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Thread: Mouth Swab Drug Testing

  1. #1

    Default Mouth Swab Drug Testing

    My doctor requires a urine drug test to be done at each and every visit. However, at my last vist, I was having a bit of a tough time going, so the tech told me not to worry about it we'd do something else just this one time. (As if they weren't really supposed to be using this test and were only doing so because they were ready to close for the day) I was told to take a big drink of water, getting my tongue really wet and to hold this stick type thing in my mouth (without letting the chewing gum I had in my mouth touch it) I held it there just a couple minutes and then it was put into a small vial containing liquid then sealed.

    I didnt even know they made a drug test like this. But Im pretty confident the gum in my mouth did come into contact with the side of the stick as I was taking it out of my mouth. Should I be worried? Does anyone know why this type test is rarely used and what are the benefits / limitations of this drug test?

    Thanks in advance for your input
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    @chera, your post is very interesting. I have never heard of such a test and I used to be a lab technician, altho it was about 25 years ago.

    I'll bet that @alumni might know about this. Maybe he will come over here and enlighten both of us.
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  3. #3
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    ok, when i was gonna do cashiering at a grocery store (a first job in 2 days after moving to new town,post death of late great ex and the alimony,) i was given the mouth swab test.

    the area had become known for recreational users. the manager desperately wanted me to take the job.

    i made it clear i had lupus. was on meds. bitch that i be.

    so, she told me: listen, i guarantee u, as long as u did not do coke, h, meth and one other biggie i cannot recall, THIS MORNING, then u will pass this test.

    i took it. i said, what if i smoked the nite before. again, she said, nope, only if u used one of the heavy meds, this morning, would it show up.

    she winked. we knew i had not.

    so, in my humble opinion and all that, cuz i cannot recall but i did look it up thereafter,
    u r in the clear. which is why they don't do that test.

    it really is unreliable. tests only for 3 or 4 heavy heavy meds. that u took within hours of the oral swab test.

    it was to give u a pass, but to be able to say to corporation, i gave them a drug test.

    not to mention, u had gum in mouth. oh, yeah, that test is so reliable. i would not cream any alleged results they came up with.

    it is, really, a wink wink nudge nudge test.
    or was, in 2007.

    (did not take the job. did pharmacy tech, next door, instead. no drug test. he just knew i was trustworthy he said.)
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  4. #4
    Quote Originally Posted by chera View Post
    My doctor requires a urine drug test to be done at each and every visit. However, at my last vist, I was having a bit of a tough time going, so the tech told me not to worry about it we'd do something else just this one time. (As if they weren't really supposed to be using this test and were only doing so because they were ready to close for the day) I was told to take a big drink of water, getting my tongue really wet and to hold this stick type thing in my mouth (without letting the chewing gum I had in my mouth touch it) I held it there just a couple minutes and then it was put into a small vial containing liquid then sealed.

    I didnt even know they made a drug test like this. But Im pretty confident the gum in my mouth did come into contact with the side of the stick as I was taking it out of my mouth. Should I be worried? Does anyone know why this type test is rarely used and what are the benefits / limitations of this drug test?

