July 2, 2009 - 7:41pm
2 reasons I am worried.
1) For the past 4 days before the urine test, I had not taken my prescribed dose of Oxydodone and Hydrocodone. I am prescribed to take 2 hydrocodones per day and 1 Oxycodone per day. 4 days ago I run out of hydro completely and had only 4 left of oxy. Therefore I was taking half oxy every night to make it last. I am afraid that I won't have sufficient trace of both drugs on that test. Should I be concerned about this?
2) I smoked a little bit of marihuana about 1 week ago. I mean, I had about 5 hits of a pipe. Previously to this I smoked heavily for about a week at my friend's house.. that was about 1 month ago.
What should I expect to happen next time I visit? Or is my doctor going to call me before I make my next appointment to tell me about his findings? Will he make me come in to humiliate me and tell me he can't treat me anymore? will he keep treating me but will give me a warning or regular tests to see if I keep smoking? will he tell my primary care doctor about the THC that more likely will appear on the test? If he denies me future treatment, will I be able to go to another PM clinic or I my doc will have to tell when the new doc requests medical records? Sorry for all the questions but I am really worried. This is the first time I have been on PM and totally forgot about the random tests.
Any advise will be appreciated!
July 2, 2009 - 8:32pm
#2
woodstock:I am worried about
woodstock:
I am worried about having THC positive.. and not having enough oxy and hydro in my system. Like I mentioned, it had been 4 days since I had Hydro and 4 days of only having half pill of Oxy. The test should still show traces of both right? would it be a good answer to tell my doc that I just did not have that much pain lately and just cut my dose to a minimum? THat may fly.. but the THC may be the real issue.. hopefully they measure the THC amounts and he can see it is little and not kick me to the curb because of that. thanks for replying!
July 2, 2009 - 9:31pm
#3
woodstock
in my past ive learned that an opiod is a opiod i really wouldnt stress out I WOULD NOT SAY I DIDNT FEEL PAIN also if he was any kind of pain MGT.DR. he would actually agree with your pot smoking thats why they now have co ops.unless your selling them Id chill out a little.
July 2, 2009 - 9:39pm
#4
..
usually a PM doc will drug screen everyone it is just ideal practicing procedures and could be authorized for him to do it... Everytime that I was tested they used a screen that could test the difference between oxy and hydro. Also pot in your system may terminate you.. If it shows up
July 2, 2009 - 9:54pm
#5
guesswho- It really depends
guesswho- It really depends on the test that your doctor runs on your urine analysis. There are some test that just detect any traces of opioids. If this is the one that is done, you'll show a positive for opiates because of the oxycodone. However, you probably don't have any hydrocodone in your system anymore after 3 days, so if your doctor runs a test that specifically shows what opiates are in your system then you may have some explaining to do. Additionally, there are urine anaylsis tests that show the levels of the medication in your system. Did your doctor (or whomever gave you the test) ask you when the last time you took each of your medications was? If yes, then they probabaly ran this test. Even if they didn't ask, they still are going to expect to see a certain level of each medication in your system based on your doses if this test is done. My doctor runs this test (the one that shows the levels of the drugs in my system), but I don't think it's common. The way your doctor prescribes the oxycodone (1 a day) is kind of odd considering that it only is supposed to last 12 hours. How is your medication prescribed? If it is written take as needed for pain, then you'll probably be fine. If it says that you are supposed to take 1 a day, then again you may have to do some explaining to your doctor. Honesty is the best policy. My only concern is that it doesn't sound like you were taking more of your medication because you had extra pain (based on your statement that you are willing to say you have had less pain and are willing to have the dose cut in half). I really do hope you are taking your medication for legitimate pain as described, if not then maybe having a dirty UA will be a good thing. Taking more of your medication than is prescribed can be really dangerous.
As for the pot, it will most likely show up. That one you're going to have to again be honest with your doctor about. Some doctors don't care too much if you smoke it, but a lot do. Did you have to sign a pain contract when you started with this doctor? If so, does it have a clause in there that says you can't have any other controlled substances in your system? If you're honest with your doctor and let him know that you messed up and will do whatever he asks from now on he may keep you on. A lot of doctors are willing to give you one chance at making a mistake.
