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Thread: Testing at pain clinics

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    Default Testing at pain clinics

    So I'm trying a pain clinic for the first time as my previous doc screwed up (long story)...he's not a doc to see for pain anymore

    the pain clinic does a fairly extensive test (if i had to guess, I'd say it was a 10 panel...I think there's only 5 and 10 so I'm thinking 10)...

    They had me write down all my scripts before going in for the first visit and of course checked all of them with the pharmacy (they are covering themselves as much as possible as far as I can tell)

    Due to extensive pain, I've had to turn towards oxycodone 30's a little more often than my script for 10/325 vicodin...they'll also find xanax and a few other drugs most likely (all prescribed except the oxycodone...and it's been way too long since i've been prescribed perc's to try putting that one by them (especially since i was stupid enough to leave that one off the list of prescriptions (didn't think there would be any sort of piss test involved)), but none that I'm worried about other than the oxy and benzo's...

    they know i'm prescribed xanax at a fairly high dose and have been getting klonopin prescribed as well...i also have a script for 10/325 vicodin

    what I can seem to find online is whether or not they'll be able to tell the oxy apart from the vicodin in a piss test as well as acceptable levels of amounts of opiates and benzo's and if they'll be able to tell that i've taken valium a handful of times in place of xanax (old script of valium so i can always try to explain that one)...I've been doing quite a bit of research, but can't seem to find the specifics as far as what they can actually pick apart when sending this to a lab. The place uses a cup that has strips on the outside of it so you already know if you are positive for things when they rip the cover off the front of it...my pain is awful and I'd rather continue to use the oxycodone 30's if possible (occasionally mixed with a couple of vicodin). Will they be able to tell the difference between the opiates and if so, how many days in advance would I need to stop taking oxycodone and just stick to the vicodin (which I'm running out of, hence my need to go to the pain clinic). Also, will they be able to separate the different type's of benzo's or just see that there is a positive test for benzo's?

    I've done my research, as some of you know, I've been in a lot of pain for a long time and have really cut my benzo use down significantly over the past year+...sometimes I swap out using xanax for valium to continue weening off of xanax...it's been at least a good month since i've taken any klonopin.

    I have about a week to prepare for this and any help would be appreciated. It's incredibly hard for me to work effectively without the oxycodone and just the vicodin, but if they can actually pick apart each specific drug in these tests, I'll do it for a short period of time.

    Any help would be appreciated as I feel like I've researched this one like crazy and can't find specific/adequate answers, only vague answers that don't give specifics.

    Thanks in advance.
    Helpful naynay Rated helpful

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    I'm guessing since they had you write down all your scripts. Is they want to see if you are taking your prescribed meds, not selling them off. And if you are adding meds to what you've been prescribed.

    That alone tells me this test is in depth enough to differentiate between oxycodone and hydrocodone. Stick with the vicodin and xanax. Cut that unscripted stuff out immediately.

    I'm not sure if they differentiate the benzos, but valium has a long half life. So stop taking that ASAP. And you're better safe than sorry, you don't want it on your record that you weren't accepted to this PM. Because you failed a drug test.

    IME Experience 30mg of oxycodone = 45-55mg hydrocodone and they are pretty interchangeable.
    Helpful burner Rated helpful

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    How many days would someone have to stop oxycodone in order for it to not show up? I was hoping I could just do the weekend and beginning of the week since I'm in a lot of pain with just the vicodin. Are you saying it's likely to show up next week even if I stop now and just go with higher doses of hydro until I ween down a little bit? I guess I'll try to stop that today and see how I do on just vicodin (although I may start with a slightly higher dose and bring an oxy with me just to be safe).

    I believe they mainly test to make sure you aren't abusing other drugs (coke, meth, barbituates, etc.), but I'm not completely sure...I originally went in thinking that they would only test after going there a few times so they could make sure I was taking the meds rather than selling them, but this doesn't seem to be the case.

    I certainly don't want it on my record which is why I've been going back and forth as far as canceling this appointment or continuing on with this PM clinic. I have already quit smoking bud a couple months ago even though that eases my anxiety and helps with pain just for this PM clinic (easily the longest amount of time I haven't smoked since starting).

