Pain meds

[jarhead2531]

I take 10 mgs. of Percocet for back pain, 3 times a day. I would like to know if I stopped taking Percocet how long would it be before it is out of my system so I could pass a drug test ?

[Tuckamore]

LOL. No problem! I need reminding!

[philnoir]

Sorry Tuck -- you know, my wife says that I repeat myself also.

Maybe there's something to it?

[Tuckamore]

Thanks Phil,

I have been to Dr Jeffery Fundin's site several times as you suggested some time ago. He does have a wealth of information.

[philnoir]

Check out the website of Dr. Jeffrey Fudin,  B.S., Pharm.D., FCCP, FASHP, Diplomate, American Academy of Pain Management.

http://paindr.com/home/

He's a pain pharmacist, and has a wealth of information on his site and blog regarding the treatment of pain with opioids.

[Tuckamore]

Thank so much for your input.

I bow to your knowledge in this arena. I am intend on acquiring more information and education on this very important issue for all we Chronic Pain Patients, Drug Testing.

Take Care,
~Tuck

[philnoir]

Your question is actually more complex than you realize, as it depends on the PK or "pharmacokinetics" of your body's metabolism of oxycodone, the synthetic opioid used in Percocet. With better PK, oxycodone is quickly converted in the liver to its metabolites and excreted by the kidneys -- a process requiring 24-48 hours. With poor PK, metabolites stick around longer.

There are two kinds of UDT (urine drug testing) -- immunonassay and chromatography.

Immunoassay is simple and involves colored reagent strips that simply detect the presence of certain opioids. They can be performed by an untrained medical aid -- just dip the stick in the urine, and compare the color of the patches on the strip. Immunoassay gives a yes/no answer -- if the patch matches the color on the bottle, then your doctor has found presence of opioid in your urine.

Immunoassay is sensitive in general out as far as 48 hours, so to be safe, double that time. Stay away from percs for 4 days before the test.

Now, chromatography is another story. It is a sensitive and specific test used in medical laboratories to measure a variety of blood and urine metabolic parameters -- not only the presence of medications, but for measuring basic body function. That wide-scan that we used to call an SMA 25 that reports your electrolyte levels, and specific cardiac and liver enzymes is run using chromatography. Today the technique is computerized, but still requires the skill of a certified medical laboratory scientist.

Chromatography for UDT seeks out metabolic fractions of specific drugs. For instance, a chromatograph of oxyocodone would also detect the presence of noroxycodone -- an inactive metabolite, as well as a small percentage of hydromorphone -- a very strong opioid marketed under the name of Dilaudid that is believed to be responsible for making oxycodone more effective than its sister opioid, hydrocodone.

So, a chromatography panel would show the presence of some oxycodone, some noroxycodone, and some hydromorphone, each in certain percentages. A skilled pain doctor would spot your oxycodone use in a glance.

Chromatography is much more sensitive than immunoassay, and the computers that generate results for chromatography have tunable cut-off values. Those cut-off values determine how little metabolite will be detected.

If your doc is using chromotography he'll be sending the sample out to a lab and results will not be available until next month, usually. It is an expensive process.

To summarize:

Immunoassay -- quick and cheap. Accurate out to 48 hours. Can't detect use prior to 48-72 hours after the test, depending on PK. Avoid use 3-4 days prior to testing.

Chromatography -- thorough, expensive, extremely accurate. Can detect metabolites for over 48-72 hours. To be safe, avoid use 1 week prior to testing.

[Tuckamore]

Hello Jarhead,

Welcome to the Pain Management Forum. I'm glad you found us and took the time to post. I can't help but be curious. Why do you ask the question?

How long you have taken Oxycodone (percocet) what dosage  also places a role in detection.

In part it depends on the type of test that is done. Some drug tests are more sensitive (and accurate) than others. Initial (immunoassay) and confirmatory (gas chromatography-mass spectrometry [GC-MS]) testing are the methods most commonly utilized to test for drugs. Using a combination of both tests allows a high level of sensitivity and specificity, meaning there is an extremely low chance for false positives or false negatives.

I am not super familiar with the specifics of these drug tests as some of our members are. I do know the literate states Oxycodone is detected for 24-48 hours following the last medication. I also know that metabolites may stay around longer. The safe answer is probably closer to 21-30 days.

I hope that helps. Please share with us why you are asking. We're not here to judge. We can to help.

My Best,
~Tuck