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Chronic pain patients, 16 panel drug testing doesn't test for Marijuana

Discussion in 'Drug testing discussion' started by imme, Feb 1, 2012.

  1. imme

    imme Silver Member

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    I apologize in advance for the convoluted presentation of this question.
    My uncle's pet raccoon had a very strange dream and now he has a burning question. The raccoon dreamed he was at his pain management clinic. They used a quick cup test to make sure he's taking the drugs he's supposed to take. He understands that if this panel is as it should be, then the pee gets sent to the lab to be tested for 16 different substances, plus one that's been added by his doctor to check for alcohol.

    In his dream he has given a copy of the drug testing form. The 16 panel test lists the drugs they test for but it does not list marijuana metabolites!?! Could this really be possible? It just doesn't make sense to him that they would not test for weed. But he has studied the form until his eyes are hurting and he doesn't see any-where on the form that the 16 panel tests for it. His understanding is that unless there is a need for a confirmation test he could go ahead and smoke weed. Is this correct?

    Other panels do test for MJ metabolites of course, but the 16 panel does not list it anywhere, even as an add-on. The 16 panel doesn't list THC or cannabinoids either.

    Do other chronic pain patients know what they are tested for?

    Any input would be greatly appreciated because Marijuana really helps a lot with his pain. But he doesn't want to do anything that could cost him his pain medication since it's not legal in his state yet, :) for medical use.

    Thank you for reading such a convoluted question. Also, he did do a LOT of research and searching on forums before writing this, but still is not sure if what he sees on the form is correct and it looking for validation or education about why this is or is not correct.

    Thank you, everyone.
     
  2. Mick Mouse

    Mick Mouse Palladium Member

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    Call the lab and ask! It's not like they will take down your name and do some kind of cross-reference or anything. For one, they are way to busy and for two, they don't care! The people at the lab get paid to test things, not to offer judgements on what or who they test (if they even know!).

    Failing that, ask your doctor. Obviously, if you are concerned with what he may think, you may have to be a bit creative-like playing dumb and asking your doctor to explain exactly what "all this stuff" means, but it can be done easily enough. Don't mention marijuana or if it is tested for or not, just let the doctor talk and if they don't mention Marijuana, then you are good.
     
  3. Phenoxide

    Phenoxide Super Moderator Staff Member

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    It seems pretty plausible that they're not concerned about cannabis to be honest. Pain clinics just want to check you're not scamming the system so they're looking to see that (1) you come up positive for the drug you're supposed to be taking and therefore aren't selling it on, and (2) that you're not taking any other unprescribed opioids which would indicate an abuse issue.

    If THC isn't on the list then I guess they aren't bothered. Out of interest what are the 16 panels listed? You're right that they may identify THC metabolites if the sample is sent for confirmatory testing though, depending on how exactly the confirmatory analysis is performed. I agree with toxinreleased that to be sure the best thing to do is ask the lab. Also be sure to read over the fineprint of your pain clinic contract if you have one, as this might give some idea of their policy on illicit drug use.
     
  4. imme

    imme Silver Member

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    Thank you for replying to my post. I wrote a lengthy reply in return and got timed out and lost the whole thing. I wrote down the drugs they test for, but it's after 1am now and need to get some much needed sleep. I'll repost that info tomorrow.

    ToxinRelease I'd like to talk to you some day about opioid reduction with MJ. Good for you! This is where he/I want to be.

    I'm afraid to call the company as it might raise a red flag. Wouldn't they need to know his name? Talk about a red flag as this is DEA material according to pain management. Maybe you could call them for me? LOL, just kidding.

    It is reassuring that you Phenoxide, think it's at least possible that they don't test for it. I thought perhaps I was missing something obvious. I now know more about drug testing than I ever wanted to.

    Sending blessings for pain free (emotional too) days for all of us.

    imme added 555 Minutes and 44 Seconds later...

    My main reason for questioning MJ testing is that I've spent a lot of time on a medical university pain management website. The doctors there say they are the police and that since Marijuana is a schedule I drug according to the DEA than they must treat anyone using it as such. No doctor will risk their license for someone breaking the laws by smoking MJ with the DEA involved. Anyone testing positive for MJ is kicked out of PM.

