URINE control or YOU’RE in control

URINE control or YOU’RE in control, THAT IS THE QUESTION!

…or perhaps we should call this, “How to Beat Your Urine Drug Test”

Attention Patient-Dealers and Substance Abusers:  Learn how your doctor analyzes your urine in order to determine whether or not you are taking your medication as prescribed, abusing illegal substances, and/or taking prescription drugs from another source!

Attention Doctors, Nurse Practitioners/Physician Assistants, Pharmacists, and other prescribers: Is disclosing such information a case of the “Emperor has no clothes”?  Not so much when you consider that patients, substance abusers, and providers alike all have access to the information highway we call the World Wide Web.  The important differentiation is that patient-dealers and substance abusers can be knowledgeable and savvy about misleading their provider, but if their provider is more erudite, the latter is supported by science and chemistry.

Perhaps the byline should read,
Attention Patient-Dealers and Substance Abusers: Don’t be foolish, you can’t change science.

But who will pay for the tests?

Perhaps the byline should read,
Attention Third-Party Payers: Don’t deny urine tests required by the provider.  It’s a public safety risk, unfair to legitimate patients, a liability to clinicians, and more costly in the long run.  Simply put; it is penny wise and pound foolish.

There are three simple elements to doing the Urine Drug Test (UDT) right:

  1. Make sure the specimen is actually from your patient.
  2. Know the difference between a urine Immunoassay (IA) Qualitative Testing (aka enzyme screen test) and Laboratory-based Quantitative Testing, the latter of which is confirmed by gas or liquid chromatography mass spectrometry (GC-MS or LC-MS).
  3. Make sure the sample is a “valid” sample.  There are two permutations of this…
    Adulteration Behavior Checks (ABC) and Specimen Validity Testing (SVT)

Adulteration Behavior Checks (ABC) is helpful to discern if a patient has demonstrated aberrant behaviors in an effort to hoodwink their provider regarding drug use/misuse or hide drug metabolites. The specimen can be tested for dilution, substitution, or the use of adulterants.

Specimen Validity Testing (SVT) is helpful to discern if an unexpected UDT result is from a medical condition such as a urinary infection or to changes in a medical condition, the latter of which necessitates further assessment (think Australia…some foreshadowing).

A simple Google search for “beat a urine test” yields 30 pages of hits.


A patient presents to your office on the following drugs:
OxyContin 20mg PO Q12H
Promethazine 25mg PO BID PRN
Pantoprazole 40mg PO Daily
Quetiapine 100mg PO QHS
Lortab 5/325, 1 PO Q6H PRN

There are many possible scenarios with this first example.

  1. An office UDT by IA (enzyme analysis) is completely negative for everything, but positive for cannabinoids (marijuana).  The clinician doesn’t confirm the sample with AMC, SVT, or LCMS quantification.  Instead, the patient is accused of using illegal substances and not taking prescribed drugs.

The problem:  OxyContin at the prescribed dose very likely may not come up on a urine enzyme test and the cannabinoids may be a false positive from pantoprazole.

  1. An office UDT enzyme analysis is positive for opiates, negative for substances of abuse, but also positive for methadone and amphetamine, neither of which was prescribed.  The clinician doesn’t confirm the sample with AMC, SVT, or LCMS quantification.  The patient is accused of using illegal substances and not taking prescribed drugs.

The problem:  Quetiapine is causing a false positive for methadone and promethazine is causing a false positive for amphetamine.

  1. An office UDT enzyme analysis is positive for opiates, negative for substances of abuse, and the patient has a previous history of polysubstance abuse and is a known alcoholic with PTSD and anxiety disorder.  The clinician is happy with the results and orders no further specimen testing.

The problem:  Had the clinician ordered the ABC, she would have found that the sample was in fact tampered with by using Visine eye drops to reduce the 9-carboxy-THC level, which upon confirmation showed high levels of cannabinoids.  After quantitative confirmation, this sample tested positive for clonazepam and fentanyl, neither of which are generally picked up on a standard urine enzyme test. 

  1. An office UDT enzyme analysis in an Australian pain clinic is negative for opiates and all other substances.  Since the OxyContin dose could theoretically test positive or negative, the Lortab is written PRN and the patient states that he didn’t require it last week; the clinician is happy with the test and does no further investigation.

The problem: Specimen Validity Testing (SVT) would have shown in this case that the creatinine, specific gravity, and pH were inconsistent with human life.  Upon further testing, this sample seems to have come from a kangaroo.

So there you have it; four of several possible other scenarios for one example.  Believe me when I tell you that I’ve seen far more egregious issues with various urine tests.

A simple Google search for “beat a urine test” yields 30 pages of hits.

5.  But, imagine another scenario where the patient presents and is acting evasive and doesn’t look “right” to the clinician but she can’t quite put her finger on what’s wrong. The patient has been treated with oxycodone. The patient is asked to provide a specimen and the IA office test result is positive for opiates and negative for illicit drugs. The patient is nevertheless only given a three day’s supply of their medication because the clinician wants to send the specimen to the laboratory for definitive testing via LC-MS/MS.

The third party payers want us all to rely only on this IA result; providing a full month’s worth of oxycodone (the most abused prescription opioid in the US on a per prescription basis) would be ignoring one’s instincts and, as will be seen below, constitute contributing to the further loss of control of this individual and risk the further diversion of substances to the community.

The problem: The laboratory definitive test result is positive for hydrocodone and hydromorphone and cocaine. The patient is asked to come back and discuss these unexpected results. The patient reports using up all of the oxycodone in the early part of the month and then trading a few of the “pills” to barter for a larger number of hydrocodone tablets on the street. The patient also admits to cocaine use at a party nearly 4 nights earlier.

The pain physician then makes the diagnosis of polysubstance abuse and refers the patient to an addiction medicine provider for a consultation.

