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On fentanyl. Have Lyme. Suggested heroin showed in lab test. Concerned?

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General & Family Physician
Practicing since : 2004
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My pain mgmt dr. said heroin showed up on my lab... I have been on fentanyl for years, and until recently was on ms4 for b/t pain. I have Lyme dis and temporarily had an increase in pain while on iv antibiotics. No other factors involved and no other faulty tests, and no positives occurred in two years of prior testing. What might prompt him to say so? Also, I did not have lab done that day. Obviously it was not mine but why would he do so and not admit some mistake? Also, is what I tell you here completely private or do you all keep this data on file? Thank you for answering my concerns.

I only want my email listed, not my physical address. I want to maintain personal privacy and do not wish to have my information logged other than email address, please. On the last page , at the last second I believe I saw my physical address which prompts me to write this addendum. Thank you.

I also was on another medicine at the time which did not show up on the test and should have. This medicine was Xanex 0.5. I've had the same prescription over two years and the medicine cannot be refilled. However, I was taking it during that two - three week period that I was particularly needing it. I also asked the intake nurse if it was listed on my medication record BECAUSE I was taking it and wanted to be certain of this. Otherwise, I would be breaking the rules if it wasn't listed. Also, I'd expected to have a drug test that day as it is usually done every 3 months unless o/w indicated, and my husband and I wondered why one hadn't been done. Why would a physician do this sort of thing?
By the way, I did not intend to be assigned to the category, "drug abuse". I have not abused any drugs. Thank you for your assistance.

After my physician told me all of this he wrote my prescriptions at almost half of the usual dosages. He said it was indicated to do so. I was very uncomfortable with this medicine change as it wasn't a "stair step", but more of a leap. I have not returned to him except to tell him what I've told you here, and to ask him to place my concerns on the chart. He only wrote that he did not think I was abusing heroin, but did maintain that this was the situation. Lastly, I also mentioned that I felt his staff must have confused my name with someone else's lab, since labs are not done securely there, but his reply was simply that it did not matter since this was not a legal issue. I am quite concerned that when I seek a pain manager again I sill be denied because of this entire ordeal. I am ggoing to see if I can submit a hair sample which I had not thought of before. My home health nurse suggested it the other day, but I am afraid I have exceeded the time allotted for this sample. This was all done around January which is about 8 months ago. However, I will still have it done. I've felt that I've really suffered by having to go through this, on top of dealing with Lyme.
This ends my questions to you. Thank you for any information you can offer.
Posted Mon, 14 Oct 2013 in Drug Abuse
Answered by Dr. Chakravarthy Mazumdar 8 hours later
Brief Answer:
A drug holiday is better while on pain medication

Detailed Answer:

It seems you were more bothered about your pain doctor asking about heroin abuse. You were not comfortable with the half the dose of pain medicine even though you did not have respite for the full dose. Is it? You would want to prove the suspicion by the doctor as wrong, you want to test with a hair sample, am I understanding you correct? Third you were concerned about privacy.

Suspicion is common for pain specialists as they deal with compounds which are intermixed and linked. Even if you take Fentanyl when they subject for drug test it shows up. It should be considered false positive. However you should not be bothered about the tongue slip by the pain doc. Please go ahead with positive mind and leave behind the past incident. If the levels are more than a threshold then it is considered illegal. The doctor who prescribed you the dose of Fentanyl would be held responsible as well. So it is important to do the drug testing for any center before they actually continue the doses. It is up to you whether you still want to go ahead with hair sampling. It would not make a big difference right now.

Now please continue with the dose prescribed by the doctor and get back to him after few weeks. He should realize the dose would not help to relieve the suffering. It is also better for you to keep testing with half the dose sometimes as you may get addicted to fentanyl and other pain medicines. So one way this is a good approach and achieve pain tolerance. I also suggest you to work with Naturopathy doctor in your area for pain relief. I appreciate that you were not taking Xanax regularly, the need should be justified as it has addiction potential.

We categorize the query such that relevant specialist can answer for e.g pain specialist in your case but if they do not accept the question a primary care like me would pick it after few hours. We do not display any personal details here not even your email leave the physical address. Let me assure you.

Let me understand you better.

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