Urine test when on pain meds

[Swish23]

I take several medications for pain and one of the medications is soma. In the test it showed I had tramadol in my system. I don't take tramadol.  Why did that happen?

[Tuckamore]

Hi Swish,

Welcome to MedHelp's Pain Management Forum. I'm glad you found us and posted your question here.

As usual our Remar has offered some good information. UDT (urinary Drug Test) is a chemical science - either well or poorly understood by PMP. Chemistry was never my strong suit - and that's what UDTs are all about.

It depends on the type of UDT your PMP utilized. The quick, inexpensive UDT often used in a Physician's office is not as accurate as a more expensive UDT that is often "sent out" and preformed off site. Those inexpensive UDTs are called  Immunoassay drug tests.  They are designed to classify substances as either present or absent and are generally highly sensitive but not always accurage. In pain management, specific drug identification using more sophisticated identification tests is required for more accuracy. These UDTs are called Gas Chromatography/Mass Spectroscopy (GC/MS) or sometimes they use a High Performance Liquid Chromatography (HPLC). Either is used for the identification of a specific drug and/or its metabolites. It's important to know which UTD was used by your PMP.

Some drugs metabolites can appear similar to another drug. Sometimes an opiate will "look" like another in a UTD - due to how it metabolites in the body. PMPs must be very educated to be able to differentiate. GC/MS testing is 99% accurate.

It is generally excepted that the absence of expected drug(s) and/or drug metabolite(s) in a UDT may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing. The concentration value must be greater than or equal to the cutoff to be reported as positive. Where the Cut offs are set is important in accurate testing.

Soma (Carisoprodol HCL) is a skeletal muscle relaxant. It has a first pass metabolite which is Meprobamate (a barbituric acid like substance). It may show up in as UDT as a barbiturate as it has similar properties.

Tramadol is now classified as an Opiate. Tramadol is metabolised to O-desmethyltramadol. It is of the benzenoid class. It appears to metabolize similarly to Soma. Benzenoid and Barbiturates appear similar. Please remember that I am far from and expert in UDT and chemistry. It appears these two drugs can "look" similar in UDT - but it's only my assumption.

I want you to know that I believe you. I hope your PMP will also. He/She may be doing further testing or have further interpretative evaluation of your UDT. Hang tight and ask questions.

Please let us know the results. I'll be very interesting in hearing more from you.

Best of Luck,
~Tuck

[remar]

These two medications may have some of the same ingredients. Or it could be the way your body breaks down some of your other medications.
You may want to ask for another test. A specialized one. Unfortunately, this can and does happen, false tests. It depends on how your body breaks down your meds and it also depends on what kind of test they're giving you.
I recommend you do some research in this and take. Print what you find and take it to your pain Dr. He/she should already know about this but either don't know or they will believe what the test says.
Can I ask what your Dr said to you when the test came back showing Tramadol when you do not take this medication?