It has come to my attention that many large managed care organizations have selectively excluded certain urine testing such as quantitative confirmations, ABC, and/or SVT.  This sets a very poor precedent, is a public health risk, and a disservice to honest patients.  Moreover, it’s somewhat comical that these very same companies will happily continue to pay for the patient’s OxyContin listed above to the tune of thousands of dollars, but won’t spring for the comparative pennies it cost to do things right. 

A simple Google search for “beat a urine test” yields 30 pages of hits.

Should a managed care organization that doesn’t know the patient be making these decisions?

Is it fair to falsely accuse a patient of wrongdoing because their insurer won’t pay for a test?

Should we give patient-dealers and substance abusers the advantage so they can divert drugs to unsuspecting teens?

Does this post help some shady characters better understand these tests and leave us clinicians like the Emperor with no clothes?

The only ones with their pants down here are the third party providers that are paying for hundreds of thousands in drugs costs, many of which find their way to the streets in part because clinicians don’t have the education, time, energy, or third party payer support to monitor these things.

This is an unfortunate public health risk that is meagerly addressed.

For help interpreting false negatives / positives and unexpected results, see the #Urintel software platform and smart phone app HERE.

NOTE: Although we welcome questions, several patients have shared stories of various indiscretions whereby they’ve taken more drugs than prescribed or another drug that was not prescribed, and have asked how they can beat the test or if their doctor will be able to tell if they took something they should not have taken. No questions will be answered to help someone trick their medical provider.  Such questions will be deleted. If you have an honest question, it will be answered.

697 thoughts on “URINE control or YOU’RE in control

  1. I have just received an Adult ADHD diagnosis and have to do a supervised urine drug test before being prescribed medication. I have been prescribed phentermine and filled my last script 6 weeks ago. I still have some of the meds however, as I only take them sporadically. I took the last one 3 days ago. I believe by the time I take the test on Monday I will have 0.5mg of phentermine in my system. Is this likely to cause a false positive?

  2. Hello Dr. Fudin,

    I was prescribed lortab 10mg post-operation and took my first dose on Sunday evening. Well I was just informed by a potential employer that I have to take a urine test Friday morning and although I’m prescribed I don’t want to have a negative perception from a failed drug test. Should I be worried that it’ll come back positive?

    1. It is doubtful you’d be positive. But, if asked about prescription medication you should be honest. There’s nothing wrong with going to the ER and getting a single dose or hydrocodone.

      1. Dr I normally take 10 mg Norco four times a day but the day before my urine test I only took two. Will it still be in my urine prime test? Just want to make

          1. TOXASSURE COMP DRUG ANALYSIS,UR…from labcorp . Also do you know of any reason why alcohol would show up in my system if I do NOT DRINK. I am however a diabetic and I’ve read some places that can cause it to show up. I’m lost on that.

  3. I have never taken a Norco before I was having some back pain my grandmother gave me one of hers yesterday I have to take a urine test on Thursday should I be okay

  4. I’m a 65 yr old woman with multiple health issues. After reading all these stories about good people losing access to their pain meds due to faulty urine tests, I am terrified that I’ll lose mine, too! I have avoided going into a pain management program and I’m glad of that, but recently my pcp told me I had to consent to mandatory, random drug testing if I wanted to continue getting my hydrocone and produced a written contract for me to sign. I’ve been taking 4 to 6 10/325 hydrocodone a day for over 30 years and my quality of life, (such as it is) depends on them. Am I addicted to them? YES, but that is nobodies business but my own! What is important is this: With pain meds I have an acceptable, quality lifestyle. I can work, go places I enjoy, with minimal pain. Without them, I can barely walk across my house. Who do these “professionals” think they are? How do Drs. get away with ruining so many people’s lives, refusing to run other tests and denying them the meds they need to live any sort of normal lives? I don’t give a damn if I’m addicted. I feel the end justifies the means. If I’m OK with that, who are they to say otherwise? Sooner, or later I’ll fail a test, because I use marijuana, which is legal in my state. This is totally unacceptable!

