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Thread: Can a drug test tell the difference between different benzos? (& do doctors test when prescribing benzos?)

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    Default Can a drug test tell the difference between different benzos? (& do doctors test when prescribing benzos?)

    Recently started seeing a doctor and got a prescription for Ativan (for legitimate treatment of anxiety), but also have used some Valium as well. As I understand, diazepam has different metabolites than lorazepam, and it also has a much longer half-life.

    First question: would a drug test be able to tell which benzos I've been using? I just want to know in case I get tested by my doctor or a potential employer, especially because of the very long half-life of diazepam.

    I figure a simple drug test (ie the basic multi-panel drug test, or home drug tests) would show up positive for benzos regardless. But after that, they usually send the sample off for a more advanced test (ie GCMS) to confirm the result. With the second test, would they be concerned as to which benzo I was using...or would I be fine as long as I could present a prescription for Ativan?

    Second question: how common is it for a doctor to give a drug test if they're prescribing controlled drugs? I've heard stories of people being drug tested by their doctor, particularly if they're prescribing C-II or high "street" demand medication (ie oxycodone, adderall). Or if the doctor knows the patient has a history of substance abuse.

    But the doctor didn't give me anything "stronger" than the benzo, so how likely would it be? I don't want to exhaust my supply of ativan since i don't know how long she's gonna keep me on it, and in some cases valium is more preferable (longer duration etc.)

    Thanks all.


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    I am sure there is a way they can tell but the standard tests just test for Benzos in general and lump them together. You can buy a test strip on eBay for as little as a couple of dollars or even an entire panel if you like to test for more substances. These benzo strips just tests for the metabolites from benzos.
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  3. #3
    Quote Originally Posted by NotMyRealName View Post
    I am sure there is a way they can tell but the standard tests just test for Benzos in general and lump them together. You can buy a test strip on eBay for as little as a couple of dollars or even an entire panel if you like to test for more substances. These benzo strips just tests for the metabolites from benzos.
    Yes i know that you can get a cheap drug test with a benzo panel, which will usually show positive if there are benzos/metabolites in your urine. It doesn't differentiate as to which benzo is present. But it is probably different when your test sample is actually being sent to a lab (which is the case with many employers/doctors).

    I believe they use a somewhat similar "basic" test (immunoassay) to find a preliminary result, but if there are any positives they perform a GC/MS test to confirm. As I understand, they can test for the presence of a particular substance in your urine, rather than any of the possible substances that could trigger a positive on the immunoassay test.
    Last edited by dayton; 03-19-2012 at 12:43 PM.

  4. #4
    The only way to tell which specific drug you were taking, as opposed to drug class (i.e. benzos) is to take the blood/urine sample to a lab for an extremely expensive analysis, as the previous poster alluded to with the GC/MS process. Those processes look for quantities of specific atoms in the sample, and by analyzing the data they can determine exactly what compounds are present.

    I have never, in my entire life being drug tested or knowing people who have been tested, known anyone who got tested at this level. There are various, much cheaper forms of testing that are typically used, and the most simple ones don't even look for benzos. If you have to take a test that does identify benzos, it is not going to tell which benzo you are taking, it will simply come out positive or negative.

    So if you were prescribed klonopin but were also taking valium, this will not be revealed by any of the more common drug tests. You'll just get a positive for benzos, or your drug test won't even flag benzos at all (like the 5 panel test that doesn't even check for benzos).

    But if the question is, is it POSSIBLE to determine which specific drugs you have taken within a certain class of drugs, the answer is yes. I have just never seen it done other than in potentially criminal cases.

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    Diazepam has two active metobiltes and has an extremely long half-life. Since it also is stored in body fat, this also affects the time you need to clear it out or your system.
    Last edited by royce; 03-19-2012 at 02:57 PM.

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    Even during blood tests at hospitals and rehab units, they do not run a sophisticated panel to identify between benzos. The only time those tests are ran to identify the specific benzo or other specific drugs from another class, is during forensic studies, which majority of the time only occurs during autopsy, if requested due to suspicious death or in high stakes criminal trials.
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    A DOC or OTC drug test (el cheapo, that is....about $30.00) usually tests for categories for example, cocaine, opiates, benzos, marijuana, stimulants, etc. They do not pick up fentanyl.

    I have been routinely tested for fentanyl (test cost is in $100's). Most medical professionals are tested at this level these days. Test determines specific drugs. Law enforcement, BCP, and ICE have very inexpensive chemical tests that determine chemistry and quality.

