Opioids How can fentanyl show up in a urine screening w/o taking it?

[Phoenix_03]

So I just got back from my clinic where I go every 2 weeks to pick up my methadone doses. I had done a urine screening last time (2 weeks ago) and today a counselor pulled me aside and said my panel came back positive for benzos(legit script), oxycodone(legit script for a kidney stone) and fentanyl. I’ve never knowingly used fentanyl and I’ve been clean off dope/coke for 6 years. Have never bought street drugs since, no pressed pills, nothing. I take my methadone, and I have scripts for a benzo and dextroamphetamine. The counselor asked if they possibly gave me a shot in the ER, I said yes but of toradol, definitely not fentanyl. I showed them all my paperwork from that visit, no fentanyl mentioned at all. How the fuck is there fentanyl in my system? Is there anything that can cause a false positive?? This actually scared the shit out of me, my brother in law OD’d in my house like a month and a half ago from sniffing 2 bags of dope which had to have fentanyl mixed in, if not solely fentanyl. His tolerance isn’t as high as mine but still, 2 bags? He was legit dead for a few minutes til an ambulance came and hit him with Narcan. Any opinions on how this can happen?? I didn’t lose my bottles because i have never given a dirty urine in the 6 years I’ve been going there.

 

[MsDiz]

Immunoassay’s are always presumptive until confirmed by a chemical technique. I wouldn’t worry about it. Can be for any number of reasons, cross reactivity isn’t understood by those who administer the tests.

 

[Nurse Ratched]

Like Ms.Diz said. Immunoassays are the first part. Mass Spec is the actual metabolite count. Pee again and have them re-test. If the mass spec comes back with Fentanyls metabolites your urine does indeed contain them. You kept your take homes so that is good.

 

[Phoenix_03]

Like Ms.Diz said. Immunoassays are the first part. Mass Spec is the actual metabolite count. Pee again and have them re-test. If the mass spec comes back with Fentanyls metabolites your urine does indeed contain them. You kept your take homes so that is good.

The original screening was about 2 weeks ago, but they did ask me to give another one today. The counselor told me to call in a couple days for results since I won’t physically be back there for another 2 weeks. I googled urine screenings and false positives, a lot of it was a little over my head though as far as the testing methods. Enzyme-mediated immunoassays (which is what I assume you and MsDiz referred to) and gas chromatography followed by mass spectrometry. I think I get how the immunoassay test works, I’m just confused as to how I’d be positive for fentanyl. It showed methadone, oxycodone(opiates), benzodiazepines— all valid, AND the fentanyl. False positives seem to happen when you ingest something like poppy seeds or if you take certain medications (out of all the listed ones i found I don’t take any.) I’m hoping it was a one off fluke or maybe a lab error, because if my test today comes back positive i don’t know if they’ll still believe me. And i’ve never taken fentanyl nor do i want to.

 

[Phoenix_03]

Immunoassay’s are always presumptive until confirmed by a chemical technique. I wouldn’t worry about it. Can be for any number of reasons, cross reactivity isn’t understood by those who administer the tests.

So when they do urine screenings at places like a methadone clinic do they do this chemical technique to confirm, or just go off the initial immunoassay test? The only urine testing I’ve seen done is the dip sticks you put in a cup of urine and watch to see if the colors change. Is that the kind of test you’re talking about or is it a bit more involved than that?

 

[Nurse Ratched]

The original screening was about 2 weeks ago, but they did ask me to give another one today. The counselor told me to call in a couple days for results since I won’t physically be back there for another 2 weeks. I googled urine screenings and false positives, a lot of it was a little over my head though as far as the testing methods. Enzyme-mediated immunoassays (which is what I assume you and MsDiz referred to) and gas chromatography followed by mass spectrometry. I think I get how the immunoassay test works, I’m just confused as to how I’d be positive for fentanyl. It showed methadone, oxycodone(opiates), benzodiazepines— all valid, AND the fentanyl. False positives seem to happen when you ingest something like poppy seeds or if you take certain medications (out of all the listed ones i found I don’t take any.) I’m hoping it was a one off fluke or maybe a lab error, because if my test today comes back positive i don’t know if they’ll still believe me. And i’ve never taken fentanyl nor do i want to.