    1. Iam have the same issues. Iam 61yrs old and I have been treated for the last 25 years with pain medications epidurals and since we had this opiate epidemic doctors are not wanting to prescribe the medications or they want you to go to pain management because the DEA or FDA requires you to have drug screens drug screens and my doctor that prescribe my medicine as an anesthesiologist she gave me my epidurals and my pain medicine they’re not set up for drug screens is done as an outpatient surgery I have been trying for a year and a half to find a doctor that can write my medicine and do the drug screen and that accepts my insurance but due to the change because of the opiate epidemic I could not find a doctor that wrote methadone and which actually my doctor put me on 20 mg of methadone a day that has worked perfectly fine for me for the last 17 years they also gave me Norco which I thought was a part of the opiate problem they prescribe me narco for breaking pain but they actually didn’t help me that was the reason I was put on the 20 mg of methadone which is great for bone pain that’s all I needed to get through the day to meet so I can live a productive life and function I did fine and I have for years but now because of the law I cannot find a doctor that is willing to write do nothing for me but they’ll write all kind of narco and muscle relaxers and I was under the assumption that the narco and was what started and all of this an opiate epidemic so they’re trying to take me off or have my methadone want me to take all these steroid and cortisone shots in my back which I’ve been doing for the last 13 years and I’ve solely believe that they have caused more of my health that used I read back on the side effects of steroids and cortisone shot and it said right there I’ve had lots of vision my thyroid is not working my bones are deteriorating I have memory loss and so on and a solely believe all this started due to the steroids but I couldn’t get my pain medication without having the steroid cortisone when my doctor had for years do not do drug screens it is considered an outpatient procedure the epidurals I go four times a year that’s all you’re allowed to have she had to quit seeing me or could face jail time so I find the pain Management center that tells me they don’t write medication but wants me to go every week for a month to have more steroids and cortisone shots and then they give me 90 lortabs the stuff that wasn’t working for me to start with I had to take too many so they switched me to methadone but only took two of 20 mg and work fine but instead of doing what I know is best for my body and what I felt better at they would only see me if I quit taking the methadone and took four to six Norco a day with muscle relaxers and Klonopin stuff I’ve never took except the muscle relaxers occasionally so why I decided to quit going to the pain management doctor and keep looking for a doctor that would write 20 mg of methadone and possibly some muscle relaxers that would last me for months a 30-day prescription but I can’t find one anywhere that will see me in the very few I have I don’t have the insurance that they that will cover their visits so now I have to go to a methadone clinic every day anything know that I’m having to use them as pain management they’ll kick me out can make a long story short we live in the free country supposedly we’re given tons of papers we have to sign explaining what medication can do what will happen if we abuse it all this it takes an hour to fill all the paperwork out and it’s my body I should be allowed to put in it what I choose and not the DEA or the FDA dictating to me or my doctor or my drugstore what I can or cannot take and once you put your name on a paper understanding what’s your rights are and what will happen if you miss use your medicine then it should be your responsibility to take that medicine right and if you don’t then you don’t need it and people need to step up and be responsible for what they do and quit laying all of the blame on someone else if someone od’s and so forth that is so complicated now just to go to a doctor and get a prescription I might sound like I’m talking from one extreme to the other and I probably do but I’m just so frustrated with being told what I can and cannot do with my own body and be responsible for what I put in it it’s not my doctor’s fault and it’s not the drugstore’s fault it’s misused and the same with the holidays drug test there’s cold medicine there’s other medications you can be taking that will give a false positive reading it’s all so screwed up the government is in our homes and our lives in everything we do my grandchildren live with me and I don’t want to get started on that subject either because that’s another can of worms when it comes to your children and school it’s just everything is just overwhelming overwhelming you just about have to be a little lawyer to understand all the laws what you can and cannot do and they constantly change and if you screw up you can go to jail and if you don’t know the law they’ll tell you that ignorance or not knowing that law there’s no excuse for it you should know sometimes I wonder if we’re not living in a dictatorship because that’s the way it’s going everything we do in our lives we’re being dictated to from what we put in our stomachs or what we do with our children our grandchildren but I’m with you I could go on and on and on so I need to just stop I understand how you feel completely about your medications and what they’re doing and they’re testing it it’s just all so crazy and I will keep you in my prayers and hope that everything goes good for you

      1. I just wanted to let you know it’s your Dr.s that stopped writing your meds! I like to do research being disabled since 2002 that’s one thing I can do. If you look up at the CDC website and search Opioids 2021 it will tell you why. The Dr.s had to report to the government who was taking what, how many and the strength. The Dr.s didn’t want to do that so they stopped writing prescriptions as of January 2021! I was sent to so many pain specialists it’s not funny. I am a Chronic Pain Patient never failed a urinalysis over 20 + years. I have many problems due to what happened to me with a certain Pharmaceutical Company! I got Aseptic Meningitis, paralysis of my left side which with the help of God I finally got my body back. I was not even given medication to withdraw off of my prescription’s. My RN at the doctors office said try putting back some of my medication in case of another hurricane or flooding. I was able to put back enough to withdraw myself off of my Methadone on my own. I am 65 now went without pain medication for over a year. I called a clinic that gave meds to withdraw from medication but they wouldn’t take me because I never abused drugs. I am on hospice now and getting help for my pain and sleep problems. I went from 145lbs to 99lbs within 4 months after they stopped my pain meds. I would rather not take anything but do to the damage to my Central Nervous System and more problems I have no choice. I hope this helps answer some of your questions. God Bless…..

    2. Melissa!!! Exactly!! Now gov coming between drs and pts… I have a Bakers cyst and outside of my transplant on 9/11/11, I’ve never felt such pain… I’ve never had drugs and in this 3rd world health care we got now, 3 places NEVER asked me my pain level or even offered ….I went to west marion hosp last nite and a Russian gave me lidocaine patches and 9 ultram ( only 9 by LAW) this is unacceptable… I’m emailing Gov. DeSantis.

    3. Bless your heart!!! I feel your pain regarding this issue. I too wonder how this can happen to people who legit need the pain meds to function a normal life! I worry all the time that my Dr will find a reason to take me off because that’s what they do now! The fear is REAL and it sucks!

    4. I hear you girl. Like I said I’ve been on 10/325 oxycodone for yrs and like you, with these pain meds I’m able to lead a normal life with a flare here and again however, Iif I don’t take them, I’m in bed. Any amount of repetitive motion sense my joints into mania. The pain is unreal. I lived with the pain and flares for yrs, not going to pain mgmnt Dr. Until it got so bad, laws changed and are changing more, not for our benefit either. I’m sitting in limbo waiting for a new Dr to get my file with a POS for Suboxone. I’m sick over it. I hope the letter of explanation will prove my case. If not , that crap is on my record. What will I do then. RA is no joke.

    5. I’m having the same problem with my ex doctor. I used a few THC legally obtained gummies he freaked out. I said he was full of s#:t.to his face. He cancelled me. Now it’s war.

  5. Dr. Fudin –

    If I took 3 5mg oxycodone every 4 hours on Friday (total daily dose 15mg), 3 5mg oxycodone every 4 hours on Saturday (total daily dose 15mg) and 4 5mg oxycodone every 4 hours on Sunday (total daily dose 20mg) and had a pain management drug test for oxycodone Monday morning (12 hours after last dose on Sunday night), would I test positive for oxycodone? Would I test positive for both the 100ng/ml and 50ng/ml cutoffs?

    Thank you

      1. Hi, I have a quick question. I am in pain management, have been for past 6 years, never take anything not prescribed and have never had a positive UA for anything I’m not prescribed.
        Well, today I tested positive for OPI and OXI. I am prescribed 10-325 hydrocodone. Is this what is causing the positive? I thought OXI was specifically for Oxycodone and OPI was for hydrocodone?
        I have a severe UTI, would that cause a false positive?
        Is it even a false positive since I am prescribed hydrocodone?
        Am I over reacting?

