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What Causes False Positive Test Results For Oxycodone?

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Posted on Mon, 6 Jun 2016
Question: My pain management Doctor did a urine test and said I showed up positive for oxycodone or OxyContin (I'm not sure which he said and I don't know difference). My friend had given me a pain pill 5 days earlier that she said was the same as my morphine. So is there a differemce? If so, how long does that stay in your urine they send off to a lab bc now I'm in need of a new doc. I've been on Xanax and morphine for 10 years for herniated discs. I really need to know how long this stays in your system. Withdrawals are KILLING me!
I forgot to add that the same time I tried cocaine for the first time (REALLY EMBARRASSING). I find it easier to ask doctors that don't know my entire family this question because quite honestly if I were reading this I would look down upon me! I've been in pain management for 10 years and I promise this is the only slip up or stupidity on my part.
doctor
Answered by Dr. Dr. Matt Wachsman (2 hours later)
Brief Answer:
well... I wouldnt look down on you...but....

Detailed Answer:
the unsupervised taking of multiple addictive drugs is a bit of a red flag of addiction and will cause.. ahem.. complications in your life.

The oxycodone was a bit of bad luck:
1) it stays detectable only for about 5 days, so it was far from 100% likely it would be found
2) it is only detectable if you do the right test. The common over the counter narcotic screen not only cannot differentiate oxycodone from morphine, it probably wouldnt even detect it!

Most drugs of abuse are detectable as a rule of thumb for about 5 days. This can increase in people with liver or kidney disease (take longer to get rid of it) or if more is taken. Marijuana is the exception where constant heavy use builds up marijuana breakdown products that can linger for over a month.

Another option for pain manangement is to integrate it into an overall addiction plan such as methadone or suboxone.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (43 minutes later)
Well I'm a little confused because your saying it can't be differentiated from the morphine my pain management doctor has had me on for 10 years, but he did a random urine drug screen that he sends off to another lab. So if you can't differentiate morphine (which is one of my prescriptions he writes for me) than why did he say the lab that does the urinalysis said I had oxycodone in my system? You're saying morphine and oxy show the same. Do you understand why I'm confused now that he told me I need to find a new pain management doctor? Also, another doctor on this site that I spoke to about the cocaine (worst mistake I made in my LIFE) said that doctors can flag you in some system so other doctors know not to give you pain medication. My pain management doc didn't say anything about that, but at the time he was quite mad…understandably. Since my drug screen showed the cocaine and the pain medicine he doesn't prescribe, will he be able to flag me somehow where every Doctor can now see this embarrassing information? That seems to me like it would violate HIPPA, right? Or can you, as a doctor, flag me in the system? I have no idea what methadone or suboxone is so who would I need to see to look into that. Does that 5 day rule also apply for the cocaine?

I honestly don't do drugs that aren't prescribed to me. I messed up. My dad died skydiving, my uncle hung himself, and then my brother committed suicide as well. Not that that's an excuse because I have an amazing life and 3 beautiful children. So I went a little errrrr CRAZY! If I do find another pain management Doctor (depending on the answer to my question about being flagged in the system for all doctors to see), do I tell him about my indiscretions? I can assure you I've learned my lesson about trying illegal drugs or trusting the friend who gave me the oxycodone because I forgot my meds at home? Like I said, I understand that you don't know me and I'm sure you're thinking I'm some drug addict, but this is the reason I paid for this site… anonymity! So you think that I'm good with a doctor I found that had a new patient appointment on the 13th of April? As long as I don't take anything that isn't prescribed to me from here on out, I'll be good by the 13th?
doctor
Answered by Dr. Dr. Matt Wachsman (47 minutes later)
Brief Answer:
to clarify

Detailed Answer:
as mentioned.
2) it is only detectable if you do the right test. The common over the counter narcotic screen not only cannot differentiate oxycodone from morphine, it probably wouldnt even detect it!
He sent it to an outside lab. And this implies the more sophisticated testing was done that CAN differentiate/detect oxycodone from morphine.

The flagging is a complex issue. Certainly doctors who directly share his records will get his records. I believe it is at the Federal level that the privacy consent I have laboriously worked on for months has included provisions for patients to change/withhold/alter their consent to share their medical information. THis has to be directly communicated (probalby best via certified mail in writing) to the doctor to withold consent to share medical records outside of the office. This will be a big problems in that others will not be able to get the documentation of what medicines you were on and why you were on them and the justification for giving them. Furthermore, when someone comes in as a new patient who was previously on a controlled substance from another office this is a red flag and begs the question why arent they still at the previous office. One might ask for the previous records. If they are not able to be obtained, that is a problem.