Your'e ok. Not to worry. I don't know much about lab stuff but Ms.Diz does. She works in one. But you have the basic idea. The mass spec is the one that is usually spot on. If you have not ingested any Fentanyl, and are taking only your prescribed meds, and are being a good little girl/boy I would rest assured that the specimen you gave today will be negative at the mass spec level.

 

[Nurse Ratched]

So when they do urine screenings at places like a methadone clinic do they do this chemical technique to confirm, or just go off the initial immunoassay test? The only urine testing I’ve seen done is the dip sticks you put in a cup of urine and watch to see if the colors change. Is that the kind of test you’re talking about or is it a bit more involved than that?

It is much more involved than that. Labs don't care about those dip sticks. They have better toys.

 

[Nurse Ratched]

If you are just getting on site tested with a dip stick and not having all of your pee tests ( as in everyone at the clinic ) sent away everytime I'm not really sure how methadone clinics do it. A pain Dr. sends them for mass spec ALWAYS.

 

[MsDiz]

So when they do urine screenings at places like a methadone clinic do they do this chemical technique to confirm, or just go off the initial immunoassay test? The only urine testing I’ve seen done is the dip sticks you put in a cup of urine and watch to see if the colors change. Is that the kind of test you’re talking about or is it a bit more involved than that?

Yeah, look, @Pumpkin2021 has explained it well.

What usually happens is, if you’ve tested positive, as you have for fentanyl. They can choose to send that off to have further testing. A MS (mass spectrometer) is the usual go to. It will break down your urine and see exactly what’s in it to put it simply. If you’ve been good then you’ll be negative for fentanyl.

The reason there are false positives is due to cross reactivity. It’s detecting metabolites from another drug possibly and showing up as positive for fentanyl. The dip sticks are highly problematic for this and the people doing the tests have little knowledge of how cross reactivity can affect the results. If you are SURE and positive you are getting a false positive then insist your urine is sent for further testing.

 

[Phoenix_03]

If you are just getting on site tested with a dip stick and not having all of your pee tests ( as in everyone at the clinic ) sent away everytime I'm not really sure how methadone clinics do it. A pain Dr. sends them for mass spec ALWAYS.

They send the tests to an outside lab, I just mentioned the dip stick tests as the only ones I was personally familiar with. I think those might be easy to manipulate or alter. Plus, I wouldn’t be surprised if their accuracy, compared to more advanced testing, was significantly lower. Speaking of manipulating, the first clinic I was a client at used to make you pee with someone in the bathroom watching you. Well, not technically staring at you as you peed, they looked away but they watched for movement or any unusual behavior that might indicate you were up to something. I hated that, i felt like that was going too far and should NOT be allowed in that setting.

And for the record, I really have been a good little girl - been clean (excluding prescriptions) since the first day I went to the clinic! I’d be scared to cop nowadays, not knowing what may or may not be in a bag.

 

[Phoenix_03]

Yeah, look, @Pumpkin2021 has explained it well.

What usually happens is, if you’ve tested positive, as you have for fentanyl. They can choose to send that off to have further testing. A MS (mass spectrometer) is the usual go to. It will break down your urine and see exactly what’s in it to put it simply. If you’ve been good then you’ll be negative for fentanyl.

The reason there are false positives is due to cross reactivity. It’s detecting metabolites from another drug possibly and showing up as positive for fentanyl. The dip sticks are highly problematic for this and the people doing the tests have little knowledge of how cross reactivity can affect the results. If you are SURE and positive you are getting a false positive then insist your urine is sent for further testing.

I searched a little bit trying to find a good explanation for why false positives can occur. Too much medical jargon, I wasn’t getting it. Your comment finally answered it, thank you! (Pumpkin too, thank you both for answering my questions!)