    I will give just hydro a try today with xanax and will probably bring oxy to be safe...I just really don't like the idea of some doctor telling me what I can or can't do to my body (especially w/ bud since it's less harmful than what he's looking to prescribe me). They seem to drug test more than people I know that have been in prison (kinda ridiculous in my mind).

    Does oxycodone metabolize into heroin/morphine on these tests while hydrocodone just shows up as codeine or do they all metabolize into morphine and thus show up that way? Also I'm worried that the amount of xanax might show up to be a little high...overall, I'm kinda rethinking whether to rethink going to this appointment or not because I certainly don't want anything negative added to my records, but could use the help from the doctor enough to have stopped smoking, to try to stop oxy for a period of time and to just go with xanax even though the dosage might be a little higher

    Do you have any specifics as far as how a lab treats these items?

    If there is a risk of it showing positive for heroin (due to the oxy) or something bad because of the benzo's, I'd rather quit the idea of PM and just go with what I've been using and been weening off of things myself over time. Do you happen to have specific amounts of time/days that these things stay in your system and what they show up as in lab tests?

    Thanks.

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    The reason I think they are using a test that differentiates opiates.
    They know you are taking hydrocodone, so they know you will test positive for opiates. They most definitely are testing for Coke, Meth, Heroin, Weed.

    So they have to be able to differentiate whether you are taking Hydro as scripted or you are a Heroin abuser.

    Neither oxy or hydro metabolizes into morphine or codeine. Hydro metabolizes into hydromorphone. So on a test exclusively for Heroin and Morphine, hydrocodone may not show up. Thats also why they have to be able to differntiate between opiates. They have to make sure you have Hydro in your system, and that you aren't selling your script.

    I think they will test for oxy, it has to be a seperate test. Its so commonly taken by people in PM that they will be looking for it.

    "Synthetic and some semi-synthetic opioids/opiates cannot be ruled out by opiate assays, and "false negative" results are likely. Oxycodone has poor cross-reactivity in the opiate assay. A separate screening test specifically for oxycodone is needed."

    But very high oxycodone concentrations can cause a positive for on a standard opiate screen (Heroin, Morphine). That would come back as preliminary positive and they would send for further analysis. And then see it was oxycodone, not Heroin. This is a good look at the metabolites and what you could test positive for,
    http://labmed.ucsf.edu/sfghlab/test/...olismChart.pdf

    *This post was auto-merged. The following text was added 2 minutes after the last post:*

    As far as xanax your levels shouldn't be off the wall, unless you are binging for a couple days before the test. If its anywhere in normal range for a scripted patient, and not crazy high you will be fine. Different people will have different levels after a day, depending on how quickly they metabolize xanax.

    As far as specific times, they can be determined somewhat for a single dose. But for someone taking daily meds, its very hard to predict.
    Last edited by akl63; 10-12-2011 at 12:12 PM.
    Helpful cajunbulldog Rated helpful

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    Most pain clinics bring out the big guns on pee test and go for levels as well as detection. The level test ensures you are taking your drugs at the correct dose and also will detect anything not scripted.

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    Angry Bad experience w/pain dr-i let him know it!!

    I get the whole pain doc reasons, etc.. Having multiple sclerosis I've been around the block so to speak- ANYWAY- I really, really like this doc. Honest about everything. I had just filled HIS rx for oxycodone 15mg- IR no tylenol, 2 days prior when I saw him he forgot I ad to take a UA. No big to me I had 0 to hide. 3 days later he called all nice and then said I had tested positive for high doses of morphine. I was shocked! I had 3 words for him- WHY? (jst got 150 pills dude), WHERE?? ( they all run your name on pharmacies list fyi). HOW? ( meaning how can I get morphine at any dr. which wold be on the pharmacy list). Hey, I've played by the rules since 2010 and I take it personal when accused of something I KNOW isn't in my system! I demanded a blood test right then. If you're gonna accuse me, let me prove you wrong. "Not neccessary, these tests make mistakes, don't worry". BS- Hippa is a crock, they all know the "latest gossip", he told me I had to find another doc- just procedure really! Try telling a new doc why yo got "cut-off". I was so fn mad I told him THEIR MISTAKE has labeled me a seeker and to not allow me to prove my innocence is not legal- it's not! I'm sorry for rambling but I don't take morphine. I've found a great primary doc, I told him everything, how pissed I am,my thoughts of taking action unless my name gets cleared!
    He called the dr. who told him he believes me, hell I made the pharmacist show me what morphine looks like to see if they f'd up! My new doc, bless his heart, takes care of my meds and old neuro wants to still treat my "ms"- if I've forgiven him he says. I dunno, sometimes pain docs do no more than a primary and can make a real condition that can be controlled easily, a freakin circus! I wish all the best to anyone w/a pain guy. Most of em have ego's that I can do without! If you ever are accused of a drug in your system that HONESTLY isn't there- fight it! If not, that druggy label will go w/all your records.
    Helpful magchik Rated helpful
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    Yea high concentrations of oxycodone can cause a positive on a normal opioid test (Heroin, Morphine),