Actually, Im thinking you are asking quite good, reasonable questions. The answers are independent of particular individuals and are independently verifiable. Some breakdown products of some drugs stay for a lot longer than the drug itself (marijuana and tobacco). Not the ones we are discussing. The duration of felt effect is about the same as the half life of the drug (hours). The detection methods can detect drug at much lower amounts than the amount needed for an effect but they are not infinitely sensitive. If a drugs effect drops by half in 6 hrs, then its half life is probably about that long. So, 6 hrs, half as much is there. 12 hrs is 25% left, 18 .. 12.5%, 24...6%, at 48 hrs it is 6% of 6%, 10 days would be 6% to the 10th power. That is very very small.

The previous records and explanation of previous medical history is much more of an issue than the urine test.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (4 hours later)
I appreciate the wealth of knowledge you have provided to me. I'm very lucky you were the Doctor I was was fortunate enough to get. I think I'm going to just be upfront with the new doctor with what happened with my current doctor and hope for the best. If I were you're new patient, would you appreciate the honesty or automatically turn me away? The new spine care and sports medicine Doctor I found gave me their first new patient appointment since I was out of medication. They had a waiting list, but she said she didn't want me to be sick. So I'm hoping that being honest with her will go a long way. Or at the very best she will help me with the other medication you recommended earlier. If you don't mind telling me what you think about being honest, I would appreciate it. My husband told me not to say anything because they never asked for my records and they were more concerned that I was out and having withdrawals. I didn't even know why I was feeling the way I was feeling until speaking with the new office and the doctor's PA explained that this happens when a patient quits taking medication without being weened down.

I really appreciate you being so kind. This subject has been so embarrassing for me. I don't care what I had going on in my life. The decisions I made were extremely stupid. The saying "you made your bed, now you have to lay in it" is fitting. So the last thing I need is your take on what I should tell the new doctor's office. They didn't ask for my previous records, but it doesn't mean they won't once I get there. So, again, thank you for all the information you gave me concerning the urine tests a pain management clinic will make you take randomly. I have records from a previous clinic that I originally was going to when the doctor was arrested. He has his medical license back because I have recently found him in New Orleans at a different office not affiliated with his Baton Rouge office. I can get those records and I've only been under this doctor's care for 1 1/2 years. I was with the other doctor for 8 1/2 years. I'll make sure to send that certified letter and pick my records up from him for myself. I can't thank you enough for not making me feel worse about myself than I do now because no one can beat me up like I'm beating up myself. Plus, I'm soooooo sick. I feel this is my punishment.
doctor
Answered by Dr. Dr. Matt Wachsman (2 hours later)
Brief Answer:
quite welcome. but Im not a usual doctor.

Detailed Answer:
First on the honesty.

Choices frame the situation with many assumptions. Based on internal brain structuring of the world, we notice virtually nothing. We retain information on virtually nothing. We take as important virtually nothing. Oh, this includes how doctors organize the world also.

If someone goes to a drug rehabilitation/treatment center there are many assumptions the person going there has. And if someone goes to a sports/pain center then there are different assumptions. Based on assumptions, different sets of facts become salient. It is surprising how very much of the world that one perceives is due to automatic filtering by unconscious brain centers and how very much is plain filtered out based upon the assumptions one has. How much about your first grade teachers facial hair ARE you mentioning to the doctor? Well...if you are filtering out nearly everything in your brain anyway, why not just answer the questions they ask you? If they ask, you have used recreational drugs rarely. Include every use ever. A timeline is helpful. Three puffs of marijuana in high school, one try of methamphetamine, heroin, cocaine and LSD each in sophomore year of college then 2 uses as an adult is one pattern. All of the same use all beginning last week and at the same quantity produces a very different timeline/picture.
But only if asked.

I have a unique perspective on this.
1) board certified in addiction and running a suboxone treatment program.
2) I have the realization that the same brain structures, brain actions, underlie a lot of behaviors: whimsically taking medications and whimsically taking food, being used to waiting until theres a deadline and rushing for it at the last moment.
3) and a realization that these same brain structures/activities/proclivities underlie addiction and much of my behavior. Furthermore that there is a human tendency to distance oneself from tragedy and those who have it that is plain delusional.
This is the basis of my book on food behavior.
http://www XXXXXXX com/dp/0000/
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (3 hours later)
Well you being a different doctor has helped me feel comfortable with you and I truly wish you were in Louisiana. That being said, I appreciate all of your help and your honesty. I'm planning on taking your advice and my granny is VERY addicted to food so I'm glad you sent that link because I bought her a kindle for Christmas and I'll have that book downloaded on there yesterday. Lol. I do seem to put doctors on a crazy pedastal, but we all make mistakes and we are all human. Dr. XXXXXXX getting arrested for making up patients to cover the fact that his PA had some drug ring going on…so I'll stick to questions asked and if that doesn't work out I'll try to find someone who will help me with suboxone. I'm hoping that helps with pain! Thanks for everything and I'll try to keep you informed on the doctor situation. Assuming I'm able to ask YOU…I'm just learning how this site works :)
doctor
Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
Several points to conclude.