    Thanks in advance for your input
    @chera - Are you kidding? You have to go through all of that at the doctors office. Don't want to pry about your condition, but one thing I will tell you (I am fairly certain) the only reason why the doctor puts you through those tests is so they can bill you more (or your insurance more) if you have insurance. If my doctor did that garbage to me, I would crack him with my heel. This is a really interesting topic to get into. Would you mind sharing some information for the forum about what condition you are being treated for, what meds you take, and what kind of doctor..and maybe your background, so others on the forum may or may be able to relate and get an interesting thread going? Also, there might be other options for you to consider in telemedicine pending your condition. If I am asking for you to share more than you are comfortable with....then just say so. IMHO you are being victimized.
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  5. #5
    Quote Originally Posted by Loubitan View Post
    @chera - Are you kidding? You have to go through all of that at the doctors office. Don't want to pry about your condition, but one thing I will tell you (I am fairly certain) the only reason why the doctor puts you through those tests is so they can bill you more (or your insurance more) if you have insurance. If my doctor did that garbage to me, I would crack him with my heel. This is a really interesting topic to get into. Would you mind sharing some information for the forum about what condition you are being treated for, what meds you take, and what kind of doctor..and maybe your background, so others on the forum may or may be able to relate and get an interesting thread going? Also, there might be other options for you to consider in telemedicine pending your condition. If I am asking for you to share more than you are comfortable with....then just say so. IMHO you are being victimized.
    I don't mind sharing at all....thanks to all of you for your responses and concern. I have been a chronic pain patient for over 10 years. I have M.S., Fibro, and neck and back disc injuries resulting from a car accident a long time ago. I had been treated by the same pain management doctor, until they were abruptly closed a little over a year ago. They're not very many in my area at all(nor are they welcomed here by a lot of people, which is sad)......so I considered myself extremely lucky whenever a new place 45 minutes from my home opened last year. During that time, there has not been a month go by that I've not been required to take a urine drug test; a urine drug test in which someone accompanies you inside the restroom (THIS was a new one for me). I know that's why I always have a difficult time "going".....it's soooo much harder than you know with someone watching They explained to me that the DEA told them that they must do this in order to avert diversion and be in compliance if they wish to remain open. And yes, they DO Bill my Medical Insurance around $145 every month. However, they do not accept my insurance for the cost of the office visit, which is $200 each month.
    They are a VERY STRICT office with ALOT of RULES, which I have absolutely no problem with if that's what it takes to assure they will be able to stay open and treat others like myself, who truly need pain management.
    I do like the doctor very much, she has always seemed genuinly concerned, and is always sympathetic to my condition, treating me with a sufficiant amount of medication. I am prescribed oxycodone 30mg every 4-6 hours as well as a fentanyl patch---however, I've found myself not using these due to negative side effects.
    At any rate, I do believe they like me there and the lab tech I spoke about, didnt want me to say anything about being given that test because as she said, they're only allowed to use it on each person 1 time ever and I guess she didnt want me to have used my 1 time up. But it would be SOOOOO much better if the would use these every time. These every month required urine tests is the very reason patients have to wait so long at each visit and why they NEVER get out by 5 every evening. Even if I go in with a full bladder, most of the time it takes 2 trips to the restroom before I can actually go (By the way...Their rule is 2 trips w/ the tech are all you're allowed in a visit)
    * I asked if those swab tests were really expensive or something, the reason being that they didnt normally use them...she said no, not at all.
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  6. #6
    Quote Originally Posted by chera View Post
    I don't mind sharing at all....thanks to all of you for your responses and concern. I have been a chronic pain patient for over 10 years. I have M.S., Fibro, and neck and back disc injuries resulting from a car accident a long time ago. I had been treated by the same pain management doctor, until they were abruptly closed a little over a year ago. They're not very many in my area at all(nor are they welcomed here by a lot of people, which is sad)......so I considered myself extremely lucky whenever a new place 45 minutes from my home opened last year. During that time, there has not been a month go by that I've not been required to take a urine drug test; a urine drug test in which someone accompanies you inside the restroom (THIS was a new one for me). I know that's why I always have a difficult time "going".....it's soooo much harder than you know with someone watching They explained to me that the DEA told them that they must do this in order to avert diversion and be in compliance if they wish to remain open. And yes, they DO Bill my Medical Insurance around $145 every month. However, they do not accept my insurance for the cost of the office visit, which is $200 each month.
    They are a VERY STRICT office with ALOT of RULES, which I have absolutely no problem with if that's what it takes to assure they will be able to stay open and treat others like myself, who truly need pain management.
    I do like the doctor very much, she has always seemed genuinly concerned, and is always sympathetic to my condition, treating me with a sufficiant amount of medication. I am prescribed oxycodone 30mg every 4-6 hours as well as a fentanyl patch---however, I've found myself not using these due to negative side effects.
    At any rate, I do believe they like me there and the lab tech I spoke about, didnt want me to say anything about being given that test because as she said, they're only allowed to use it on each person 1 time ever and I guess she didnt want me to have used my 1 time up. But it would be SOOOOO much better if the would use these every time. These every month required urine tests is the very reason patients have to wait so long at each visit and why they NEVER get out by 5 every evening. Even if I go in with a full bladder, most of the time it takes 2 trips to the restroom before I can actually go (By the way...Their rule is 2 trips w/ the tech are all you're allowed in a visit)
    * I asked if those swab tests were really expensive or something, the reason being that they didnt normally use them...she said no, not at all.
    @chera what state do you live in? Also, why do you not take the meds. that are prescribed to you? If you don't take the meds. why would you go to the doctor and take their tests? I don't think the DEA instructs doctors on what tests to give patients? That is not their job. Something is not adding up with your doctor office. The reason I ask what state you live in is because it could be the department of Health and Human services of your state? Are you on state medical insurance too or some kind of disability?