    As I said in the earlier post, it should have been a preliminary positive. And been sent to the lab to check out. After that it would comeback as a false positive (pass).

    If oxycodone was the only thing you were taking, I don't see any other explanations. Unless you were smoking opium, making tea or using codeine.

    Levels, taking 1mg of xanax a day how high could your level really be with its relatively short half-life. I do know everyone's level would be different. For instance if someone ate a grapefruit would have higher levels, someone with high body fat would also. So there has to be some range, and if you aren't taking it way too much the week before... Its seems to me, JMO, that you'd be within the limits.

    Now if you were taking valium like crazy, with its long half life, it would be a lot easier to detect a high level than it would with Xanax.

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    Default oxy in system

    Quote Originally Posted by burner View Post
    How many days would someone have to stop oxycodone in order for it to not show up? I was hoping I could just do the weekend and beginning of the week since I'm in a lot of pain with just the vicodin. Are you saying it's likely to show up next week even if I stop now and just go with higher doses of hydro until I ween down a little bit? I guess I'll try to stop that today and see how I do on just vicodin (although I may start with a slightly higher dose and bring an oxy with me just to be safe).

    I believe they mainly test to make sure you aren't abusing other drugs (coke, meth, barbituates, etc.), but I'm not completely sure...I originally went in thinking that they would only test after going there a few times so they could make sure I was taking the meds rather than selling them, but this doesn't seem to be the case.

    I certainly don't want it on my record which is why I've been going back and forth as far as canceling this appointment or continuing on with this PM clinic. I have already quit smoking bud a couple months ago even though that eases my anxiety and helps with pain just for this PM clinic (easily the longest amount of time I haven't smoked since starting).

    I will give just hydro a try today with xanax and will probably bring oxy to be safe...I just really don't like the idea of some doctor telling me what I can or can't do to my body (especially w/ bud since it's less harmful than what he's looking to prescribe me). They seem to drug test more than people I know that have been in prison (kinda ridiculous in my mind).

    Does oxycodone metabolize into heroin/morphine on these tests while hydrocodone just shows up as codeine or do they all metabolize into morphine and thus show up that way? Also I'm worried that the amount of xanax might show up to be a little high...overall, I'm kinda rethinking whether to rethink going to this appointment or not because I certainly don't want anything negative added to my records, but could use the help from the doctor enough to have stopped smoking, to try to stop oxy for a period of time and to just go with xanax even though the dosage might be a little higher

    Do you have any specifics as far as how a lab treats these items?

    If there is a risk of it showing positive for heroin (due to the oxy) or something bad because of the benzo's, I'd rather quit the idea of PM and just go with what I've been using and been weening off of things myself over time. Do you happen to have specific amounts of time/days that these things stay in your system and what they show up as in lab tests?

    Thanks.
    I just posted my UA nightmare, but I wanted to tell you lots of water is important, depending on the type of test- now they've got tests so specific it's unreal- generally, 48-72 hours is safe. I cannot say how any test can f up though! The worse thing is when they think "oooh, she's busted", they aren't proffessional! The whole office knows, looks at ya like a criminal, and the rule is spposed to be PRIVACY! Here I go.... if yo want to be real safe, take a laxative of some kind. ( sounds gross, but like those fleet ones). They clean out everything in there lol! 2 days is usually good. Sorry I'm so bitter lol!
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    @gotpitbull if I were you I'd be ticked too.
    I woulda immediately demanded the results. You'd think before someone on oxy caused a preliminary positive for morphine. Being they are a PM clinic and a lot of people on oxy most likely.

