False Negative for Oxycodone

[Quattro225]

So I had 2 false negative urine tests at the VA so they canceled my Oxycodone 5mg contract. I have no idea why i am getting negative tests I take them as prescribed except for the times I will save a few for nights I can't sleep, I suffer from Fybromyalgia, Sigmoid colon resection, knee problems, trigger finger, ulnar neurophathy, and PTSD.
I have to be getting false negative's, I take enough the should show up. It is the government so i'm sure they are using the good test, it actually says Oxycodone-NEG. I have Patient Advocate involved because this is wrong.
Any help or suggestions is appreciated, my current meds are:
Oxycodone-5mg
Cyclobenzaprine 3x a day
Pregablin- 2x a day
Trazadone-100mg once a day

[demoeb]

I wanted to add something important - Please google this study that shows how these immunoassay tests for drugs (UDT's) are sometimes not much better than flipping a coin, especially for Oxycontin confirmation testing
search for this "False-positive & false-negative test results in clinical urine drug testing" - its by "future science group"

There was thousands of random UDT tests analyzed and for oxycodone, false-positives occurred 41% of the time, and false-negatives 31% of the time. This is a peer-reviewed professional study by Millenium.

[demoeb]

Same thing has happened for me. I have had compliance testing for oxycodone several times (at least 10 times) and around 50% of them came back as negative. It cost me 2 regular doctors, it resulted in me being accused of diverting, and tomorrow I am to do yet another of these tests so I am understandably stressed. After the last UA immunoassay test that came back negative I decided to contact the pathologist at the lab it was sent to and he said false negatives are common, and the doctors I had should have contacted his lab so they could have retested it with GCMS which is a different and more comprehensive test, but both doctors refused to even pick up the phone because it was easier to accuse me of diverting or lying in some way apparently. It seems apart from Oxycodone being harder to detect than other opiates, and Oxycodone needing a different test to normal opiates, that some people due to genetic differences produce different metabolites than others. It's fairly well documented it seems, but I personally have found a lot of doctors outside of hospital have big egos which may be damaged if they ask another medical person for assistance. It caused me over half a year's worth of agony until I could no longer take the pain and had to go to ER, and endless stress from the accusations. I've had to make many phone calls, write many emails, and I am still being treated not only like an idiot, but like some kind of inferior person for daring to disagree - because I know there was oxycontin in my system despite the results saying there weren't.

My advice: get a GCMS test. It can be done with urine too. It costs ~$75 which you may have to pay for. If they refuse, tell them to talk to an experienced pathologist who can tell them that the immunoassay confirmation tests are not infallible, and are commonly incorrect. This is not just an issue with oxycontin but from looking into it, it is more common with it. See if you can take your daily dosage in front of a medical person, pharmacist etc every day for 1 week.. say.. start on a Monday, and on the Friday have the confirmation test. If it still comes back negative then apart from your dose being too small then perhaps it will give your side a bit more weight.

[somanyidiots]

The estimate is that 88% of doctors and a large number of labs (surprisingly) do not realize that oxycodone, oxycontin, percoset, percodan and a few others are not opiods, they are opiads.  They are synthetic.  The cutoff level for opiods is 2000 ng/ml, the cutoff for opiads like oxycodone is 100 ng/ml.  Either a more sensitive test needs to be used or a test specific to opiads must be used to avoid a false negative.  An excellent Federal resource for this info is published by the U.S. gov., valid and current as of May, 2010, reference SAMHSA.  Got hit by a truck doing 60 mph 29 years ago, so been here and done this.  Have even had it happen in a hospital where they were giving me the drugs and watching me take them.  UA's are considered to give 'potential and presumptive results', and for federal employees and DOT workers a followup confirmatory test  is is required either by gas chromotography mass. spec. and/or GC Tandem mass spec.  Unfortunately, it is not required for private practitioners.  There is not a UA on the market with a zero failure rate, the failure rate I used to use was 2-6%, although there is a guideline written for the New York State Law Enforcement and Judiciary System that puts the failure rate as high as 10%.  You have to wonder how some people ever got a certificate let alone a degree.

