[waynes77]

my wife is very sick with ALS she is on oxycontin 80 mg 3x a day she had a urinalysis done it showed no opiates so she went and got a standard hair test done that she paid for personally & it showed negative for opiates and I know she takes her meds I see her take it daily and we even checked the pills they have same markings on them plus if it wasn't her right meds she would be in so much pain and even having withdrawal's cause she has been on this for over 2 1/2 years is there any test to prove she is taking her meds I know for a fact she is but now they don't think she is cause of that urinalysis is there any test that is 100% I know this is weird but I know for sure she takes it daily she can't even miss a dose with out crying in sever pain

[JudyKayTee]

I don't understand why there is a question about what she is taking.

The person to ask is her Physician OR the person requesting the testing.

Or are you saying that these are fake pills, a wrong prescription?

I'm not sure of your concern -

[DrBill100]

my wife is very sick with ALS she is on oxycontin 80 mg 3x a day she had a urinalysis done it showed no opiates so she went and got a standard hair test done that she paid for personally & it showed negative for opiates and i know she takes her meds i see her take it daily and we even checked the pills they have same markings on them plus if it wasn't her right meds she would be in so much pain and even having withdrawal's cause she has been on this for over 2 1/2 years is there any test to prove she is taking her meds i know for a fact she is but now they don't think she is cause of that urinalysis is there any test that is 100% i know this is weird but i know for sure she takes it daily she can't even miss a dose with out crying in sever pain

This is a common problem with oxycodone (OXY). A standard opiate screen seldom picks up OXY because it is a semi-synthetic opioid. The lab has to specifically test for this drug at a much lower cutoff (100ng) whereas the standard opiate panel has a cutoff of 2000ng.

Because of the very small quantity of pure opiate in OXY, and it's fast-acting nature, metabolism is also an important factor. Therefore the longer the time between dosing and the test the lesser the chance of detection.

If you are going to order a test you must specifically advise the testing laboratory that you are looking to confirm OXY, not opiates. There is a specific test for OXY.

This happens quite often in pain management practice.

[waynes77]

No I am asking is there a test that is 100% accurate that can detect oxycotin I know the pills are real I just do not understand how these test can fail when I know she takes them . My wife has a very terminal illness & she is trying to clear her name with all the advancements there must be a test that can prove she has been & is taking her meds & as for her asking her Doctor he dropped care of her because of this one Urine test

[waynes77]

Thank you very much DR.Bill for your info the most inportant thing is she wants to clear her name cause that can mark her records where no 1 will treat her & its not fair when she really has been taking it & has done nothing wrong

[waynes77]

Thank you DR.Bill for your info she just wants to prove it & clear her name because now she has that in her records & it is not fair when she has done nothing wrong but thank you for your time to answer this & for the input & also on hair follicle tests is it the same where they need to check for oxy & not just opiates ? Cause now the only way to really prove it is to show she has been taking them & it go's back 90 days

[waynes77]

The only way to really prove now that she has been on it would be a Hair Follicle Test because it goes back 90 days and it can prove that she had been on that medication at the time of the UA... now is that test going to be the same way? Where u have to check specifically for Oxy and not Opiates?

[DrBill100]

I further recommend that you advise the physician that ordered the test, in writing, of the errant finding. As stated previously, this is not a new problem, it is much studied (Ex: Reisfield) yet an array of recent surveys indicate that few doctors ordering drug tests understand the test or how to properly interpret it. Very disturbing findings that lead directly to the circumstances confronting your wife.

[waynes77]

Thank you very much you have been a big help & full of information. I really appriciate your time and answers

[DrBill100]

thank you DR.Bill for your info she just wants to prove it & clear her name because now she has that in her records & it is not fair when she has done nothing wrong but thank you for your time to answer this & for the input & also on hair follicle tests is it the same where they need to check for oxy & not just opiates ? cause now the only way to really prove it is to show she has been taking them & it go's back 90 days

Please take the time to read the Reisfield study provided (just the abstract will do) because it contains the variables that weigh on the test. In relation to Hair Follicle testing, this test is not understood by most that rely on it.

1) It never tests a hair follicle, only the shaft. In fact it doesn't test hair at all. It begins by pulverizing the hair, removing the drug by chemical extraction processes and then testing the solution in a two-step process.

2) The first step is by Immunoassay (IA) with a much higher cutoff and level of sensitivity than is present in the confirmatory step (see below). IAs depending on the lab, have an error rate from 7-40%. This first step is the same as if they were doing a urine test and generally it proceeds to confirmatory testing only if the test is positive at this stage. On your test results should be some numbers or ID that would specify the type test administered and where it stopped in this sequence.