As for how your doctor will inform you, it can vary. Some people on this board have said that they were sent letters in the mail stating that they had a dirty UA. Usually these letters will state that the doctor will continue to treat you for 30 days, but they will no longer be prescribing you any narcotic pain medications. If you are kicked out of this pain management clinic for having something in your system that you shouldn't or not having opiates in your system then it may be hard to find another doctor. Your new doctor will want your charts from your previous doctor to prove that you were on the meds and to show why you were on the meds. They actually need to verify this to prescribe you meds without the risk of getting in trouble. Once they see that you were kicked out of the previous doctor's clinic for non-compliance then they may be hesistant to prescribe to you since they run a risk of getting in trouble if they do knowing that you previously weren't in compliance. Some doctors won't contact you about the UA and will just discuss it withy you at your next appointment. I know you think it may be embarassing to have your doctor do this, but it really is your best chance at continuing care if you need it. This way you can talk with your doctor about what went on and let him know you are willing to comply from now on. You can make a plan with your doctor on how he can trust you again. Sometimes when a patient has messed up a doctor will only write scripts to cover 1-week of meds at a time, they'll have random weekly UA's, they'll have random weekly pill counts, etc. This all lessens the liklihood that you could take more meds than prescribed, etc.
I hope this info. helps. I wouldn't worry too much at this point until you actually know the results of the test. I don't know your situation or why you ran out of your meds early, so I do hope that you are taking them for legitimate pain and as you are supposed to. In the future if you ever need to take more of your medication than is prescribed because you have more pain or whatever, you should ALWAYS contact your doctor first. You really need to be careful and responsible as a pain patient if you want to continue to receive proper care. I am guessing from your post that you are young, and as such will probably be under a much more watchful and scrutinizing eye. Doctors seem to hate to prescribe pain meds to younger patients, and a doctor who is willing to do so can be hard to find. You don't want to mess that up.
July 2, 2009 - 9:54pm
#6
woodstock
This Doctor would be spending a small fortune having those test done all the time yes you will test positive for smoke 30 - 60 days like i said an opiod is an opiod does he not trust you or all GOOD LUCK
July 2, 2009 - 10:47pm
#7
thanks for your reply
thanks for your reply Kelly!
The nurse asked me when was the last time I took my medicine. I said last night. I didn't say I had 1/2 Oxy though. The hydro run out about a week earlier than what it should have because I shared some with my wife. I know I'm not supposed to, but that is the truth and I also know I can't say that to the doc. The doctor was quick to prescribe the same regimen of hydro and oxy again without hesitation since I told him that I use the hydro during the day since it doesn't make me drowsy and the Oxy at night when I am at home since it is stronger. Both oxy and hydro are 7.5mg and 325mg acetaminophen. It says take 1 twice daily for the hydro and take 1 daily for the Oxy. Is this cocktail considered a high dose for 1 day? I have no one to compare to.
What do you mean by it may be a good thing to have a dirty UA?
I hope that when they test for THC that they measure the amount, not just a positive, and see that it is low or insignificant and are willing to overlook it. Is there any way to say that I smoked pot that will help my case? How can I justify it? I remember signing a bunch of paperwork when I first signed up, but I did not get a copy. I don't remember much of it.
I am nervous because I have chronic back pain. He knows, he has given me cortizone shots on my lower back and I regularly get deep tissue massage at his practice. I mentioned to him that I have an appointment with and orthopedist next week and we even discussed having an MRI done to see if there was something odd with my spine. At least my pain is real and documented by serious attempts to get better with rheumatologists and chiros, PTs etc..
If I lose these pills I am not sure how I will cope with going about my day. 
July 2, 2009 - 10:51pm
#8
7.5mg hydrocodone and 7.5mg
Having a dirty UA could be a good thing if you are abusing your medications. It will ultimately lead to you not taking them any longer which could save your life. It really isn't my positon to judge if you should or shouldn't be on pain meds but there are still some red flags in your post.
7.5mg hydrocodone and 7.5mg oxycodone is an extremely low daily dose...so low in fact that I wonder if your doctor considers your pain serious. Also you mention that you havn't had an MRI yet...what exactly is the problem with your back? How was it diagnosed...
PM doctors typically measure for not just presense of prescribed meds but also levels. At that dose the hydrocodone probably won't show up at all and the oxycodone dose will read pretty much normal because it is such a low dose. It would be hard for them to tell with any level of certainty the difference in urine levels between 3.75mg and 7.5mg.
For illegal drugs they will almost definitely just test for the presense of and not levels. Testing levels is more expensive and to run that kind of a test of every illegal drug would be pretty expensive so they choose just to test the level of prescribed meds, typically.