    Hospital ER's routinely do complete tox screens.

    I have had several false negative tests.
    Last edited by royce; 03-19-2012 at 03:00 PM.

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    Quote Originally Posted by royce View Post
    A DOC or OTC drug test (el cheapo, that is....about $30.00) usually tests for categories for example, cocaine, opiates, benzos, marijuana, stimulants, etc. They do not pick up fentanyl.

    I have been routinely tested for fentanyl (test cost is in $100's). Most medical professionals are tested at this level these days. Test determines specific drugs. Law enforcement, BCP, and ICE have very inexpensive chemical tests that determine chemistry and quality.

    Hospital ER's routinely do complete tox screens.

    I have had several false negative tests.
    @ royce
    yes er routine tox screens, approx. 2 yo., when i happened to not have my ID.and due to a nasty m.s. rebound speech wasn't clear, cost approx.$1467.82. I think i should have been taken back to e.r. and treated for shock when that bill came in the mail, but I was afraid they'd do another one ;(

    *This post was auto-merged. The following text was added 53 minutes after the last post:*
    @dayton @Oxidize
    Well oxidize now u can say u know of one "virtual"stranger who has been tested at varying levels ,at varying times for various reasons. I think it may depend on your state for some of the tests. For example, in New York State if you are prescribed a pain killer stronger than tylenol the dr. must do random u/a's. These are generrally 5-panel tests. If you are prescribed certain other p.k.s like fentanyl by a G.P. you must submit to a u/a every time you get a new script, which is every month because there are no refills on the patches. When I was on fent. rather than see the dr 12 times a year I would go to the office,pee in a cup(IN the ladies room not in the office)
    then go sit in the waiting room for 10-15 min.and the receptionist would subsequentially call my name , hand me the script and say "see u next month"
    One time the u/a read pos. for marijuana,Dr. came in and told me I had dirty urine. Me, being ignorant at the time said yeah they had a cancelation and called me in to fill it so i'm probably a bit dehydrated.How does that song go "in the shape of an L on her forehead" he looked at me like i was speaking lithuanian.Than asks me how long i've been smoking pot for.Of course being the girl w/out a sense of humor i said "um, i think since my last u/a.GEEZE I was kidding, THEY were not amused. So i drank about 2-3 glasses of water, reentered the bathroom with the door open this time, filled my "juice"cup and went back to the doc.Let me mention I had been with this office for 40 some years, first with dr. ED then his son Dr head. not like I was unknown or Dr shopping..So when he says i can send this to a lab for more intense testing i said certainly,cause i hadn't smoked pot since i past my state boards. Turns out the poppy seeds on my bagal for breakfast caused a false pos. But not until the lab called to ask what i'd eaton, had this occurred to anyone.Also turns out this test cost $862. Subsequently each u/a I've had since has been sent out to Ameritox. The standards fee is $99 for a 10 panel, and upwards t0
    $600 for more advanced. When i had my 1st pain managemeent consult. luckily they use a scale system and with my "known" income the $99 one is $17 and the $600 one was $48.
    SOOOOOOOOOO what was i supposed to be saying b4 i started this book?
    oh @peacefulfeelings, there is a test that can be ordered by a p.m. dr. that will generally differentiate between certain classses of benzos. this was included in the $600 test and the only reason I know is cause the nurse practitioner read off the u/a results to Dr. Igor the horrible and stated all 3 classes of benzodiazipines were neg. I was like PHEW glad i didn't have raison bagal that day or who knows what it would say
    Last edited by betsky; 03-19-2012 at 04:11 PM.
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    @betsky good info to know. It's been about 4yrs since I've been in the know and working in the medical field where I learned of specifics for testing. Things may have become a bit more sophisticated when testing on a intake levels now. I'm still quite familiar with testing procedures for hiring practices in medical and high technical professional arenas. Even during work comp cases that arrive at a significant bodily injury, unless catastrophic, string testing does not occur unless it is a lingering letitigation.
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    I was at one pain clinic for 4 years, and two years at the one I'm at now. Every tox screen they did told them every benzo, (which benzo) and how much was in my system. I was hospitalized twice about 2-1/2 years ago and they ran a full comprehensive panel. My doc lets me read my entire record while I'm waiting for him to come into my room and it tells the exact benzo I'm taking, plus every other med in my system and how much.