Detailed Answer:
heh, its a workbook, so there can only be a print edition.

Suboxone is equivalent to about 30 mg a day of morphine or oxycodone and it has the unique property of not being entirely as strong as other narcotics so its power/effect maxes out at the 30 mg mark. If people need more than that for pain, and that is not a function of addiction, then, suboxone will not be entirely successful, if that is about what they need for pain then it will.

and you are certainly welcome and I am always available for direct questions (they get mad if I do not answer a reply, so even if you thank me again, I am required to reply welcome again!).
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (6 days later)
I only have 6 hours before this discussion is automatically closed. My appointment with the pain management doctor is tomorrow morning so my "come to Jesus" moment will be happening tomorrow at 9 am. I get a different answer about the unfortunate cocaine incident every time I ask a doc, google it, and even my best friend runs an extremely expensive drug rehab and HE gave a different answer. Some say no longer than 3 days other say upwards of 10! I also just found out my mom has breast cancer and she's having a double mastectomy Wednesday morning. So I'm dealing with a whole lot and now may be cutoff off all my meds. If I broke the contract, can he just let me go with nothing to help with the withdrawals? The word suicidal has never been a way I would describe myself as, but honestly I'm thinking that's what will happen if he just lets me go. Anyway. I just wanted to keep this open for the shit storm that will probably hit tomorrow morning.
This metabolite thing is what is going to screw me and these panic attacks and suicidal feelings are crazy. I have 3 kids, but don't know what I'm going to do. You're the doc I connected with best, which is why I'm dumping my shit on you. It just makes me crazy bc every time I ask a doctor about coke I get a different answer, that drives me crazy
doctor
Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
ten is wrong.

Detailed Answer:
3 days is often true and I think I said 5. Frankly 3 or 5 are in the same ball park range and the difference between 3 and 5 depends somewhat on what the lab is going to call a positive. But ten is long and I havent seen 10 with any literature supporting it. 10 half lives of the drug maybe...which would be 3 to 5 days.

See if you can reschedule due to the mom situation? The suicidality is quite a serious situation and justifies being admitted and put onto suboxone or methadone maintenence in general
cannot say in your particular case, but generally, strong psychological issues even without other addiction problems are strong reasons to be in a program. Even mild adjustment disorders (aggravation, feeling overwhelmed) is a good justification for getting counseling.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (27 minutes later)
I already took the test. Tomorrow morning will be the first appointment seeing him since this has happened. I really just didnt want this to close before tomorrow morning in case i needed you after the appointment. I felt the best connection with you and felt that you should know the outcome. Not that you orobably care lol. I just figured youd be the best person to help me with a solution for when he drops me. Anyway, i am truly hsving a panic attack snd have to go, but thanks for ansering promptly and kindly (as always)!
doctor
Answered by Dr. Dr. Matt Wachsman (45 minutes later)
Brief Answer:
we never close

Detailed Answer:
and you can always send a directed question to me. But, I cannot diagnose, prescribe or treat, I can give general information as a board certified addiction, internist, and clinical pharmacologist, but I cant make a pain clinic take you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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What Causes False Positive Test Results For Oxycodone?

Brief Answer: well... I wouldnt look down on you...but.... Detailed Answer: the unsupervised taking of multiple addictive drugs is a bit of a red flag of addiction and will cause.. ahem.. complications in your life. The oxycodone was a bit of bad luck: 1) it stays detectable only for about 5 days, so it was far from 100% likely it would be found 2) it is only detectable if you do the right test. The common over the counter narcotic screen not only cannot differentiate oxycodone from morphine, it probably wouldnt even detect it! Most drugs of abuse are detectable as a rule of thumb for about 5 days. This can increase in people with liver or kidney disease (take longer to get rid of it) or if more is taken. Marijuana is the exception where constant heavy use builds up marijuana breakdown products that can linger for over a month. Another option for pain manangement is to integrate it into an overall addiction plan such as methadone or suboxone.