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Take Oxycodone but Hydrocodone Showed Up!

Hi Everyone!
A very, very odd thing happened to my mother and I'm unsure of what to do as I'm waiting to hear back from her pain management doctor.  She has been on oxycodone for quite a while now.  10mg, 4-5 times per day.  She was randomly given a urine test at the pain clinic, which obviously we had to problem with, however, her test came back with hydrocodone in her system!  How is that even possible?  I've been researching and researching and have seen that there is a allowable trace amount that can be found in other pills being produced at the same facility but this is crazy to me! I organize her pills for her as she has severe rheumatoid arthritis and is unable to handle small pills without dropping them.  I have noticed the past couple of refills the pharmacy has given her a couple of different "brands" of the drug (different manufacturer).  Could that have anything to do with it?  I'm so scared they are going to release her and no longer treat her.  She has had 3 back surgeries, degenerative disk disease, and as previously mentioned, severed rheumatoid arthritis.  She is unable to take anti-inflammatories due to kidney issues and has only found relief with opiates.  She does not abuse them and I keep them in a safe location.  Will the doctor perform a second test to confirm results?  Is that something I can request?  I'm just at a total loss at the moment...thank you for any feedback you can provide.
4 Responses
547368 tn?1440541785
Hi Brink,

Welcome! I am so very sorry to hear that this has happened to your mother. Unfortunately it's not rare. UDT (Urinary Drug Tests) are as accurate as the reader - or the type of test utilized.

Your mom is blessed to have such a caring child in you. Many of our seniors are left on their own to navigate their healthcare. I'm sure she is very proud of you! I hope you'll be her advocate and step in if her PMP dismisses her.

I encourage you to do some reading on our forum. There's lots of information on UDT. It takes a good understanding of chemistry to completely understand the metabolites of drugs, etc. Unfortunately chemistry is not my strong suit.

What I do know is the accuracy of a UDT depends on the test. The most common used in laboratories is 99% accurate - it's also the most costly. Some clinics use the less costly and accurate UDT. If the results from that test is not what is expected than the specimen is usually sent out for the more accurate UDT.

No, it's not usual that the her PMP will retest her. Read her Pain Contract. They usually say that once you fail - you're dismissed.

Do you have one of the last batch of her Oxycodone? Do you suspect that they filled it with Hydrocodone instead of the Oxycodone? If so - that tablet is important and should be checked. Different manufacturers make different looking tablets - of the same drug. They all have to meet the same FDA standards. Oxycodone is oxycodone regardless of which manufacturer produces the tablet. They will all test the same.

With GC/MS or LC/MS testing, Hydrocodone may show metabolites of Hydromorphone but it shouldn't read as Oxycodone. Oxycodone may metabolite to Oxymorphone but should never read as Hydrocodone.

GC/MS or LC/MS is the most accurate of the UDTs.  Immunoassay is the least accurate and therefore ill advised in PM Clinics beyond a yes or no to opiates present.

Has the PMP said anymore than the results of your mom's UDT?

I wish I could explain these tests in more detail. All I know is what they should and shouldn't reveal. Our members may have more information for you. If your mom has a good, long standing relationship with her PMP he/she may give her the benefit of the doubt. It not unheard of. My PMP would retest me. I've seen it happen with his other long time patients. This isn't normally the case - but I hope in your mother's instance it will be.

Please let us know how this turns out. I'll be very interested to hear the way this turns out - and I'll be hoping that it's positive!

Best of Luck,
~Tuck
547368 tn?1440541785
I meant to respond to your first paragraph where you said, "A very, very odd thing happened to my mother..."  Sadly this is not odd. I hear this about every 10-14 days in this forum.

I can't explain it without some detailed guessing - but it does happen more than you may think - and way too often in my opinion.

Again if you do some reading - or search of our threads - you'll see others that have experienced the same.

~Tuck
Avatar universal
Thank you!  I havent heard back yet and of course growing more and more upset. She's been a very good standing patient for over a year. Unfortunately she just finished her last prescription and I just picked up the new one yesterday. This time it's all the same manufacturer.  I guess we will wait and see.  I'll keep you posted!  I just honestly cannot believe or comprehend this!  

Thank you for taking the time to write.  I appreciate it.  
547368 tn?1440541785
You're welcome.

If you were able to obtain a new RX that sounds promising - unless the RX was written before the results of the UDT was read. Let's hope the PMP has a heart, and a head.

I'll watch for your update!

Again, Good Luck,
~Tuck
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