 

[Nurse Ratched]

They send the tests to an outside lab, I just mentioned the dip stick tests as the only ones I was personally familiar with. I think those might be easy to manipulate or alter. Plus, I wouldn’t be surprised if their accuracy, compared to more advanced testing, was significantly lower. Speaking of manipulating, the first clinic I was a client at used to make you pee with someone in the bathroom watching you. Well, not technically staring at you as you peed, they looked away but they watched for movement or any unusual behavior that might indicate you were up to something. I hated that, i felt like that was going too far and should NOT be allowed in that setting.

And for the record, I really have been a good little girl - been clean (excluding prescriptions) since the first day I went to the clinic! I’d be scared to cop nowadays, not knowing what may or may not be in a bag.

Well done. I'm proud of you !

 

[Regulat0r10]

Hey everyone I stumbled across this thread dealing with the same issue. I have had my take homes revoked once before and just lost one week for a false positive. Thankfully my counselor believes me, he’s seen me put in the work (I had 30 take homes before I lost everything in the past) anyhow I can’t shake the feeling that there’s some kind of error, a combo of prescription meds and holistic meds or what but I may have found the culprit…

So I’m prescribed low doses of clonazepam, adderall, alprazolam and lyrica. So I just purchased a dipstick test through Amazon, thankfully after testing my UA 4 times (since I had my urine screen today) the dipstick at least said it was negative.

So prior to officially getting my prescriptions, I had purchased a sealed bottle of farmapram from Mexico pharmacy, and also had stocked 2mg clonazepam by roche and Galenika (sealed in blister packs) from a trusted source I’ve used for years… anyhow from time to time ill take the farmapram or roche clonazepam from my stash if I left my prescription in my car or somewhere else since I get lazy like that…

Usually I do not take the farmapram very often since the quality from us pharma is far more superior. That said, the roche clonazepam is legit because I have used it frequently and had passed UA’s which makes me think it could possibly be the farmapram??? Or could there be some type of medication combination with healthy supplements from a holistic doctor (very expensive one) but I’m positive he wouldn’t have any fent in his shit.

But after narrowing down what could have caused the false positive, I went ahead and crushed up every pill (aside from the ones I’m prescribed by my doctor) and nothing is coming up positive for Fetynal (not even the farmapram)

I know these dipstick tests can only be so accurate and are most likely meant to read via metabolites. But they are advertised to also detect by simply dipping it into water along with crushed up powder. Again I tested multiple times and nothing popped as positive. This is really frustrating and it’s going to affect my quality of life and yet another job position. If for whatever reason this screen somehow came up positive from the lab then I’m fucked.

The good news is I’d just have to provide clean UA’s for a month straight to get another week/step back but besides the point this shit has got to stop happening!!!! The only other option I have is to ship out everything I take to energy control for results OR which everyone else here will prob quote and agree on, is simply stop using the farmaprams ir blister packs. I’d just hate to see the stash go to waste or expire…

I’m open to other suggestions and would love to know the science behind why my dipstick test isn’t picking up anything. And because of this happening in the past I got into a habbit of freezing anout 30ml of urine everytime i UA so I can compare it to what the lab is seeing and discard it.

So I managed to find said UA that did pop as positive for fetynal since the strip detected it…but like I said, all I have taken differently was the farmapram, i truly believe that’s the culprit but again it’s not showing up when I test just the pill (crushed and mixed with powder) rather than the urine…

Thanks in advanced for the help and sorry to hijack the thread!

 

[Nurse Ratched]

I wasn't a mod when this thread was made. Apparently nobody else caught it and closed it. We don't discuss drug testing questions on BL.

Sorry we can't answer the last question posted but it's pretty obvious that all your scripted meds from the pharmacy are straight up but there might be something in the other pills you have that is suspect. Obviously it's something ( we just don't know what ) otherwise it wouldn't be showing up in the mass spec and the UA.

Closed.