    1. How long will a hydrocodone stay in my system? The er gave it to me but I take probation drug test every week

        1. I have a quick question. I see a pain mgmt dr. If I took my prescription dose of 10 mg Norco the day before my appt and my urine test will it show up on my urine test? I am prescribed 5 10mg per day. I just wanna make sure it will show up because I didn’t need much that day and didn’t take any the morning before my appointment

      1. Hi I’m not sure where to comment my question, I took 90 mg of oxycodone yesterday and I have a urine 72 hour drug test at 3pm on Monday. Will it show up?

  6. I am mystified and shocked over my recent urine test
    I am 56 old male with fibromyalgia ,nuerapthy ,arthritis and a bad hip . I have been taking hydro 5/325 oval pill t257 from the same pain for many years. He has always told me that the hydro must show up in my test when he test me so I always make sure to take it 4 to 5 hours before I go . We have had a great relationship over the years but he keeps moving to different buildings 3 times in this past which is strange to me but each to their own .I do not accept pain meds from anyone even after a surgery I never want to risk the relationship I have with my pain doctor. Last week I had a 10:15 am appointment and I took a pill the night before and one with I woke up at 5:30@am that morning. I went to my appointment and took the urine test in his new office when he came in to see me he ask me if I had been to the dentist or had medical procedures that I haven’t told him about . I told the truth which was know , I explained that I don’t go to the dentist because I have dentures and I haven’t even been to my family doctor in long while . He said my test came up showing that I had taken OxyContin and I asked him what that was because I haven’t taken anything that he didn’t prescribe. I told him the pills I took the night before and that morning looked as normal as they always did so I was in shock and hurt. He told me he could not give me my regular 3 month supply . He said they would send the urine off to a lab to be double tested and I would have to come back in 3 weeks to test again and if it shows the same I would be out of the program after all these years without a hiccup of any problems. These pain meds are important to me as it helps me live a halfway normal life and only dulls the pain enough to allow me to take my mind off the hurt in my body so I can rest at night. I am also a recovering alcoholic for well over 20 years and without my meds living with uncomfortable pain everyday is threatening to me so if the worst happens I pray I can cope . This has been a confusing issue to watch my doctor turn from a trusting/friendly relationship that is very important to and I hold hime in high regard, his opinion of me matters and now he acts distant with these accusations. This has affected me spiritually as I go to great lengths to be honest and follow the rules but a urine cup destroyed all that I worked for . I and the man above know I didn’t take anything I wasn’t supposed too but this has flipped my insides for a loop . I wish I could just over the counter Advil and others but they do not help at all even when I double the doses which is more harmful to my health. Sorry my writing isn’t great it’s late and I fell like I have been hit by a truck with widespread pain . Say a prayer for me !!

  7. If i took 1 1/2 norco Saturday morning and took 2 percocets that evening, would the norcos show up in urine test monday or would the percocets knock them out?

  8. Help! I am about to lose my pain management through no fault of my own. In 2002 I was the victim of a strong armed robbery and subsequently seriously injured that left me disabled for life with a TBI, spinal, ligament, nerve, and tissue damage.. Due to the false narrative that these overdoses are primarily due to patient abuse of their prescribed meds, my doctor took all his patients off their regular meds to comply with the new cdc guidelines regardless of condition. He took me off my lifesaving (literally) 100m Fentynal patch so fast that it which nearly killed me leaving my primary Doctor screaming at him to no avail. Now I am on 5 Hydrocodone 3x a day. It barely touches my pain but it is far better than nothing at all. Since moving long distance my new doctor of 1 year ordered a random drug test over and above my regular testing just because I said I preferred the patch because it gave me far better relief and relief around the clock. It just so happens that due to my pain no being controlled I once again began having serious medical issues pop up. My once tiny body has whole body swelling to the tune of 45lbs. My stomach has become seriously swollen so bad that I look 8 months pregnant. Thus my primary began ordering a host of testing at the same time that these random drug testing went wrong. First testing after immediately after I made my Patch statement, was negative. I explained that because he had me come in at 8 a.m. and I forgot to get my hydrocodone out of the lock box (my 4 year old grandson lives with me) and bring so I could take it on time, was probably the reason or it could have been that I just had a test that required my drinking quarts of water with something awful in it. it was so bad that I was taking my nausea pen meds every 4 to 6 hrs, as prescribed. I am a fast metabolizer. My first pain doctor in 2003 had to have me change my patch every 48hrs rather than 72hrs because I was going into withdrawal to fast and all others did the same. They had to tell me I was in withdrawal because I had no idea what was wrong with me and they had a laugh about it. My pain doctor looked at me like I was lying. So then he ordered another drug test, having me come in again just for that purpose. This time he claimed that there was no hydrocodone in my system, but there was oxycodone! Duh! Why would I do that? I then explained that it must have been another test they did the previous day. My primary had informed me that they found that my stomach had herniated up into my diaphragm and a part was herniated into my esophagus, which accounted for the waking up every night with vomit and heart burn in my throat. So he did a test to see if I had a rare bacterial infection in my stomach that some get from that type of herniation. It required me to drink water with some terrible tasting stuff in it that left me once again nauseated for days. Then I had to blow into this bag after 15 minutes. I protested about oxycodone being in my system. Showed them my hydrocodone I brought with me. I even looked up on line to make sure that the pharmacy had given me the correct med! I have never taken a prescription drug that was not mine in my life. Other than trying pot when I was a teen and hating it, I have never taken illegal drugs in my life. I hate alcohol because I hate the taste and I hate that druggy feeling! One of the reasons I liked the patch was because you don’t get that druggy feeling with it! if you do get it, you’d better rip it off cause it is malfunctioning and you could overdose. I have had to rip mine off twice in the 8 years I was on it for that very reason and it is scary. So please tell me how to deal with this. I can’t deal with the amount of pain I am in right now. I have already lost all quality of life. If I lose what little relief I get, my body just can’t take it. FYI: I was put on the patch in an effort to save my life. According to my primary and my pain doctors, I was literally dying from the pain. They thought it was the TBI that caused me to be so weak that I was in a wheelchair and the reason that I talk out of my head a lot. But it was all the severity of the constant pain. Any advice or help you can give me would be so wonderful. Thank you for your time. Sincerely Mrs. Williams

    1. I take oxycontin 20 mg 3 times daily since 2007.
      Had urine test positive for hydrocodone have not taken this medicine
      Understand that it’s a problem with the making of this drug at the Purdue factory.

