Opioids "Pain Contract" Opioid/Substance Testing

[oxyCoded]

Hi guys,

Going in to set up a "pain contract" which is pretty standard for what I take (fentanyl & dilaudid) and frequency (daily). I don't really have an issue with it since I only take what is given to me, but I had a few questions if anyone out there has some experiential knowledge.

i. In the past, they've done urine testing randomly. In addition to checking for the "presence" of the opiates I take, what are the chances that they will also check for the amount of the drug in the urine?

ii. Would taking the fentanyl buccally show up as a higher amount than the permissible mcg/hr? Note: I don't dose with a huge amounts. Since they are 72hr patches, I take one and break it up over a period of 72 hours.

iii. Same question as (2) concerning taking dilaudid via intranasal.... would it show up as an abundant amount if snorted, yet snorting only the amount that is prescribed per day as if taken orally?

Does it even matter if I were to double-up or am I just worrying over moot specifics?

 

[psychopath]

Drug testing questions of any sort are not allowed.

 

[NeighborhoodThreat]

We don't do drug testing questions here.

 

[ONandOFF777]

I am assuming this will be closed, but before it is I think you question is valid even if it is not allowed.

My understanding is that they really cant tell exactly what your levels should be so I would assume they take a base line and then as long as that shows a significant presence with no crazy numbers they then use that to compare over time. Eventually after a few tests they have a pretty good idea of where your levels should be.

So as long as you dose the same way all the time and don’t make any big changes there should not be any issues, however if you change the way of dosing one month it could effect the levels and show an inconsistency.

Every person is different their for absorbs drugs differently so I think it is very hard for them to say X person take X amount of X drug so their blood level should be Y. I just don’t think it works that way.

 

[cj]

Yea drug testing is not as acurate as the authoritys would like us to believe. The last time you pissed and time of day of the test will play a big factor in how many metabolites are in your piss. ROA could play a factor depending on the Bioavailability of the substance. I think pain contracts are mostly looking to make sure the drugs are in your system (yor not selling them) and that illegal drug ue is not happening. Another thing is that they would need to perform a gcms to look at levels of any drug in your system which is generally prohibativly expensive. Peace.

 

[ONandOFF777]

I am assuming that in some cases they do use GCMS to get the level in the body at the time. I know this is at least common practice in Methadone clinics as they do peak trough testing.

Also I know the testing my pain Dr does the first couple of times, and then about twice a year were more expensive than the following tests. We are talking the difference between upwards of $1000 for the first couple and the bi yearly to maybe $100 for the regular testing.

I know this is just speculation but I have also had one of my Dr’s tell me that my level was low at one of my previous visits, but he did mention that he didn’t have anything to compare it to (this was my old Dr, my new one has never mentioned my levels). At this point we just discussed my ROA (more the method I use as I am on Suboxone for pain) and timing of my doses. He seemed satisfied that I was just a poor absorber/metabolizer and we discussed breaking my dose out into 4 smaller doses through out the day.

I would assume since both of my last two Dr’s seem to have done some sort of level testing that it is fairly common practice.

 

[phr]

Sorry, I can't leave this open as it's against our rules.

I would just ask them exactly what testing involves. Say you're concerned about false positives, etc.