  7. #7
    Quote Originally Posted by Loubitan View Post
    @chera what state do you live in? Also, why do you not take the meds. that are prescribed to you? If you don't take the meds. why would you go to the doctor and take their tests? I don't think the DEA instructs doctors on what tests to give patients? That is not their job. Something is not adding up with your doctor office. The reason I ask what state you live in is because it could be the department of Health and Human services of your state? Are you on state medical insurance too or some kind of disability?
    I live in northern Tennessee. I always take the medication I receive; however, the patches I'm prescribed have recently started disturbing my sleep tremedously. They'd never had this side effect before, it's just started as of late. When I go back, hopefully the doctor will have more time so I can ask her about prescribing me something for sleep or switching the patches to something comparable.
    I am disabled from teaching now. I have 2 different types of insurance, one being from the state.

    In this area, southeastern Ky and northern Tn the law and dea are very strict regarding pain management clinics. Some of the surrounding small towns have even tried to ban such physicians from practicing in the towns---and I'm not talking about "pill mills', but reputable doctors. The public here simply has no tolerance or compassion for legitimate chronic pain sufferers, this is why there are so few clinics here. Before the one i now go to opened, I traveled almost 2 1/2 hours for several years every month.

    Whenever I first began at the clinic, the drug tests were not required monthly, nor did the lab tech accompany you into the restroom. The visit this changed I asked the doctor and tech why all the changes and she told me that the dea sent a representative to their office informing them of how their patient records should be, required them to watch a film showing how people will falsify a urine test using other peoples urine while in the bathroom and the things they were supposed to watch for if they suspected this, and that the only way to avoid this was by going in with everybody......so that's what they started doing.

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    Quote Originally Posted by riverstyx View Post
    ok, when i was gonna do cashiering at a grocery store (a first job in 2 days after moving to new town,post death of late great ex and the alimony,) i was given the mouth swab test.

    the area had become known for recreational users. the manager desperately wanted me to take the job.

    i made it clear i had lupus. was on meds. bitch that i be.

    so, she told me: listen, i guarantee u, as long as u did not do coke, h, meth and one other biggie i cannot recall, THIS MORNING, then u will pass this test.

    i took it. i said, what if i smoked the nite before. again, she said, nope, only if u used one of the heavy meds, this morning, would it show up.

    she winked. we knew i had not.

    so, in my humble opinion and all that, cuz i cannot recall but i did look it up thereafter,
    u r in the clear. which is why they don't do that test.

    it really is unreliable. tests only for 3 or 4 heavy heavy meds. that u took within hours of the oral swab test.

    it was to give u a pass, but to be able to say to corporation, i gave them a drug test.

    not to mention, u had gum in mouth. oh, yeah, that test is so reliable. i would not cream any alleged results they came up with.

    it is, really, a wink wink nudge nudge test.
    or was, in 2007.

    (did not take the job. did pharmacy tech, next door, instead. no drug test. he just knew i was trustworthy he said.)
    I loved being a Pharmacy Tech back in the day.. My Pharmacist / Boss would bust my nuts by expecting me to educate the young women coming in for their newly prescribed Diaphragm birth control...
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    Default @chera, I was tested for the first time at my Dr's and couldn't go.

    They gave me water a couple of times and still no go. I went to the bathroom right before I left for my dd and my appt. We didn't have to have someone in the room with us either, but we went alone. My dd went first and had no trouble cause she had been drinking coffee all morning. I was so sick that I couldn't even drink my tea that day. They tried the stick but told me to put it on my tounge. I took my teeth out to try to get salava going but the cotton on the stick made my mouth more dry. I was dry coughing too. My anxiety went up to ten!

