Patient Advocate. We are currently working to get resolved. So far lab claims that urine was labeled even though I know it was not. Pain is unbelievable. Since I'm on blood thinners I can take ibropherin. I am taking tylinal arthritis 650mg tabs. 2 tabs every 6 hours. Not helping. I feel like I'm going to crawl out of my skin. I'm not sleeping. The only thing that seems to help the pain is to not move around. But if I do that then I start to go stir crazy. I just don't know what else to do. I do appreciate everyone caring. Thanks again.

gmak 01-29-2013 11:40 AM

Re: Percocet/Fentanyl False Negative
 
[QUOTE=mitchmer;5124731]Well nothing has changed. I have been without my perc since1/24 and the patch since 1/25. PCP will not budge. I have contacted a Patient Advocate. We are currently working to get resolved. So far lab claims that urine was labeled even though I know it was not. Pain is unbelievable. Since I'm on blood thinners I can take ibropherin. I am taking tylinal arthritis 650mg tabs. 2 tabs every 6 hours. Not helping. I feel like I'm going to crawl out of my skin. I'm not sleeping. The only thing that seems to help the pain is to not move around. But if I do that then I start to go stir crazy. I just don't know what else to do. I do appreciate everyone caring. Thanks again.[/QUOTE]

Dear mitchmer, If I were you I would not mess with a pcp & I would get my records & make a pain mgmt dr appt asap & I used a TENS unit 24 hrs a day on high when I had to change drs last fall when my dr decided to be a rehab dr only. I am so sorry that you are having pain & hope this is resolved quickly for you.


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