  9. Hello, I am trying to get help in a difficult situation. Any advice it greatly appreciated. I recently am dx with chronic pain from a few different conditions. I have been taking Hydrocodone/APAP 5/325mg for a few months now and tx by my pcp. Initially taking TID then switched to BID, with TID for severe pain. I had RNY Gastric Bypass in 2014 which prevents be from being treated with NSAIDS which is unfortunate because I surely miss taking IBU PRN. Anyways, my pcp referred me to pain management to follow my case and rx medication from here on out. Here is my issue, I have had 2 urine tests done by Quest lab in the past 4 weeks. It is the test that can tell specifically which medication a substance is positive for so if positive for opiate, it would say exactly which medication. Both of my urine tests have been Negative for opiates/Norco. I have been consistently taking Hydrocodone for a few months. maybe a few days without it here and their depending when waiting on a refill. My current pain doctor is uncomfortable rx me medication regardless if he believes me or not due to his own liability. no one seems to know why my urine is negative. I am clueless myself, I am waiting to see if they will order a hair test just to prove myself. Do you have any insight? thank you.

    1. I would have your doctor contact Quest. Besides that, it will depend in part on when you took your last dose. Also, you may be an ultra-rapid metabolizer of hydrocodone, which can be determined by your doctor ordering a genetics test that includes CYP3A4 and CYP2D6. Also, I would discuss NSAID use with your GI doctor again, as certain formulations that are COX-2 selective and crushed may be an option (celecoxib, meloxicam, etodolac).

      1. I have a question if I have taken half of a 10 milligram oxycodone and I will only prescribed 5mg will it come back in that time that I have taken half of a 10 mg even if I cut in half can they tell what pill you have taken

  10. I’ve been prescribed Norco 7.5mg BID from my first pain management doctor who in my opinion was not the greatest doctor, so I left his office and changed to a very excellent reputation. I have facet joint syndrome and a grade 4 AC Separation that was repaired about 15 yrs ago but new MRI’s show tears and a possibility of a new surgery on the way. Recently I’ve been experiencing headaches/migraines almost every day. My new doctor has prescribed Tylenol #4 for my back and shoulder pain and was supposed to refer me to a neurologist last month which never went through. I tool a few of the old Norco prescription a few days ago for the headaches. I have an appointment with pain management on October 1st and haven’t taken anything for 3 days except extra strength Tylenol and ibuprofen. They know I have the old Norco script and was wondering if it will still show up in my UDT? I know it depends on a lot of factors but really just curious not so much worried. Thanks and have a great day.

      1. Hi I’m not sure where to post a question. I’ve been on Suboxone for 2 years now. I started on a 24 mg dose and worked my way down to 4 mg a day. I honestly have never used since I started the treatment. My problem is every other urine sample my doc says naloxone is in my system but the bupherine is not. I take my med daily. A new owner bought the practice so now it’s every two weeks and it’s happening once a month again with them saying this . I wouldn’t waste my time if I didn’t take the med. Today he said the same and I asked him if something is wrong with me ? My kidneys, liver something? Now I go back in 7 days . Basically punished. What could be causing this? I am very active and my last therapist told me it’s fine I probably have a high metabolism and 4 mg was so low. But I’ll get kicked out of the program for no reason. Someone please help because I know this screening is not accurate. I take my meds

  11. I took something I have never taken 7 days before my appointment with my doctor last month and it was methadone. I had no ideas that it was until after. Well 5 days later I took a norco. 3 days later I had a urine test. Will it possibly be clear or should I just look into another doctor. I have fibromyalgia, lupus, sjögrens, osteoarthritis, osteoporosis, rheumatoid arthritis and need my medication just to survive. Should I even go to my appointment.

      1. I don’t take medicine that’s not mine. All meds stay locked in my mom’s safe and in the middle of the night she handed me the methadone which is my brother’s by mistake. At 3 a.m. I took it not looking at the meds because I had asked for my xanax log. We didn’t realize until 3 days later when my brother was missing a dose. The norco’s are mine however I hadn’t gotten the paper yet for my physician. I’m only asking because i wasn’t wanting to lose my doctor I’ve had for so many years. I’m not needing an addiction specialist but thanks for jumping to conclusions. Shows that’s all you probably do for your past time. Enjoy your day of judging others.

        1. Lady i am not judging but you need to review what you typed cause the story you just told says more than you have a substance abuse problem he was just being nice and professional its obvious you are trying to “keep your dr” if your dr is the narcotics he prescribes to you and it seems your family and if your blindly taking methadone administered in the middle of the night by your mother by accident your lucky your still alive so before start degrading someone you should probably proff read and ask your self does this story makr me look like an addict even more than me tell the truth that i popped someones methadone after i ran out of hydrocodone and Xanax also methadone and Xanax mixed can kill you but the biggest kicker of all is 1 mom holds the meds 2 they are in a safe i have said enough i just wrote this cause you were rude to someone who was essentially kind to you and that burns me up … have a nice day and own up to the addiction before it ruins you at least people can half way deal with an honest addict

      2. Good afternoon,
        If I took one 10mg hydrocodone on a Saturday evening and was given a urinalysis the following Thursday morning, will it be positive with an immunoassay threshold of 300 ng/ml and confirmation test of 100 ng/ml?

          1. I’m confused, on other replies you said that a dosage that small with that amount of time (4 1/2 days) between consumption and taking the test, that you likely wouldn’t test positive?

