When the Urine Test LIES

When the Urine Test LIES

By Steve Ariens.

Many doctors are insisting that their chronic pain patients routinely have to take a urine test to determine if they are taking their prescribed medications – or not – or to discover if patients are taking other medications/substances, legal or illegal.

Steve Ariens

“Failing a drug test” will normally mean that a patient is summarily dismissed from the practice.

Many of these office practices that have elected to use the inexpensive “pee in a cup” form of test.

Physicians are use to lab testing to be 100% accurate, except these “pee in a cup” tests have a reported 20% error rate, but often the practices that use these tests… have apparently not read the “fine print” about their accuracy.

Often, some of the false positives are tests that show some drug/substance in the urine that the patient has no knowledge of ever taking.

Unfortunately, there are many foods, OTC medications and prescription medications that will throw a “positive test” for a banned substance in the urine.

Something as innocuous as the prescription medication like Amoxicillin or Ampicillin could show up as a COCAINE in the urine.

Having taken Robitussin DM for a cold could show up as PCP or an opiate.

Here is a link to a rather extensive list of possible false positive urine test results;

http://www.keystosaferschools.com/drug-testing/drug-testing-false-positives-for-urine-testing

It may be appropriate for every patient, being subjective to urine tests, to carry a print out of the list on the above hyperlink.  If you show a “false positive” at the physician’s office for a urine test… it could be possible to refute the result before it is added to your medical records and you are discharged/fired from the practice.

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There are 16 comments for this article
  1. Lisa N at 5:43 am

    A good CYA practice is if ever you are at an office and your urine comes up positive while you are there… is immediately after you leave go to an urgent care outside that Dr’s hospital system or ask another Dr you trust to call in a full urine drug screen into an independent lab & GO ASAP. I mean ASAP. You probably will have to pay out of pocket. But, you will have your own “proof” of your results. Too many wait for their next appt to find the Dr didn’t send it in for further testing as required for all positive dipsticks. We are hearing many many Dr’s are using this as an excuse to get rid of even the best pain patients from their practices, even ones ppl have gone to for 20yrs and “never would do that do me”. They come back & often say “I can’t believe he did that to me”. It will go on your record as a failed test. You will have no recourse “your word against the Dr’s word”…but possibly the hair test which is far more expensive. If your Dr does the right thing, that is awesome! Just smile to yourself until the next time and repeat. (People this is done too often have trouble getting that part of their chart also, so they can’t go to whatever lab to get their own results to back up their story ..many go to CA).
    Great article.

  2. Sheryl M Donnell at 7:16 pm

    Cora,

    Your message is outstanding. It could be just about any one of us. Please consider sending it as an opinion piece to major newspapers for publication as a voice for us all. We need people who wrote as well as you do telling our stories!!

  3. Sheryl M Donnell at 7:09 pm

    Besides the false positives there are huge expenses involved too! I know for a fact these are wrong often. My daughter had these tests done by blood testing even at a hospital for an overdose. She tested positive for marijuana. She had never used that, but OD’d on a lot of other things trying to take her own life. Thankfully she survived and has gotten the treatment she needed however, no matter how much she tried and asked they retest her to prove she never had marijuana in her system (And had far worse in her body she admitted to) they refused to retest or believe her.
    Lots of wasted money on these tests for nothing but humiliation of patients and huge expense.

  4. Wanita1 at 9:33 am

    This is a discriminatory practice that needs to end. Do they test other people to see if they are taking their medications? If not then you all are being discriminated against based on disability and should lodge a complaint with the DOJ as practice should not contravene The American With Disabilities Act. Urine testing should only be done if a patient has given the physician a reason to test.

  5. PatientZero at 9:12 am

    Exactly! I’ve been dealing with this since become disabled and it’s a nightmare. I’ve had tests come back with errors on multiple occasions and when you attempt to get it sorted out, the labs are not accessible to the patients and often the drs offices. I have stopped eating poppyseed dressing and recently learned my insomnia medication can apparently produce a false positive for ecstasy! The other problem is that one of my medical conditions at its core is an electrolyte disorder, so depending on the day, my symptoms, hydration, etc. the tests often come back skewed because of my abnormal electrolyte levels. Even worse is how many times meds come back wrongly as “Unprescribed/another Declared” because the dr office who has my full medication list doesn’t record the info correctly or test for a med so it comes back flagged. This is a huge liability for pain patients whose charts are scrutinizing by multiple drs and government organizations who may get the wrong impression because of careless clerical errors.