    There are exceptions of course but my doctor is not going to be one of them.
    All PM cares about is keeping peace with the DEA. Hm, maybe that's why my doctor doesn't test for it? It's not like there's a law that says he must. At least I don't think so. And if he did he would have to let go of many of his patients which is how he makes his living. Hm...,something to think about.

    I tried to play dumb with the nurse doing the testing but she wasn't forthcoming. I'm going to try and call Ameritox. If they ask me for any information about myself I'm going to have to hang up the phone. I won't risk them getting my name and sending it back to the doctor.

    Doctors can order any panel they want so they really need to know either the panel or my name.

    Here is the list of drugs that they test for in panel 16.

    Amphetamines, Benzodiazepines, Fentynal, Cocaine, D/L Meth., MDMA, Heroin, Methadone, PCP, Tramadol, (Ulrtram), Lyrica, Soma, Opiates, Oxycodone.

    "Individual/Confirmation testing: (for panels 16 and 17)
    A practitioner may order confirmation on specific drugs: THC metabolites, Cocaine, Meth, Ecstacy, Propoxyphene, TA's. If confirmation is desired the box next to the drug on the Point of Care test must be checked."

    There is a line drawn through all boxes on this person's form.

    "Confirmation must be noted in patient records, blah, blah. The drugs listed in this section will bypass screening and go directly to confirmation no matter what drugs were tested at Point of Care."

    Any PM management patients who are interested in MJ for pain please let me know as I am very hopeful that one day I too will be able to get out of the Pm world where people are treated like criminals and drug addicts even when they're not.

    Doctors are the new scapegoat for the failed war on drugs. Sad but true.

    imme added 2 Minutes and 51 Seconds later...

    I have no idea why my post auto-merged. I must have done something wrong?

    Phenoxide, I wanted you to know I added the tested drugs for panel 16.
     
    Last edited: Feb 1, 2012
  5. Mick Mouse

    Mick Mouse Palladium Member

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    It seems strange that they test for Lyrica. Also, they list "Opiates"-AND fentanyl, heroin, methadone, oxy's, etc.? Quite a bit of overlap there. However, I guess those are all drugs of concern when you are in a PM clinic or setting, so it makes a little sense.

    I would recommend never asking either a nurse or a MA for information like that. First of all, it is none of their business. Secondly, people in those positions quite often have the attitude that they know as much, if not more than, their bosses, which can lead to a whole host of misunderstandings and confusion. No, in situations like this, ALWAYS talk to the doctor in person. This will eliminate situations such as the nurse or MA running to the doctor with a set of facts that may not be entirely accurate, thereby placing ideas in the doctors mind that are better kept away. Plus, you have to remember that it is the doctor who is your medical professional, not some office flunky. It is entirely plausible for a patient to inquire about ANY facet of his or her care while in the middle of a doctor appointment, and you are much more likely to get an answer from the doctor during such a visit without a bunch of suspicious-minded bullshit. Besides, there is nothing wrong with wanting to be proactive in your own medical care and getting as much information as you care regarding your treatment plan. If your doctor looks at you crazy for that, you may want to consider getting another doctor. Or just tell them-"I am interested in being proactive in my own medical care and I feel that you are somewhat suspicious of that. WHY?" Quite often, a difference of view is simply a lack of communication. By doing this, you can open a dialog with your doctor and better the relationship between the two of you.

    And no, you did not do anything wrong. The software for the site will auto merge your posts if there has been no response to the original post before you post again. Or something like that! Either way, you didn't do anything wrong.
     
  6. Emin

    Emin Silver Member

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    I once heard a story from a friend who in on the methadone treatment. He is a chronic weed smoker and didn't quit when he started the program. After a few weeks, he had a drug test and was freaked out that they were going to kick him out. For weeks he was waiting for them to talk to him and it was eating him inside, so eventually he went and out rightly asked if they were going to do anything about the failed drug test. They say "what bad drug test"? My friend says "the one that I should have failed for smoking" and they look at him with a funny look and say "we only test for barbiturates, benzodiazepines, and opiates." :)
     
  7. imme

    imme Silver Member

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    Thanks for the replies Toxinreleased and Emin. Not feeling to good right now, pain is rearing it's ugly head again. Just wanted to let you know I appreciate the replies. More later when feeling better if I have anything to contribute.
    Emin, This is good news. Yay!
     