[Quattro225]

Thank you for all the feedback. I got my tooth pulled today so I didn't get around to calling the doc. Tomorrow my mission is to get this solved.

[geminigirl1963]

I'm sorry to hear that your pain is so bad - I also live wiht severe chronic pain, so I can relate to how tough it can be and how frustrating it is.

I am wondering, though, about your comment on the blood test.  If you're taking the meds on a daily basis, it shouldn't make any difference if the meds get out of your blood in 1-3 days - if you're taking it every day, then it'll be there when they do the test.

Have you talked to your doctor about the possibility of switching you to a different pain med?  If your body is metabolizing the oxycodone too quickly, it's possible that a different med might not only help your pain more, but also your body may not metabolize it as quickly as it appears to do with teh oxycodone.

Hang in there and I hope the patient advocate is able to help you.

[Quattro225]

I can take a blood test but i was told it gets out of your blood within 1-3 days. I saw a few posts about an enzyme that some people produce that can give false negatives. The lab tech said he can see I am on it, by how my eyes look.
I feel bad, I was so stressed out when they canceled my Oxy, I really don't have any idea why it will not show up. I have had three ua's two were negative and I'm still waiting for the other results. I took it yesterday.
Stupid pain... I wish it would just go away but I know it's something I have to live with, I am only 28.

[demoeb]

I know this feeling and stress from being accused. I lost 2 regular doctors over it, it's put a permanent 'bad mark' on my medical records and for over 9 months I was forced to stay in agony without any pain relief because it was wrongly assumed by these 2 doctors that the tests were 100% accurate. These UDT tests really are for paranoid mothers worried their kids are on drugs (I wouldnt even rely on it for that though)

[peekawho]

You may simply be a fast metabolizer of your medication.  However, I have no idea where you go from here, to prove it.  Can you request a blood test?

[Quattro225]

I use the trazadone for sleep, it is a perscribed sleep med. I take the oxy three times a day. I sometimes get pain so bad that no medication can help, So I take close to 90 oxy pills a month to control my pain, I think the VA is turning my tests to false.

[geminigirl1963]

Is your oxycodone 5mg only a one daily dose?  If so, that is a very low dose and that could be the problem - especially if you are tested on a day following a couple of days when you have "saved" some for nights that you can't sleep.  Because of this being a low dose, if you skip doses, it's more likely that it wouldn't show up on your UA.  I hate to say it, but if you say that you take your meds as prescribed EXCEPT for when you save some for nights that you can't sleep, then you really AREN'T taking them as prescribed.  Even if you are not taking MORE than what you are prescribed per day, if you are not taking them according to the dosing instructions, then they are not being taken as prescribed.  I'm not trying to be mean or anything here, just trying to explain why you may have had a negative UA for the oxycodone.

Even if you're prescribed to take the 5mg a couple of times a day, and skip a few doses to save those pills for nights when you can't sleep, and then take one before your appointment and possible UA, it's still likely that your UA could come back negative.  Becasue of the low dose of the medication, it more than likely would take more than one dose to build up in your system before it would register enough on a UA to show it being there.

I would suggest that if you're having trouble sleeping, you talk to your doctor about the possibility of prescribing you something specificially for that, rather than savign some of your pain meds for that purpose.

One last thing - just because your testing is being done through the government - the VA - that does NOT necessarily mean that their tests are top of the line or correct.  It's surprising how many posts and articles I've read here on medhelp about other VA patients having the same issues with their UAs - either false negatives or false positives.  So just because it's the government, that does not preclude them from having problems with their testing procedures or test kits themselves.  It's good that you have the patient advocate involved.

I wish you the best of luck and urge you to talk to your doctor about getting an actual sleep aid for sleep rather than using your pain medication for that use.  Doing so could actually save your pain mangement contract.

[corey_ham]

Friend, perhaps these mixing many medicines. I read a few days ago in findrxonline that abuse of medicines can bring consequences later. Hence recommend you visit to the medical specialist and you make a check-up.