  6. Angie Heavner at 6:32 pm

    Thank you for this information. I had a problem a few yrs ago with something showing in a urine test 3 times. I found it weird that the doctor never said anything to me about it yet the attorneys (mine, and the hospitals) brought it up. Luckily two doctors (both were specialist called in for the lawsuit, again mine and theirs) both agreed it was 2 of my other meds causing it. Explained why the doctors never said anything to me about it. Freaked me out when my attorney said something and I did research because of it. It upset me and could have cost me my pain doctors and my lawsuit.
    So thanks.

  7. SleeplessNPaindSwirld at 5:25 pm

    My pain management office prescribes me patches, a NSAID & a pain creme. At an appointment earlier this year, I’d asked the PA if it was OK to use CBD Oil. She said it was (since they’re not prescribing any opioids) & said she was surprised I wasn’t smoking marijuana to alleviate my pain & gave me the OK to do so, although not yet legal here in Ohio. I asked what’d happen when I failed my urine test. She told me they have patients with illegal drugs in their system all the time & that all they do for those patients is injections. I was shocked, to say the least. I’ve never failed a urine test, yet have heard from others going to the same office that they’ve either had things found in their urine that they never took or their prescription didn’t show up on the test & they got dismissed, no questions asked. I’ve had issues with this PA since Day 1, when I’ve been nothing but compliant & respectful. I doubt I’m the first, last & only person she gave the ok to smoke marijuana to, but why is she doing this? I’ve been told several times to keep holding on until they exhaust all other options before they prescribe opioids, but if I test positive for marijuana, I’ll never see that script. Now when it’s in fact legal here in Ohio, I’m all for it. But, why would she give the ok for something that’s clearly stated in the contract will get a patient kicked out?! Hmmm…

  8. Tim Mason at 5:17 pm

    The “Dip stick” test shown in the photo is a CLIA waived test. This means a monkey can be trained to do the test.
    If there is a suspect compound in the urine the specimen is sent for a LC/MS/MS analysis and there is no disputing this type of forensic analysis. You know this is going to happen to your urine because it is split in two separate containers, DOT does this all the time to be 100 percent certain.
    Then there is the “hair test”. This analysis too is highly accurate and can determine drug consumption up to 3 months in males and much longer in females due to their long hair.
    Most high end pain management clinics can determine 50 drugs and metabolites in under 10 minutes using a Raptor LC column and standards. In fact, this analysis can determine if the patient converted his/her morphine sulfate to heroin and injected it. The metabolite can also determine the mode of use.

  9. Michelle Ziemba at 5:14 pm

    Steve, thank you so much for writing this article! It never occurred to me to think about false positives of drug testing. I would like to think my doctor would be willing to talk with me first if something unusual occurred because I’ve been a patient of the pain clinic for several years and I was upfront about my marijuana experiment when they started testing.

    But you never know. Doctors are under so much scrutiny. My pain clinic has eight locations and because they’ve been doing things such as drug testing and taken other measures to keep patients safe, they’re still feeling pressure from the state medical board and the CDC guidelines.

  10. Mark Ibsen at 2:31 pm

    Many of the high dose opiate patients I saw were ultra rapid metabolizers of these meds.
    Because they metabolize so fast,
    They had no opiate in their urine when tested, and were fired.
    No conversation
    No taper
    Just out.

    By the time I saw them
    They were miserable, upset
    In agony
    And withdrawal.

    And
    All due to a test that only gives a clue to possible behaviors,
    Not actual evidence of diversion.
    Weird.

    So much irrational stuff going on.