    The urine test must not be great cause my dd showed no vicodin and she took it with her regualar meds 2 hrs before. The Dr. said the lab test was better. We paid 25$ for hers. She doesn't have insurance. They give her breaks for all they can.

    I went back in 2 hrs later and spilled mine exept for just enough to test.

    You know how it goes. You need your meds to show up. I don't want my clean. Well, we got all our meds anyway. I wonder if the tests are not effective. Or maybe all my gastro meds mess the tests up. I take at least 12 different meds. Only 2 are pain meds, soma, xanax, ambien,valium, and trazadone for occasional bad insomnia,

    He has been such a good family dr for his whole career!

    Someone explain these tests? I tried in another thread and for some reason I was ignored.

    Thank you @ chera for bringing up a subject I was worrying about.

    Deb
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  10. #10
    If it's a five panel urine dip test, Vicodin is not going to show positive. Not an opiate.

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    Default @ Alumni, really. Why not just send them to a lab first.

    I don't know my results yet. The only hydrocodone I took was in tussinex. I am on the fentanyl patch, percocet and the others I said.

    I was just wondering about the lab my Doc uses. My son's test showed no vicodin or soma and he is taking it for chronic pain due to a congenital foot deformation. My daughter is the one that tested negative at the office but was told the lab was more extensive.

    So they might get in trouble for having no vicodin when they take their meds?

    Deb

    And I don't think I gave a good sample. I thought these tests were to show compliance?

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    I went to a pm doc over the summer when I was in severe pain. I was at my wits end and had resorted to smoking MJ the night before for my first time to help me relax a bit and take the edge off. Which it did. Then went into this doc who made me put this swab in my mouth and hold it for 10 minutes. They were checking for benzo, opiates, mj, etc.


    Mine came back 100% clean which was weird considering the smoking the day before. I did not have any other meds in my system. That was the only mouth swab I have ever had.
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    @alumni , vicodin ( hydrocodone ) is an opiate, but it is a synthetic opiate much like oxycodone . It is because of this , that the urine dip stick tests are not very sensitive to it . I had an issue many years ago when I was prescribed only 3, 5 mg hydros per day and i would always test clean by the urine test. They would send it out for GC/MS analysis and it would come back positive . They finally just sent it out every few months and gave up on the dip stick method . Each test is different though and some are better able to pick it up . Most of them work on an ab method much similar to ELISA and my guess is that it is the antibody used or perhaps the sensitivity of the substrate reaction that may make the difference . The one used by my doc now does pick up hydro , even at low levels , but shows a cross-reactivity for oxy. When they first started using it , it caused some issues , but myself and another patient both came up positive for oxy within two minutes of each other even though we were both only prescribed hydro. I shudder to think what would have happened if it was only one of us there at the time . What is also scary is that the company claimed this was not possible . Within a few days of using the test, it was clear that the company was wrong as all patients prescribed vicodin only were testing positive for oxy .
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  14. #14
    I realize that this terminology can be confusing at times but narcotics like hydrocodone and oxycodone are not chemically identified as opiates.
    They fall, along with the other semi-synthetic and fully synthetic painkillers, in the more general category of opioids. Opiates specifically are drugs that contain the alkaloids of the poppy plant and are often referred to as "naturally occuring."
    Examples would be codeine, morphine and heroin. Metabolites of these substances are the ones tested for in the typical 5 panel urine dip tests. That's why in the vast majority of results from this type of UA, medications like Vicodin, oxycodone, methadone, etc. are not identified as was the case when you were testing negative for Vicodin. You're correct that through further lab analysis, however, these semi-synthetic drugs can be identified as they can initially with tests involving more panels such as a 12 panel test.
    Confusion between hydrocodone and oxycodone presence in urine results can happen because of their chemical similarity. They tend to get lumped together even in the larger panel tests.
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    I think I can answer the question about why PM doctors do urine tests everytime you visit. When you begin seeing a PM doc, they ask you to sign a contract. This contract says you agree not to use any illegal drugs, or alcohol while in their care and taking your meds. It also says, you agree not to go another Doc to receive the same kind of treatment. They do the UA for several reason, but most of all it's to check for substances that are not supposed to be in your system. They also want to make sure the medication they prescribe you is in your system. UA's have become more advanced in recent years. They can detect the smallest amounts of alcohol for up to 7 days from consumption.