    On the privacy thing they shouldn't even let the receptionists call you. Unless she has the doc on the line waiting to tell you. These rules are broken constantly, especially at places with limited patients that staff gets to know. Gossip starts etc, for someone working at the ER not so much because they only see you once and probably forget.
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    Default DRUG TESTS- hmmmmmmm

    Quote Originally Posted by akl63 View Post
    @gotpitbull if I were you I'd be ticked too.
    I woulda immediately demanded the results. You'd think before someone on oxy caused a preliminary positive for morphine. Being they are a PM clinic and a lot of people on oxy most likely.

    On the privacy thing they shouldn't even let the receptionists call you. Unless she has the doc on the line waiting to tell you. These rules are broken constantly, especially at places with limited patients that staff gets to know. Gossip starts etc, for someone working at the ER not so much because they only see you once and probably forget.
    Bless your heart! It really is against the law to claim "whatever' is in your system W/O letting the patient/accused PROVE OTHERWISE! PLUS, I told him, I just got 150 pills, you say I've got extremely high morphine in me, I weigh 115 and there's 24 hours in a day- I'd be dead you moron! Or at least have overdosed! he knew I was telling the truth cuz I wouldn't shut up. Busted people don't keep calling and bitching for days like I did. And your privacy comment, that too is against the law! everyone from receptionist to the janitor knows everything! Since I know the truth,I look each person in the eyes, and almost hope they do anything to set me off! Gosh,this ordeal has made me a bit scary lol!!! ( see, I need therapy now haha)

    *This post was auto-merged. The following text was added 14 minutes after the last post:*

    Quote Originally Posted by akl63 View Post
    Yea high concentrations of oxycodone can cause a positive on a normal opioid test (Heroin, Morphine),

    As I said in the earlier post, it should have been a preliminary positive. And been sent to the lab to check out. After that it would comeback as a false positive (pass).

    If oxycodone was the only thing you were taking, I don't see any other explanations. Unless you were smoking opium, making tea or using codeine.

    Levels, taking 1mg of xanax a day how high could your level really be with its relatively short half-life. I do know everyone's level would be different. For instance if someone ate a grapefruit would have higher levels, someone with high body fat would also. So there has to be some range, and if you aren't taking it way too much the week before... Its seems to me, JMO, that you'd be within the limits.

    Now if you were taking valium like crazy, with its long half life, it would be a lot easier to detect a high level than it would with Xanax.
    @akl163,I truly appreciate your insight on drug tests. The last time I took one after my nightmare I told em, "you tell ME what's in me,I'm not writing a thing down. Just insert --- drug, jerks! I shoulda snorted a ton of coke and smoked an ounce of weed, might as well cover all the drugs possible!"
    Last edited by gotpitbull; 10-12-2011 at 03:52 PM.
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    I know in the smaller places these people can be ridiculous. I got dirty looks at the Spine Institute here, because I was $600 behind on the bill. It was like everyone there knew, as soon as I got behind everything changed. No one was helpful (Took 3 months to get a referral and have records forwarded to a surgeon). I'd show up at physical therapy and was just told to do last weeks workout by myself. Waiting in the exam room, like a extraordinarily long time for the doctor. Close to an hour.

    The only person who shoulda known was someone from St X-Crook Hospital's billing department. Yet everyone in the office knew, and when I showed up to my referral which required up front payment...

    After waiting to see the doc, I was told (rudely) there was nothing they could do to help me, it will just get better. And that they didn't appreciate people coming in expecting not to pay and that's all. Well when I checked in they didn't ask for the payment so I didn't pay, I had to almost yell at the guy to come back, gave him the check already filled out and signed. He left and went to the receptionists, and electronically ran the check.

    It was so obvious someone had said something to the surgeon about me being behind on my bill. He wasn't even affiliated with that hospital group, and was so rude to some patient he just met.

    He came back in, muttered some sort of sorry, and examined me for 30 minutes. Reviewed my tests on his computer for awhile. And then started me on steroids, scheduled an appt to have a spinal injection and scripted me Percocet and some muscle relaxers. Pretty much outlined a plan, all the options if things didn't work and other things we could try before surgery.