    My two daughters also had to take comprehensive tests to get jobs.

    I've never had the urine tests where they stick a strip into a cup of urine. All of my tests go out to labs (as does all other patients at these clinics). That's why I wouldn't consider buying valium or xanax because I'm scripted klonopin and the test would show both. (no, not on probation and I've never even had a speeding ticket (knock on wood) )
    Like betsky liked this post

  11. Most ER's do NOT do complete drug tox's. Almost all ER's do is 7 or 10 panel Urine drug screens. Occasionally an ICU doctor will do a complete serum drug screen but they are expensive, most labs don't do them so they are send out tests and can take a while to get results back.

    Urine drug screens just give the broad category, not the actual medication you're on.
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    Quote Originally Posted by sinister View Post
    Most ER's do NOT do complete drug tox's. Almost all ER's do is 7 or 10 panel Urine drug screens. Occasionally an ICU doctor will do a complete serum drug screen but they are expensive, most labs don't do them so they are send out tests and can take a while to get results back.

    Urine drug screens just give the broad category, not the actual medication you're on.
    I think in my case we can agree to disagree, but only because I've seen my tox reports and they specify what benzo and what opiates you're on. At pain clinics it's important they know that you are taking your own medicine and having it show up as just opiate wouldn't work. (if it did, I could take hydrocodone instead of the oxycodone I'm prescribed and wouldn't get in trouble).

    Also, I have my test reports from the hospital (they drew blood as soon as I got there, made me pee in a cup and drew blood twice a day when I was there) and I can see where they added xanax on the 2nd day and ativan on the third day. It also shows when they switched me from diluadid to morphine.

  13. Maybe it's regional or case specific. But Pain clinics usually do run comprehensive urine drug screens, for the exact reason you said. It's important for them to know what exactly what you're taking. ER's almost categorically just run a 7 or 10 panel drug screen because of the cost and turn around time. It's not important for ER docs to know exactly what you're taking to treat whatever the problem is, the category works just fine. At least in my experiences. But I'm open to learn how things are done elsewhere.
    Jrama Queen

  14. #14
    My doctor is trying to do a full blood screen for depression. Like the works. Will this show different types? Or for.that matter anything drug.related? I haveent had a blood screen for ten.years so Idk what she is exactly checking but almost everything from.what I read.

  15. a blood test wont show actual depression they always do a full blood count looking for anything physical that can be ruled out such as thyroid problems, i wouldnt worry about it x

    sorry never read first thread, just thought u getn a blood test to see if you had depression, the drug screens i use at work dont identify what specific benzos, x
    Last edited by susie31765; 03-21-2012 at 07:54 AM.

  16. #16
    Sorry I hate typing on my phone. Yea my doc prescribed.me klonopins. I just wanted to.know what scull blood test for depression will show I think she just wants to know that.my.body is healthy but will it show the drugs in my system

  17. #17
    Quote Originally Posted by drschmalzy View Post
    Sorry I hate typing on my phone. Yea my doc prescribed.me klonopins. I just wanted to.know what scull blood test for depression will show I think she just wants to know that.my.body is healthy but will it show the drugs in my system
    You're fine. They have to specifically test for that, and they won't unless you give them a reason to.

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    Routine tox screen can be costly. The OTC/ DOC $30 test only tests for categories.

    Also a CBC/ screen may only test for blood chemistry, not toxicity
    Last edited by royce; 03-21-2012 at 08:10 PM. Reason: 2nd line addition

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    Quote Originally Posted by royce View Post
    Routine tox screen can be costly. The OTC/ DOC $30 test only tests for categories.

    Also a CBC/ screen may only test for blood chemistry, not toxicity
    I agree. There's a high likelihood that the blood test is to check for white blood cell counts, possible thyroid problems, cholesterol levels, etc. Even if she does test for drugs it shouldn't matter since yours are prescribed. My PCP did blood work every year and never once checked for drugs. It was purely to make sure all internal organs were functioning correctly. My white cell count has always been high but he says it's because I smoke.

    If you are given the sheet to take to Labcorp or some other company you can always look at the form to see what they are checking for. My doc would fill out the sheet and tell me to go at my earliest convenience and don't eat for 12 hours before. There was no reason for him to check for drugs since he knew my pain clinic did that and before I went to a pain clinic I wasn't on anything so again, no reason to check.

  20. #20
    Thank you celldwellder


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