          2. Single dose of 10mg hydrocodone, approximately 108 hours between consumption and urinalysis.

    1. I am an RN who previously worked in a pain management facility. My answer is YES you should go. When you see your MD or PA immediately tell them what you did. Always be honest. They can’t help you if you lie. You not only put yourself in physical danger but you put them in a liable position. If you have a MD/PA who really cares about your treatment they will administer the correct UA test and take it from there. You will also build trust between you and your provider. If they won’t help you or dismiss you then you are in the wrong place or with the wrong provider. Find a new MD/DO or PA. Then don’t make that mistake again. Lying is never worth dying for it.

  12. taking daily by prescription Latuda 80 mg, bupropion 300mg and Oxcarbazepine 300 mg could this cause a failing result in an ecup drug test?

    1. A CBC alone is a test for blood parameters such as red cell count, white cell count, and more. It is not a test for drugs. Oxycodone will test for oxycodone regardless whether it is Percocet or plain oxycodone, but unlike Percocet, plain oxycodone does not contain acetaminophen.

  13. I took two five mg pills for two days of Vicodin and may have a UA drug test 6-7 days from now. Is there any possibility that it will show up past the 4 day mark if I have a slow metabolism?

      1. Hello Dr. Fudin,
        Yes they are. No funny business going on here. The test is also a maybe since it’ll be pre-employment.
        Thank you for the speedy response and I hope you had a great Fourth of July.

        1. Okay. Great! Usually hydrocodone is out by 3-days if the standard immunoassay test is done as opposed to chromatography. If you actually have a prescription, you could just bring it with you and tell them up front that it was short term, if that was the case – but that’s up to you.

          1. I actually decided to just take some aspirin instead of risking having to answer questions and show my prescription to a new employer. How long for a chromatography? Thank you for the information though. I appreciate the time you take to answer everyone’s questions.

          2. My roommate has been on oxycodone for years now he recently had a urine drug test came back showing fentanyl I know that he has not taken any thing of the sort how is it possible did the lab screw up

      2. Daryl says:
        July 4, 2019 at 1:07 PM
        I took two five mg pills for two days of Vicodin and may have a UA drug test 6-7 days from now. Is there any possibility that it will show up past the 4 day mark if I have a slow metabolism?

        WHY not just answer the question of this person?

  14. I took a quarter of a vicoden on Sunday night. I have a drug test for a potential employer. I am worried it will show up. The drug test is on Wednesday the 3rd of July. Am I going to fail the test or will it show up. SInce Saturday the 29th of June I have had the equals of a half of a Vicodin 7.5 mg.

  15. Hello,
    I am prescribed 30 mg oxycodone basically for a failed back surgery. I normally always take it as directed- several times a day, however on my last refill I had run out a few days early and at time I was given a drug test from my doctor and it showed up as very little oxy was in my system, however I was also at same time taking Lasix daily which causes me constant urination…..could this Lasix have greatly reduced the level of oxycodone in my system since I was “peeing” constantly before my drug test?….and therefore reduced the level shown of oxycodone my system?….please help…I see my doctor about this situation very soon. I am a true chronic pain patient and need my pain meds to function and have some quality of life!

  16. Hi Doc.
    Just found out I have a drug test on monday for work, and I took norco for back pain 2 on wednesday, and one on thursday night. What is the likelihood that the test come out positive? I’m 5’1, 140 lbs.

  17. Does Tramadol and Norco show up as the same thing on a pain clinic drug test. Or will they know that I took one or the other?

      1. Hello Doc, I am prescribed 4-10mg oxycodone for my spinal injuries. I was in more pain this month than normal so ended up taking a few extra throughout the month. My appt is tomorrow on the 2nd of July and I only have half of one left (5mg). If I take the pill a couple of hours prior to my UDS tomorrow, will it come up positive? I’m hoping it does as I’m afraid of telling my doctor I ran out early due to fear of being discontinued from the meds also together. Thank you so much!!

  18. Hi Dr. Fudin. Can a urinalysis detect the amount of oxycodone in your system. I’m on a rather low dose and I’m concerned that it may not even show up. If that’s possible. Thank you for providing a place where people can come and ask these questions.

    1. If I have taken 1 5mg perc on Monday and have a urine screen on Wednesday. Should I be worried? Also, from the moment a perc is swallowed how long usually until its detected in the urine. Do you think it would show up on a urine screen 2-3 hours later?

      1. Raylynn, If you’re taking Percocet that wasn’t prescribed, you have lots of reasons to worry; passing a urine test is the least of it. If they were prescribed, there’s nothing to worry about.

      2. 2 hours after taking a single dose to show in urine…if taking longterm it will show up always and stay in system longer bc it builds up

          1. I took a single pill of hydrocodone on monday night (7.5) have a drug test on friday. Will i pass?

  19. Hi Dr. Fudin,
    I was prescribed a 3 day supply of oxycodone earlier this year by my OB for pain management during a miscarriage. The pain was fairly manageable after the first day and I didn’t use all of the medication. Yesterday evening (Thursday) I tripped down the basement steps and banged my hip pretty good. After a trip to urgent care and confirmation of no broken bones, I was told to take 800mg of ibuprofen and ice the area. The ibuprofen didn’t touch the pain and I couldn’t sleep so I took one of the oxycodone for some relief. I just received a call from a potential employer and they want me to take a urine test on Monday afternoon. Am I in danger of failing that test now?

      1. I take vicodin 7.5 220 tabs a month. If I take percocet 30mg will it show up in monthly urine drug test?

  20. Hello, My husband and I have been sleepless. He got a great job offer and had a pee tested Monday..but he took hydrocodone on Sunday night. He had back surgery in Feb and got hydrocodone priscribed. Sunday he felt pain so he took 1 pill. He has not taken one in over a month and out of all the days he took one and gets drug test the next day..ugh. We are really hope either it wont show up or the intended employer doesnt make a big deal about it.