  8. bookworm83

    bookworm83 Silver Member

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    I'm one of those 'office flunkies' in a Pain Management clinic that toxinreleased holds in such derision & my office tests for most of the drugs/compounds that imme listed in her post:
    Amphetamines, Benzodiazepines, Fentynal, Cocaine, D/L Meth., MDMA, Heroin, Methadone, PCP, Tramadol, Soma, Opiates, Oxycodone.

    We do NOT test for Marijuana/THC.

    We did at one time, but stopped due to the fact that even with a largely geriatric/65yo+ patient demographic, we were losing so many patients due to positive drug tests for THC/Marijuana that it was making business unsustainable. Add that to the fact that unlike the other illicit substances that we test for that are highly addictive & full of dangerous health hazards & marijuana/THC carry none of those same risks, and it makes it even less important to test for marijuana/THC. If anything, marijuana helps get some of our chronic pain patients to eat & if it helps them relax & get a little bit of additional relief, we're (well, almost all of us.. our APN isn't on the boat) all for it.

    I do have to whole-heartedly disagree with toxinreleased on their negative & insulting characterization of all non-physician staff of Pain Management clinics. Perhaps he/she has been unfortunate enough to deal with ridiculous, petty, & stupid staff at the clinic he/she went to, but that by no means makes it legitimate to paint all of us with that same brush. I'm well aware that I am not a doctor & that I do not know everything. However, I make my living & am quite proud of being part of a team who is in the business of helping people with chronic pain have better/increased quality of life. I may not be a doctor, but I (and the rest of the people I work with) am involved in all aspects of what my clinic does & I (& the rest of the staff) DO have extensive knowledge regarding drug testing, medications, interventional procedures, etc & often am far more adept at answering questions/explaining things in an understandable way than our doctor is. We're not idiots or office flunkies or morons, and if something that a patient says to us raises red flags/concerns about illicit usage of street drugs or medications we prescribe, we do take it to either our APN or our big boss, the doctor. We have a legal responsibility to report to either our doctor or APN anything that could put our clinic/doctor at risk with the DEA. Have you SEEN the news regarding prescribing pain medications/prosecution of doctors for illicit-illegal use of prescribed meds by patients/etc?? It takes a patient being incredibly shady to raise those red flags for me, but if I do see a red flag, I'm sure as heck going to act on it-- our office fills a dire need in the medical field & provides a place of last resort to hundreds of patients, and I'll be darned if I am going to allow one shady patient to put that at risk.
    Sorry for the rant, but those comments just really rubbed me the wrong way. I would hate for my patients to stop asking me questions/coming to me for information just because they saw a ridiculous suggestion like that one online.

    I hope that your uncle's raccoon's drug test went off without a hitch & that there were no issues with it. I also hope that the raccoon is able to find pain management regimen that offers some lasting relief-- & if it contains marijuana, more power to 'em! Use it if it helps & gets the job done!
     
  9. Nightowl

    Nightowl Silver Member

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    Hello I am Nightowl, My mother takes oxycodone 30mg given to her by her pain med doctor. One of her children took half of her medication and she was without it for sometime. She got some loratabs from a girlfriend and have been taking them until her next appt. She had a pill count today and ofcourse it came up short. She told him what happened and he yelled at her and since she was yelled at she couldn't bring herself to tell the doctor about taking the loratab. She was also drug tested and now she is a wreck because she is worried that it will show up different. Can anyone tell me what to expect with her drug test. And what she should do if it back wrong.
     
  10. stryder09

    stryder09 Silver Member

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    When confirmed by a lab, oxycodone (oxycontin, percocet) use will be detected as oxycodone, noroxycodone and/or oxymorphone in the urine.

    When confirmed by a lab, hydrocodone (vicodin, lortab) use will be detected as hydrocodone, norhydrocodone, and/or hydromorphone in the urine.