I have run into a delemma in getting my pain medication refilled by my pain management doctor.

He has been prescribing me MS contin 30mgs and Hydrocodone for several months due to a severe back pain condition. Three months prior to this announcement I received a random urine test. A low level of hydrocodone had shown up, NO morphine, because I hadn't taken any for 3 days because I had to travel, however a pain medication called OPANA showed up in this test somehow. My prior physician had given me a script for this three years ago, and I discarded this more than a year ago because it was outdated.

As a result of this, because my current MD had never prescribed OPANA, he cut me off all Optoids. How could the pain medication OPANA (Morphone) have shown up in my urine test 13 months after I discarded them all? This makes NO sense to me whatsoever. This drug did not agree with me when prescribed to me in 2008, and it was replaced by hydrocodone. I don't believe I ever took more than 5 of these back then to begin with. What is your advice in getting my regular regimen reinstated? Is it possible Morphine MS Conin and Opana could have been confused between the two on the urine test? Are they chemically similar where this could have happened?

Joe

josef,

It isn't possible that the Opana from months previous could show up on a drug screen. Eliminate that consideration.

My next question is use of the descriptor Opana. Who said that? Do you have a report from the lab? My purpose in asking is that Opana is oxymorphone. While often prescribed in this form it is also a breakdown product (metabolite) of oxycodone. This often creates problems for doctors ordering these tests and is subject of numerous advisories.

However, in your case that shouldn't be a consideration as Hydrocodone breaks down into hydromorphone. This should be easily distinguished from oxymorphone IF a confirmatory test was conducted.

Further, there is some indication "that in some patients chronically treated with morphine, that in some patients chronically treated with morphine, hydromorphone can appear in the urine as a result of a minor metabolic pathway. (http://www.jenniferschneider.com/articles/Conv_of_Oxycodone_7_20_7.html)morphone can appear in the urine as a result of a minor metabolic pathway." I do not find record of a similar oxymorphone interaction.

Pain management doctors are usually completely reliant on testing labs for interpretation (unless they have in-office testing). I wonder if there may have been some confusion in transmitting the information, a misunderstanding of the morphone involved.

There is one other possibility. Hydrocodone is known to cross-react with opiate test panels creating a false-positive. Such cross-reaction would not be specific to a medication however (Opana). That specificity can only result from confirmatory testing such as GC/MS or equivalent.

It is very important to determine if this claim is based on a drug screen (immunoassay ) or if the confirmatory test was conducted. Often they are not and I question because brand names aren't identified in the latter only the metabolite [I]oxymorphone should appear.

IAs are error prone while the confirmatory approaches 100% in accuracy.

Any further information that you can provide in relation to the test will be helpful in researching your problem.

There is nothing to worry about. Some medications remain in your blood even for five years. You should go to your doctor and consult the problem in details. Majority on these pages will be only guessing your problem.

There is nothing to worry about. Some medications remain in your blood even for five years. You should go to your doctor and consult the problem in details. Majority on these pages will be only guessing your problem.
I accidentally gave you an agree. It should have been a disagree. DrBill knows what he is talking about. It doesn't sound like you do.

Some medications remain in your blood even for five years.

Can you name just one please?