  11. Cora at 11:47 am

    Something that amazes me in all of this ‘opiate crisis’ that all this care and concern is being focused on helping the addict with a glut of resources being diverted from pain patients . An example is providing safe injection sites which I have no problem with. However, physicians are currently on an agenda focused purely on support. and treatment of the addict and accommodating them when the pain patient is faced with having little , no care or substandard care offered to them. We aren’t doing anything illegal ! Why are we being denied care? In many instances we might be lucky enough to find a physician that is amiable to care for a pain patient nevermind also delivering quality care to a pain patient. How is it that a physician can turn away any patient? Somehow even before the opiate crisis this was always the case. Chronic pain patients have always had two year waiting list to get into a pain center here in Alberta. That is not new. In the past, Doctors accepting new patients would indicate no pain patients accepted. That was outlawed so now they just turn you away after the initial meet and greet with some lame excuse. Now doctors are doing everything they can to care for addicts and continuing to turn pain patients away. All I hear is about how we are to blame for the abuse and misuse of opiates. Use of opiates is an integral tool in our pain management toolbox. Ask any pain patient and they will tell you that medication is an important piece of pain management but it is not the only modality used to survive chronic pain. It’s like the innocent criminal that doesn’t admit his/her wrongdoing because they are innocent and receives a harsher penalty for lack of contrition. If I disagree with my treatment plan and or can’t decrease my medication usage because my pain levels are too high I’m immediately judges as drug seeking. Or if I’m not coping well with new higher pain levels, I’m now depressed . Now I’m going to be put on antidepressants . If I disagree then I’m non compliant. Can’t tell you how many mds said to me if your mood was better your pain would be better. Sure that may make sense but they are no longer looking at the root cause of the problem. If you don’t treat the cause of the disease then the disease continues. It makes me angry because I believe that undertreated pain is the cause of chronic pain and it becomes entrenched somehow. On the radio today our mayor declares the need for a safe injection program in,our city because it will save lives and we have to change our thinking around addiction that addicts are not criminals and are mentally ill and we need todo everything we can to support them. This is great but in the meantime, I’m forced to sign agreements with my doctor not to a use street drugs (I never have ever ). I must submit to random drug testing at my cost, my pain medication is delisted so they are no longer covered by insurance. It’s supposed to be a deterrent to opiate abuse. Now my prescriptions cost $5000/year instead of $1500. My medications have either been stopped or decreased without my knowledge or without my agreement and when I go in for follow up reporting significant increases in pain and decreased function, I am considered drug seeking. My meds are counted and I never use more than I’m supposed to yet when I go in for refills and need the same amount of medication and haven’t made improvements in my function and quality of life, it becomes all about my character and possible psychological issues or being labelled as drug misuse or abuse disorder. I am already receiving acupuncture, massage, physio, chiro, and physio and exercise, IMS , injections, radiofrequency , stretching, trigger releases, meditation, relaxation, support group , biofeedback , and counselling on a regular basis all at my own expense to $5000+/year with insurance. Despite all that I do to help myself, I am being denied the medication that remains an integral part of my pain management strategies and impacts my quality of life, which is very low despite all my efforts to make it otherwise. Now I’ve been sent to a Cannibis Clinic, which is alright but so far nothing I’ve tried is helping but in the meantime my MD continues to decrease my meds. All that is happening is I have more pain and I can do less and less for myself. Again I ask why am I being judged and made to conform to a care plan that is not good for my health? Why is it my fault that my body is not responding the way we need it to? I am doing my very best! I am not an addict! I need my pain medication like a diabetic requires insulin or a cardiac patient requires antihypertensives. Those patients would never be denied proper medical care, so why are chronic pain patients being denied care or forced into care plans that don’t work for them? The answers are really simple and are before us. Good quality care for all. Let’s hope that this run away train gets stopped before it destroys more lives. I know that my quality of life and my health has suffered enough from poor treatment. I know we have rights and we must fight for them or they will disappear. I have yet to be asked to do a drug test but the stress about it always is there. I can’t imagine getting some false result to deal with on top of everything else

  12. Mona Twocats-Romero at 9:21 am

    I just printed out the list of substances and what they could register as. 8 pages on 4, two-sided pieces of paper. Now I can carry it with me.

  13. Dorothy Morris at 8:46 am

    Very informative article.I wish book didn’t cost so much shipping to send.Thanks for this article!

  14. Mona Twocats-Romero at 8:02 am

    Thank you. This is very important information that many folks, including chronic pain patients are unaware of. And my experience has been that once a pain patient you are always suspect as a drug seeker, illegal drug user, or some other nefarious activity.

  15. Drew P at 6:48 am

    My pain clinic use to drug test me once a year, however, now it’s every other visit. This worries me greatly because I know these tests have an error rate. I also know that pain clinics shouldn’t be
    witholding treatment based on a single failed test. What ever happened to, “do no HARM”?

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