    I wanted so bad to say, I thought it was just gonna get better and you couldn't do anything. Now I need a spinal injection and maybe surgery. Didn't see him again to say the least. I've never been so hot in my life, just being lied to, right to my face without hesitation. Then I'm supposed to trust this guy sticking a needle in my spine.

    I reported the Spine Institute here to the Better Business Bureau and to Medwatch. Doubt it will do any good, I never heard anything of it. Should it really be that hard to keep my records confidential. I shoulda just told medwatch, they were really loose scripting painkillers. That woulda got someone's attention.
    Last edited by akl63; 10-12-2011 at 04:18 PM.

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    Thumbs up reporting works!! MAKE YOUR VOICE HEARD

    Quote Originally Posted by akl63 View Post
    I know in the smaller places these people can be ridiculous. I got dirty looks at the Spine Institute here, because I was $600 behind on the bill. It was like everyone there knew, as soon as I got behind everything changed. No one was helpful (Took 3 months to get a referral and have records forwarded to a surgeon). I'd show up at physical therapy and was just told to do last weeks workout by myself. Waiting in the exam room, like a extraordinarily long time for the doctor. Close to an hour.

    The only person who shoulda known was someone from St X-Crook Hospital's billing department. Yet everyone in the office knew, and when I showed up to my referral which required up front payment...

    After waiting to see the doc, I was told (rudely) there was nothing they could do to help me, it will just get better. And that they didn't appreciate people coming in expecting not to pay and that's all. Well when I checked in they didn't ask for the payment so I didn't pay, I had to almost yell at the guy to come back, gave him the check already filled out and signed. He left and went to the receptionists, and electronically ran the check.

    It was so obvious someone had said something to the surgeon about me being behind on my bill. He wasn't even affiliated with that hospital group, and was so rude to some patient he just met.

    He came back in, muttered some sort of sorry, and examined me for 30 minutes. Reviewed my tests on his computer for awhile. And then started me on steroids, scheduled an appt to have a spinal injection and scripted me Percocet and some muscle relaxers. Pretty much outlined a plan, all the options if things didn't work and other things we could try before surgery.

    I wanted so bad to say, I thought it was just gonna get better and you couldn't do anything. Now I need a spinal injection and maybe surgery. Didn't see him again to say the least. I've never been so hot in my life, just being lied to, right to my face without hesitation. Then I'm supposed to trust this guy sticking a needle in my spine.

    I reported the Spine Institute here to the Better Business Bureau and to Medwatch. Doubt it will do any good, I never heard anything of it. Should it really be that hard to keep my records confidential.
    CALL ATTORNEY GEN/bbb/a ton- they investigate!! I e-mailed a ton of people, including local news re: my treatment by all employees when "patient/dr" is the law. I got called! The attrny gen is "the people's lawyer". To investigate anyone that feels they've been betrayed, wronged,whatever, by a proffessional it was easier than I thought too. Just e-mail your story, in lamen words, be emotional- they'll contact them and you.
    NOW- I had to endure a "lumbar punction" a.k.a spinal tap and I will never, ever go through that pain again! Is the spinal injection you're speaking about? On a different note... I dunno if it's age w/me or what but so many times, like you said, I wanted to say, or ,why didn't I say, so many times! As of late, I started thinking- back the truck up- these guys make BANK, as you said- how can I TRUST this guy??? All of what you said is so true. I might be a bit, well alot, BLUNT now, but c'mon! We're like gerbils on this wheel, just doing what they say, paying $, and feeling unsure about our care? Trust is huge w/me! Once bitten, twice shy. What happened to the good ole doc that you knew, he didn't watch that red light sayin "next patient", the system's wrong man. Are you really getting a spinal tap?? WHY? I thought when I dislocated my shoulder I could not feel worse pain...
    I'm so sorry if a lumbar puncture is in yor future. Tell that doc to numb the heck out of your back dammit! And demand those pain buttons at your fingertips UPON WAKING! You take care and please keep in touch
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    The shots were steroid injections on a disc. I had one not long ago at all. They numbed me, it was just stressful mentally.

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