      1. I am taking lortab and addrall and I have to take a drug test which my doctor gives me the medicine is take .but I need to know if I take xanax will it see up in a drug test to where they can tell its not lortab or addrell .?

        1. If you’re taking Xanax, and your doctor is giving you Lortab and Adderall, don’t you think the prescriber should know? This is another reason why so many doctors are reluctant to prescribe anything these days – they don’t want their patients harmed and they don’t need more liability when someone takes something that wasn’t prescribed. The majority of prescription-related opioid deaths involve co-administration with Xanax and similar drugs.

  21. I was prescribed 5mg hydrocodone for herniated discs in my back. I took two on Friday while I was having some trouble coping with the pain. I’ve been on doctor ordered restricted duty at work and fmla. I just took a random UA today and even though I don’t believe I’ll be in trouble if they show I would rather not deal with all the formalities that will follow if I do test positive. It has been over 72 hours since I took them and had not taken them for over a week prior, as I’ve tried to avoid them as much as I could tolerate. Will the likely show up on my UA?

  22. I have been in pain management several years and was recently discharged because of failing a drug screen. My normal fentanyl and oxycodone showed up as well as buprenorphine. My daughter has taken Subutex for a while now and recently we had a death in the family that took us out of state and I kept her pills with mine in a small pill box. One of her pills had been dropped in the sink so she put it in the pill box wet. Is it possible that because its a sublingial medication that while it was wet and mixed in with my medication that when I took mine it got in my system and provided the positive results? I didnt take the medication so I have no understanding how it would be in my system any other way.

      1. I take Percocet 10/325 every six hours and
        Morphine 30mg . The morphine I take every 12 hours. One am and one Pm.
        My urine test showed up negative for Morphine for four days. I don’t understand, I take it two times a day. What does this mean.

    1. This is a prime example of not being an honest patient. That took you a minute to work out the possibilities.

  23. I had a recent work drug test. I have a prescription for hydrocodone (7.5). I took one pill Saturday afternoon, one pill Sunday evening, and one pill Monday morning. The same Monday morning I had a drug screen. I wasn’t worried since I have a script and only take “as needed”.
    When my results came back it showed I had a cut-off level and/or level of 2300ng. Not exactly sure what he meant by 2300, but I’m assuming my level showed 2300ng. The work Dr said the cut off for opiates is 100ng.
    Does this sound right for a “cut off” level? The work Dr said it looks like I take handfuls of hydrocodone and put me on restricted duty.

      1. if I took a tramadol on Saturday and have to take a drug urine test on Thursday, will it show up?

      2. In the state of California where recreational cannabis use is legal do they still test you for cannabis use while prescribing to hydrocodone

      3. So I have some issues also I have been in Pain management for 12 years and not 1 time failed a test . In January , because of the new opiate government agenda the pharmacy I went to told me they would only fill 2 (10mg) methadone a day instead of 3 a day which I was on I was also prescribed 1-2 oxycodone 5mg tid. I took a drug test Monday and because I’m a bit of an airhead I dropped one so I basically had to break one in half the day before the test now my dr is calling my phone repeatedly But are you sure they can’t tell how much is in your system whether oxycodone or methadone?
        The test says it indicates levels of creatine, oxidants , pH and specific gravity. It also says that they can preform quantitative or confirmation testing on negative qualitative testing results . Could you explain

        1. You cannot accurately determine dose taken from a urine test. Creatinine helps to determine if the urine was diluted with water; oxidants helps to determine if something was mixed in to hide the actual results; pH helps to determine if the sample was diluted, and so does specific gravity. Quantitative confirmation gives an actual level of drug and metabolites as opposed to just positive or negative, and it is far more accurate.

      4. That is not true. Urine screens show amount of drug and metabolites if test is gas spectometry or comprehensive to double check results

    1. In Urine I read up to 24 hours to 3 days IF you use it consistantly however if you do not have this drug build up in your system (taking 1 here or there) it would metabolize faster and be gone within 12 hours. I could be incorrect as I’m on here looking for answers myself

  24. Hi there,
    I have a question regarding my xanax prescription. I am prescribed 3mg a day, and that is what I take…no more and sometimes only 2 a day. Yet my UA tests are alwats (even since I started on these meds 10 years ago) showing that the concentration levels are much higher than they should be at this dosage. Any idea why that would be or what would cause this? I’m 32 years old, approximately 115 pounds and not very active if that helps at all. I am worried that they are going to think I am taking more and cut me off, this is the only medication that has ever helped my severe GAD. Any input would be greatly appreciated!
    Thank you!

    1. Tiffany, Urine levels are not a predictor of dose taken and should never be used that way. If your doctor is concerned, he/she should obtain serum (from blood) levels. That is most accurate and what would be acceptable in a court of law; not urine levels.

      1. Hello I’m 38 weeks pregnant I took a 10mg norco and I have a c section Thursday around noon is there a way lemon water for 3days can make it not detected.(also I was prescribed them but for teeth pain )but through a e r not obgyn. I just hear stories of child abuse and worried .

        1. It is child abuse. You are taking a narcotic that goes into your babys body too. Watch a video of a baby born addicted then maybe you will stop poisoning your baby. Drugs are stronger to a small child.

        1. For immunoassay tests, they can both show up generically as “opiates”. For chromatography tests they do not show up the same because one is hydrocodone and one is oxycodone, and their metabolites are different and will show up too.

          1. Hi doc, I have a quick question, I am prescribed 4 10mg oxycodone for my spinal injuries. I was in more pain this month than normal so ended up taking a few extra throughout the month. My appt is tomorrow on the 2nd of may and I only have half of one left. Should I wait to take it tomorrow or would it be safe to take it today and still show in my system in my UDS tomorrow?

