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Unread 02-25-2010, 08:31 PM   #1
iamdrew
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Default False Positive on drug test and Suboxone

Hello,

I have been taking Suboxone for a while to treat a serious Fentynol/oxy addiction. I have been off of everything other than Suboxone for about 10 months. However, I had a urinalysis done at my doctors office, and it came out positive for some type of Morphine as well as the two positives for Suboxone.

What would cause the false positive for morphine? Can the Suboxone somehow metabolize as morphine, or "possibly trickle over" into the morphine catagory as my doctor mentioned? He said not to worry about it, but I have not taken anything else, and I don't want there to be any quesiton about it.

Thank you for your help
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Unread 02-25-2010, 11:42 PM   #2
JDK613
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that happened to me before-except mine said positive for methadone (????) if your dr has the test sent to a lab the lab will be able to clear it up. that's what i did & the lab found no methadone, kinda funny if you ask me.
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Unread 02-26-2010, 12:06 AM   #3
xip
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False positives aren't all too uncommon with on site, "test in a cup," equipment. That's why your doctor told you not to worry.
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Unread 02-26-2010, 01:21 PM   #4
toms
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Did you ask the doc about it? My doc went to a screening that is done right in the office and I've gotten screwy results. Every test, I come up positive for methadone, supposedly because of an interaction with zoloft. Last year, when I had surgery and was taking norco, I tested positive for oxycodone, and not for hydrocodone. Ambien causes me to test positive for benzos. They occasionally send the sample out for confirmation, which has always showed the errors.
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Unread 02-26-2010, 01:45 PM   #5
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iamdrew,

Yeah, this has happened to me in the past and I used to sweat it, thinking the urine test was the absolute word in my treatment. I then learned that most Dr's offices use a collection cup, some are tamper-resistant, others not and get preliminary "screening" results right then and there against categories of drugs, such as benzo's, opiates, THC, DMT, and sometimes they separate Oxy from other opiates. Often the results are sometimes affected by various factors, so the doctors send the test out to a lab for gas chromatography/mass spectrometry testing which is quite specific and accurate and can return quantitative results. For example, they may have a reference range for benzo's and they indicate with this report what quantity of benzo's was found in your specimin. From there, if they want to target a specific chemical, they can request a Drug Confirmation test, which is different from a screen. It is specific and they can ask to confirm presence and quantity of Oxymorphone, for example. The GC/MS and Drug Confirmation tests are quite expensive, running several hundred dollars, where the initial screen with a tamper-resistant cup runs about 20-30 bucks.

So I wouldn't worry about false positives if you are clean. Just ask for them to send it to the lab.

I hope this is helpful.

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Unread 02-26-2010, 01:52 PM   #6
kgb623
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when i went to my first sub dr. appointment last month (new to recovery/subs), they drug tested me as expected and he said I failed for oc's. I had just gotten out of a 7 day detox and hadn't taken a percocet in well over a month. The only thing I had taken in the last 30 days was vicodin, tramadol and suboxone & darvon in detox. I have no idea how i came up positive for oxy (also for darvon but that was expected from detox). I thought he might have been bluffing me to get me to admit something. It scared me, I was like " Dr. I've been in inpatient detox for the last 7 days and on suboxone for 4 of those so, no I haven't ingested oxy/perc unless I was it was unknowingly administered in my detox program.. weird stuff
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Unread 02-26-2010, 02:04 PM   #7
Madison7
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Well, you are supposed to test positive for suboxone since you are taking it, right? The test you took was probably a screen rather than a gcms test. In some situations, you can request the gcms if you get a positive on a screen that you know is wrong. This is how its done in methadone clinics. Have you eaten a large amount of poppy seeds lately? They are found on poppy seed rolls, muffins, etc,etc. Some sources say that taken in large quantities, poppy seeds can cause false positives.
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Unread 02-26-2010, 02:40 PM   #8
Jamesisdone
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I tested positive for pcp because of a medication that trips up the test and can cause false positives and I was freaked out but they sent it to a lab and showed that in fact is wasn't pcp...
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Unread 02-26-2010, 02:47 PM   #9
Chase
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Can no illegal drug or drug not prescribed to you show up on your first visit? Will the doctor deny treatment if it does? I know to stop the H 24 hours before, but other things have longer "lives".
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Unread 02-26-2010, 02:48 PM   #10
TIM
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Be sure the doctor is reading the test results correctly. Sometimes faint lines are called "false positives" but actually they should be considered negative. It makes more sense when you see the image: http://www.naabt.org/tl/reading_test_results.jpg
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Unread 02-27-2010, 07:05 AM   #11
Boxer
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If that ever happened to me I would have literally FREAKED out.
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Unread 03-04-2010, 08:05 PM   #12
iamdrew
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Thanks for the feedback, makes me feel a little better. It was a test where is had broken out maybe ~20 different catagories of substances, and then it had a measurement amount for all of the catagories. I want to say that it was ng/mL or something like that. On all but three, it was 0 units. On two of them, it was very high, like ~4000 units, which the Doc said I should pop for if I am on Subs. However, on the Morphine, it was ~50 units, which was listed as "positive". Anyway, I spoke with my doc again, and he said he was looking into what could have caused it, but not to worry about it. It just sucks, because I know that there is a little doubt there now.