My PM doctor drug tests me and I don't even get my pain meds from him. Its kind of weird and I'm not sure what his motivations are for this. Anyone got a guess?
July 2, 2009 - 11:06pm
#9
Well from what I hear if you
Well from what I hear if you have a different medication or not any of the medications prescribed to you in your UA you will get kicked out. Also, I heard a postive urine analysis for cannabis will also get you kicked out. You could be lucky and get a second chance, but if you are truely in pain you might have really messed things up for yourself.
Cannabis on average stays in your system for 28 days, so it wasnt a good idea to smoke a week before your appointment or even at all for that matter. I was legally prescribed cannabis, but when I started going to pain management the doctor didnt want me smoking. I quit right then and there. I tried telling him how it helped me sleeped at night and it enhanced my pain medication at night, but I am his patient so I follow his rules.
If you truely are in pain then why would you risk it?
What kind of pain do you have,? Those are decent pain relievers but it kind of seems low compared to what others have on this site... most people on here have really bad pain.
July 2, 2009 - 11:16pm
#10
please please don't start
please please don't start judging. I realize my mistake and I am not a pot head. I smoked very little for that matter and If I would have known that smoking would put my program at risk I would have not done it, period. I have low back pain that wears me down to a crawl some days.I am glad to hear that I have low doses prescribed. To me they work wonders and don't need more.Maybe for that same reason, the doctor would consider me less of a concern?
There has to be a way to get my doc to forgive my THC on the test. I am really concerned now.
July 2, 2009 - 11:20pm
#11
Few people will judge you for
Few people will judge you for smoking pot. I would guess that most regular posters here have smoked before and some currently do (I know a few are prescribed). They might judge you for diverting some of your prescription but I don't know...
Like I said, be honest with the doctor and explain that you aren't smoking to get high and it helps with the pain (assuming thats the truth ofcourse). Honesty is really your best shot here...
July 2, 2009 - 11:29pm
#12
guesswho- I responded to your
guesswho- I responded to your message. Stressing won't help any. The best thing you can do is think about how you'll handle it if your doctor is upset about the weed. More than likely your doctor will give you one shot at making a mistake. We're all human. If your doctor has been supportive and understanding up to this point, my guess would be that this will dictate how he handles the situation. If your test does come up positive for THC, just let him know that you messed up, you are very sorry, it won't happen again and take it from there. Let him know you are willing to do whatever he feels neccessary to prove to him that you aren't going to smoke it again. There is even a small chance that if you are a lean/skinny person it won't show up if it had been a week since you smoked. THC binds to the fat in your body, so if you are a lean person and get exercise it gets out of your body faster. There is a cut off limit too for a positive test, so you may fall below it. Lastly, if there is anything your doctor is concerned about you can ask your doctor for another urine analysis to show him that you are following orders now and not smoking anymore. Again, try not to stress. Hopefully if you have a doctor who has been kind and understanding so far he will continue to be that way.
red husky- you mentioned how doctors would be spending a fortune on drug testing, but I think that most doctors don't actually cover the costs. I know at my doctor's office they charge my health insurance the cost of the UA. It says in the contract that if you don't have insurance or your insurance won't pay for the drug testing that you are responsible for it.
July 2, 2009 - 11:29pm
#13
Im not judging, I dont think
Im not judging, I dont think you are a pothead for smoking a few hits.... I personally wouldnt jeopardize getting kicked out of pain management for a few hits of weed.
I wouldnt stress because whatever happens is going to happen and no use worrying about something you cant change. I think things might have been better if you told your doctor first instead of them finding out from a drug test that you are short on you hydrocodone and that you will show up positive for THC.
Maybe you should call your doctor or set up an early appt. to talk with him. Its just an all around bad situation and I know the worst part is not knowing whats going to happen. You never know... your doctor could give you a second chance, but I dont think there is any information we know or could tell you to persuade your doctor into giving you a second chance except if you talked to him straight up about whats going on.
July 2, 2009 - 11:48pm
#14
Kelly! That is the advise of
Kelly! That is the advise of a wise spirit! From what you say there is even a chance that it may not show THC since I am 135 lb and 5'6'' skinny guy. I will wait and see what happens at my next visit. Thanks for the support.
Thank you all for your input. I will come back to this thread to tell you how things developed!
Have a great 4th of July!!!!!!!!!!!!! 