3) Confirmatory testing is a highly sensitive test that should pick up down to 3 parts per trillion. Once again, they are using the same derivative solution as obtained in Step 1, but it is injected into an instrument that provides a spectral printout. Opiates do hold in the hair better than other molecules, but the minute amount of pure opiate in OXY is so small that it may or may not incorporate into the hair. If so it should be detected but only at this level using GC/MS/MS or equivalent. If the test stops at step 2 (above) it is no seldom more effective than urinalysis at this step.

Also, if you intend to have the hair test, time is a determinant. Contrary to what you often read, normal hair care, UV rays and other factors do diminish the amount of drug in the shaft over time.

The laboratory must always be advised of the specific substance(s) tested for.

[waynes77]

Thanks again but I have a fast question I had called all the labs in the phone book in this area on there cut off levels the smallest on was 500 ng cut off for testing how can I get one to test it under the 100ng like you had said is it a specific one ? Cause if I pay for my wife to get it done it would be a waste at 500ng cut off right ?

[waynes77]

Thanks again but I have a fast question I had called all the labs in the phone book in this area on there cut off levels the smallest on was 500 ng cut off for testing how can I get one to test it under the 100ng like you had said is it a specific one ? Cause if I pay for my wife to get it done it would be a waste at 500ng cut off right ?

[DrBill100]

If you are having trouble with getting info on a specific test you'll need to talk to a supervisor in the testing section. Explain that you are looking to confirm the presence of OXY in a hair test and that you are willing to pay for the GC/MS or LC/MS.

They are referring to the system I outlined above, beginning with IA, etc. If it didn't turn-up at 500 then you would be paying for another and the test at this level is going to be a minimum of 200 and up.

Be sure and check the paperwork to determine that the test hasn't already been confirmed... which I seriously doubt.

Here are three major national labs. Once again do not try and explain your needs to whomever answers the phone, get someone that understands the testing process in detail. Tell them you want a LOD cutoff = Level of Detection = That means as low as the instrument will go.

US Drug Testing Lab

Quest Diagnostics

Redwood Toxicology

[waynes77]

OK thanks so much and they did not confiirn it the place where she got it done they took the hair & sent it to quest but they said because the first part came back negative they will not do a confirm & even though it was a personal test guest will not give use any info they will only talk to Allegiance witch is who took the hair sample well I thank you for all your help & patience XD but wow I never new it could be so hard to prove & to clear her name

[waynes77]

thanks again for all your help I even found the article from purdue pharma on the new reformulation of oxy witch I will post it below & even the makers of the drug say what u said about the cut off levels so urine test are not accurate checking for that drug using the normal opiate drug test that is done in a DR's office ! So thank you DR.BIll you where spot on & gave me a lot of help by the way here is the post from the drug makers it maybe able to help some 1 else who has this same problem. (5.15 Laboratory Monitoring
Not every urine drug test for “opioids” or “opiates” detects oxycodone reliably,
especially those designed for in-office use. Further, many laboratories will report urine
drug concentrations below a specified “cut-off” value as “negative”. Therefore, if urine
testing for oxycodone is considered in the clinical management of an individual patient,
ensure that the sensitivity and specificity of the assay is appropriate, and use caution in
interpreting results

[waynes77]

OK she took the proof even purdue said to have the DR. call them & they would tell him that he ran the wrong test but when she went back the doctor would not even see her. Is there any thing we can do because she even tried to see a new dr. but ofc they want records and he black balled her name where no DR. now will take hger witch is not right when it was not her fault the DR. did the wrong test but *** if u have any info on what we could do or how to get her name even cleared ?

[DrBill100]

ok she took the proof even purdue said to have the DR. call them & they would tell him that he ran the wrong test but when she went back the doctor would not even see her. is there any thing we can do because she even tried to see a new dr. but ofc they want records and he black balled her name where no DR. now will take hger witch is not right when it was not her fault the DR. did the wrong test but *** if u have any info on what we could do or how to get her name even cleared ?

September 2010 I posted a how-to complaint index. It lengthy so I'll just link you to it. Start there:

https://www.askmehelpdesk.com/medica...st-393019.html

In addition, you should thoroughly document the history of your transaction with this doctor and, based on what you have been told by the laboratory, file a complaint with the Division of Professional Registration (or equivalent) in your state.

Filing complaints with administrative agencies as outlined in no way impedes or interferes with your right to file a civil action against the parties involved should you choose to do so.

[waynes77]

OK sorry to keep bugging you lol but I really am very thankfull for you & your knowledge you have been such a great help that's again XD