Thanks again.
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Unread 03-05-2010, 09:43 AM   #13
toms
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I've had false readings on screenings, but these are always cleared up if submitted for GC/MS confirmation. AFAIK, doing this is pretty much SOP for most drug tests. The only times I ever had any real worries was when I new that I had been cheating. I don't think I've ever heard of anyone who was truly free of whatever drug was in question ending up falsely accused. I know it can happen to a tiny fraction of patients, though.
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Unread 05-11-2010, 05:31 PM   #14
neuronaut
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Default Naloxone in Suboxone causes False Positive for Oxy!!

Hi guys,
I'm a Ph.D. in physiology and a Professor at a large research university, but also a recovering addict maintained on Suboxone for the last couple months. Last month, I took a "urine cup indicator" test, which I suppose is just preliminary to lab work, but I too tested false positive for Oxycodone. So I looked through the literature and there was a paper addressing this problem. It was published nearly a year ago and my doctor didn't seem to know a smit about it! Although he didn't jump to conclusions and wanted to wait for the lab test, which may come out accurate if they are using gas chromatography or mass spec. The results depend on the antibody kit (company) used and the sensitivity. The main problem was with an "Immunalysis Corporation" homogeneous enzyme immonoassay (HeiA) oxycodone direct (basicially use "specific" antibodies to detect substance of interest). However their antibody is not specific for oxycodone, and cross-reacts with naloxone (the blocker put in suboxone along with buprenorphine) to such a degree that 70% of test subjects on suboxone alone tested false positive for oxycodone! Note that all these subjects were confirmed oxycodone-free by a more accurate test. The real culprit may have been known or unknown metabolites of naloxone. Simply decreasing the sensitivity of the test a bit, the article reported, would reduce false positives from 70% down to about 5%. However, who wants to be in the 5% when carreers, criminal matters, and medical matters are on the line! It is just a crappy antibody and because of it I'm sure many people lost their jobs or did jail time already! That's what happens when you have judges, police officers, prosecutors, and business administrators trying to interpret or evaluate the science!
I suppose they would prefer to believe corporations that just make money off of crappy antibodies! Since Suboxone was FDA approved in 2002 for use in opiate withdrawal, and it requires testing before renewing a prescription, you think they would check to see if any of the components of suboxone had cross-reactivity with what they test for! Moreover, the drug companies that make these faulty tests should lose their jobs and go to jail just like I'm sure many people have because they were screwed by their tests and not believed, and moreover maybe denied the one good drug that was helping keep them off the street and out of bad stuff! Fortunately none of these things happened to me yet but at least I'm armed with the data! So are you know: I can't access the actual journal article even from my university account, but I found a preprint at this link: http://www.clinchem.org/cgi/reprint/...9.125096v1.pdf
in case link doesn't work, look up reference: Jenkins, Poirier, Juhascik. Cross-Reactivity of Naloxone with Oxycodone Immunoassays: implications for Individuals Taking Suboxone®. Clinical Chemistry. vol 55, p1434-1436.
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Unread 02-07-2012, 11:08 AM   #15
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Default Thank you!!

Thank you so much for this post. My son is in a treatment center and as planned was put on Suboxone for chronic pain and addiction. It seems to be working very well for him; he sounds happy, grounded, and is having much less pain. However, I got a call from the treatment facility he is in a few days ago- very well known facility with a patient population from all over the country- and was told he failed a urine drug screen and tested positive for methadone. It just did not seem like even a remote possibility, and my son was devastated and swore he did not take any methadone. NOthing made sense as far as where he would have even gotten it. He had had no visitors for a week, there is none in the facility, etc. They were KICKING him out of treatment that day due to this positive methadone urine screen. I insisted they do a blood test, which of course was negative for methadone. I am in health care and demanded the blood test, otherwise I cannot imagine how this would have affected my son and his recovery. I also cannot imagine the number of innocent individuals that have been falsely accused of doing methadone and other drugs from notoriously incorrect urine screens. The physician in this facility was clueless and was also insisting he be asked to leave that day based on this incorrect urine screen. Please everyone - stand your ground if you fail a urine drug screen and you are taking Suboxone. This drug is a life-saver, and more research is needed on the cross-reactions with urine screens.
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Unread 02-07-2012, 11:37 AM   #16
Kaz25
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Thanks so much for these posts. I have been going through these same issues at my doctors. I am a recovering drug addict. My drug of choice was vicoden. However at my 2nd to last appointment I tested postive for Benzos. I never even used to take benzos when i was a drug addict. So I know it was wrong. Luckily my nurse believed me and marked it as negative. Well at my last appointment I tested postive for oxycodone. This is crazy. She didn't believe me this time. She marked it as postive and told me that people make mistakes and to get better. Basically calling me a liar when I told her the results were wrong. So the doctor questioned me about my positive oxycodone and thank god he believed me. He wrote on my results that he believed the results were inaccurate. Now I'm scared about the next time. I can't get kicked out of the program for something I'm not even doing. I guess I will just try and demand a blood test if this happens again. I'm trying to stay healthy and if I get kicked out I will be right back where I was last november. A drug addict. So anyways thanks for the advice. It makes me feel good to know I'm not crazy and I'm not the only one this has happened too.
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