July 3, 2009 - 9:08pm
#15
Red Husky
please get your facts st8, I m not the original poster, I never said nothing judgemental toward OP
Woodstock
July 4, 2009 - 3:54am
#16
Kelly690 is right
THC gets absorbed into your fat cells. It sounds like you are a lean person so it could not show up. It all depends on your body fat, how much you smoked, if you are a regular smoker. It also depends on how active of a person you are. I have heard of some people that have it out of their body less than 2 weeks, but they say the average is 28 days.
July 4, 2009 - 5:54am
#17
urine test points
Oxycodone and hydrocodone each self-identify in separate, albeit similar, opiate subcategories under most commonly used drug test regimes. As for the additional use of green street drugs, the typical elimination period is a function of your unique metabolism, diet, water intake, body fat percentage, activity level, and genetic predisposition.
It has been my experience that the average, slightly obese, (remember I don't know anything about you), is 4 weeks. Herbal flushes are anecdotally helpful at best, but try some vitamin B6 and steady water intake while cycling some moderate cardio, (ie brisk walk 30mins).
If it promotes calm, I know some individuals that smoked pot 24 hours before testing and passed without incident. Sure those people are outliers from the mean population but whose to say with any degree of certainty that you aren't an anomaly yourself?
L8rL8
July 4, 2009 - 12:04pm
#18
A friend of mine who smoked
A friend of mine who smoked for years had to quit for a job. He went almost 2 months without smoking and still failed the test. He isn't even overweight either...
On the other hand I've known people to pass within a day or two...
July 5, 2009 - 12:34pm
#19
Wish I knew
I take oxycodone daily 10mg 3X/day or less. I also started to smoke weed daily. Pain Management never asked me to sign a contract but gave me a surprise drug test. I don't know if they don't care or somehow the test didn't show positive for THC as unlikely as that would seem. But since then I have had a few appointments at the PM office and a refill of my RX and never a word about the test. I would love to know if they just don't care about the THC or what. But I will keep my mouth shut and hope they figure out what is causing the pain and fix it before they try and test me again. I would be thrilled to give up the percocets and the weed if they could fix the pain.
July 5, 2009 - 1:42pm
#20
Paineful
Even though cannabis might enhance your pain medication or have some pain relieving qualities, it will never compare to the pain relief you will get from oxycodone. So if you doctor hasnt said anything, then more power to you. Like I said earlier, I was even prescribed medical cannabis and my pain management doctor told me to quit. He has never once drug tested me, but the time he does I dont want to risk getting cut off from my pain meds.
August 3, 2009 - 4:41pm
#21
Hope all goes well
I was reading over all your post, I hope all goes well for you. I was hoping for an update:)
August 3, 2009 - 9:24pm
#22
Merinol
I take pot pills and they did not show up on a UA and I had taken them..but also had been vomiting for several days. The Merinol really helps me I lost 70 lbs due to pain and had no appitite. I brought up the subject and he rx'ed it. I read that it the pill form only stays on your system for 4 days. It has THC in it..very strange....but like I said I had been vomiting but why did my diazapam and fent. show up and not Merinol or Diladid??I take them but it said they stay in your system for 4 day's and my vomitting made them go away. The Fent. of course was there cause it's a patch...and I had taken a valium prior to the Dr visit and had not vomotted before I got there he saw how sick I looked and gave me a shot for my nausea....he really is a good Dr...in most way's. I just don't like his staff. When u call in for a refill they argue over 1 or 2 day's....then they have a 48hr waiting period to mail rx to the pharmacy.....all the while they r playing Suduko....when they could be writting out rx's.
August 6, 2009 - 3:46pm
#23
NO PROB
went in!
My doc never mentioned anything. I guess that I got rid of the weed naturally and did not show up OR he measured the levels and showed insignificant and he did not bother bringing it up. I am relaxed now.... never again will smoke a joint unless off this contract and off the pain meds.... I value them too much to ruin it.
I hope this thread helps others!!!
THanks for the replies and good luck everyone
August 6, 2009 - 5:33pm
#24
Yay! I'm glad things worked
Yay! I'm glad things worked out for you. I truly believe you made a mistake and don't plan on doing it again. I'm glad that you will continue to receive the pain relief you need. Hopefully your post will help others before they make the same mistake, like you mentioned. Happy Day for you.
if there s trace amounts of the 2 medications, he may order a second test
but why did you run out, if properly taken, your medication should last till your next visit.
if you receive a certified letter, or register mail from him he may continue to see you but no narcotics or controll medication won t be wrote.
Woodstock