    They probably don't want to use the mouth swab often, because it can't give them the specific results like the UA. I've heard you can get by one of the mouth swab tests by using a strong mouth wash or other things just before the test.

    The DEA may not be telling them specifically that they have to do UA's. However, they are cracking down on Dr's following regulations. It seems like the doc's who have alot of patients are getting hit the hardest. I have known several people who have recently been dropped by their PM doc for minor infractions. One in particular, didn't even know she was breaking a rule until after the fact.

    Another note.....They also rountinely request a list of all the medications you've had filled from your pharmacy. This is one way they make sure you are not "Dr Shopping."

    Of course, this is not the way things are all over the country. These are just my local experiences. Hope it helps.
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    Right you are @alumni , it was I who was using the term loosely. They are all opiods, but only the naturally occuring compounds are considered opiates...which is what you stated correct.y
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    Default Finally got called by the Doc's office, and silly me thought good news!

    One of the very nice nurses said subtances not prescibed were detected in my sample! He knew all the scripts prescribed by my Gastro man.

    They said it showed hydrocodone, codine, morphine, and phenobarbitol. I was actually shocked and angry. I told her I had pnemonia and was taking hydromet cough syrup prescribed by my Doc, and had finished some tussinex from October before I went in, also prescibed by him. I am also on a GI Cocktail prescribed by my Gastro which is on my record, and others prescibed by the Gastro man on my record. No way would I take phenobarb. I don't have sezures yet thank the Lord.

    They wanted me to come in with all the 20 meds, subliments, and vitamins that I take to the office tomorrow. This would take a shopping bag.

    The nurse called me back about an hour later telling me never mind. The hydrocodine in my cough medicine metabolized into morphine and codine. The phenobarb was in the Donitol in the Cocktail. I did tell her thank you for figuring it out cause I was ready to give blood to be sure.

    I didn't want to lose my Dr. for doing what I was suspossed to do under contract.

    I probably still have to lug all meds next month and take drug test again. He has all my info and we have a pmp in our state. By contract I got do what I got to do.

    She was very nice and said if I called my cough medicine in they would fill it. I guess I'm not in any trouble, it was just misinterpation. Whew!

    Deb
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    These guys are idiots.
    Opioids are known to test positive for closely relate cousins. It is, as a matter of fact, impossible to know if someone has taken heroin, morphine or codeine: the person could've taken any and would test positive for the three.

    Glad everything worked out for you, though.
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  19. #19
    Quote Originally Posted by etinin View Post
    These guys are idiots.
    Opioids are known to test positive for closely relate cousins. It is, as a matter of fact, impossible to know if someone has taken heroin, morphine or codeine: the person could've taken any and would test positive for the three.

    Glad everything worked out for you, though.
    It's possible to tell the difference on a GC/MS test, but not a typical drug test. Most tests for "Opiates" detect the presence of morphine, which is also a metabolite of heroin and codeine. So it could show positive in any of those 3 cases.

    More sophisticated testing methods could detect the presence of other metabolites that are unique to codeine or heroin. That way, they could determine which drug you are using. I think a lot of labs run a GC/MS or other test to confirm if they get any positive result.

    And of course, many other opioids don't return a positive at all on such a test because they don't metabolize into morphine. But some "10-panel" and similar routine drug tests also have panels to detect oxycodone, methadone, etc.
    Last edited by dayton; 01-27-2012 at 10:51 PM.
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    @debrad- I'm glad that worked out for you! The nurse finding that out probably saved your behind. Chances are they were calling you in the next day to drop you like a hot potato. I've gotten in trouble for the Hydromet Syrup as well. They looked at my RX records from the pharmacy. I was told not to do it again. Also, if I need cough syrup I should give them a call. I actually didn't even think about it at the time. I never feel anything but cough relief from that syrup.

    But once again, Glad things are ok with you!
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