          2. I took to Norco on Monday and I have to drug test on Thursday will I come out positive

  25. I was cut off from my pain meds at a third straight pain clinic. Honestly I failed a UA legitimately at a place I attended for about 6 years. I knew I was going to fail and never went back. Now the third pain clinic in a row has cut me off because they say my UA has multiple illegal drugs in it. This is not true. I went as far as this last clinic when they UA me I get my results my next appointment a month out. However this appointment I was prepared to get to bottom of this dilemma. So I filled the UA cup with pure water from the bathroom sink. For some reason the nurse said they was meth, heroine, oxycodone and subutex in the water sample. And they also had these results instantly to where I’ve always had to wait for lab results. I said that it was impossible and demanded a retake. They agreed. I filled the next cup up with synthetic urine from a smoke shop. They also had results immediately and also said those drugs were in my sample. I was then cut off of my opiate prescription and haven’t been to a doctor since. I honestly failed one UA in 15 years of chronic pain management. But 3 clinics in a row have lied and said there were drugs in my UA and I know for a fact there was not. I even used pure water from there sink and they told me lies. I was hit by a drunk driver after high school and have severe pain but I’m scared to go to a doctor because of this. Can I file a law suit against this doctor or what are my options? This is total discrimination.

  26. Hey Doc,
    Sorry quick question have been on methdone treatment for heroine addiction and have done great and been clean for 5 years until today ive been tit rating down and spilled my dose and im in school on externsship and cant miss for any reason. i had month old pee that is been in cupboard from another time I thought about it prepared but got a hold myself but all they do is put it in cup and see if methadone is in it. My question is I know it will stink more be a little darker but will the methadone metabolite still be presence to give me the positive line. i feel bad about the whole thing i get monthlys and go inn tomorow and this happened today so Ifeel like all my hard work of building up my takeouts is lost over one mistKE

  27. Hello, I have RA, Fibromyalgia, and Sjogren’s and have been taking my oxycodone 10mg every 6-8 hrs as prescribed for the past 5yrs. I am interested in applying for a certain job but am concerned I won’t pass the screen. Should I save myself the embarrassment and not waste anyone’s time and not bother applying for the job? Thanks very much.

    1. If the job prohibits use of oxycodone, like a bus driver for instance, don’t apply. If the job allows you to be on opioids with a legitimate prescription, it is fine as long as you can confirm you have a prescription written by your doctor or other legal clinician.

  28. I do not take pain pills at all and I took 4 hydrocodone 7.5 Saturday throughout the day for pain…old script….it is now Monday…I’m 6’1 145lbs which means fast metabolism and I drink lots of water….should I be worried if work hits me with a random u.a

      1. Hi I have a question I ran out of my Oxy Codeine medication pain medication that was prescribed by my pain doctor my mother had some Norco 10 I took 3 on Sunday I have Urine test on Wednesday will It show up

  29. Dr Jeffrey,
    Thank you for taking the time to answer all these questions. I can see from reading through that you are weary about people in drug court or on probation, but I am involved in both. I have been doing extremely well for coming up on a year now and take my Suboxone as prescribed, and do not use any opiate pain medication. I came up positive for oxycodone on a urine screen recently, I did handle the medication however I did not ingest it! I was taking care of somebody who has a legal and valid prescription for it. My urine screen however, came up negative for ALL metabolites. My outpatient counselors are doing everything they can for me because they have seen the work I’ve accomplished and how I have changed my life They are sending the test back (it was already confirmed as positive ) to get an indication of whether or not there are metabolites under the cut off level. I already know there won’t be because I did not actually take it. Do you have any information or statistics on how it’s possible for the actual drug to be present without any metabolites whatsoever? Not even trace amounts? Or what kind of window I would have needed to find in order to get the actual substance in the screen but not any metabolites? I’m not trying to beat anything, I’m just trying to get as much information as possible.
    Thank You
    Amy K.

    1. Amy,

      I do not have any specific statistics for you on this. Oxycodone presence without metabolites can occur from someone putting oxycodone directly into the urine, or is=f there are trace amounts, more likely than not, because of a contaminated tube at the lab from a previous run (the lab should have that information on file from a previous run which they generally will share with your doctor, which would solidify your argument).
      The window of time is not really important for the question you’re asking, because that is only relevant if taken orally.

  30. I deal with colon cancer my question is short kind of. I’m in PM have a great record with my Dr well after my 3rd surgery I was given oxycotin from my surgery now I take oxycodone 15mg if I’m taking a drug test will the results come up the same as my oxycodone 15 mg or different my Dr and surgon know what’s going on they approved it. Im just curious as how it looks on a 12 panel test.

    1. The Vicodin was from an old script but Kaiser is strict about using old scripts from other doctors..
      Thank you for this website.

      1. Kaiser is the worst hospital for chronic pain victims.woodlandhills pain mng drs care how they look.you are nothing but a #.This is all fact.They don’t even stock oxycodone sad cuz look at all the old dieing people.i can speak for myself they add more stress than help.Id leave I just have major issues and afraid I may need surgery on what they say can’t be operated on.so I just live in tears.

  31. Dr.Fudin,
    I have been taking 1/2 of a 5/325 Vicodin for 7-10 yrs now. I only take it on occasion, when my Fibromyalgia is at a debilitating level. Sometimes it’s 3x in a week…sometimes it’s 4x in 6 mos. The problem I have is that since moving to NC, I can’t find a dr who will prescribe it. The last one I saw insisted that I had to be being dishonest about my use, since “no one can take hydrocodone for that long and not develop a tolerance or addiction”.
    Is it possible to use hydrocodone indefinitely without increasing dosage or developing a tolerance and/or addiction? Or am I just some freak of nature…lol.
    And do you think I would fare better at a pain clinic than a primary?
    Thanks so much

    1. Sarah, When taking hydrocodone intermittently the way you describe, it is certainly possible that physical tolerance would be minimal. By definition on the FDA website, you do not meet the criteria of being opioid tolerant at that dose, and therefore are considered opioid naive. A primary care doctor should be able to handle this, and more likely than not, for such a seemingly straightforward case, a pain practice probably would not accept you as a patient, and if they did, would not likely have anything to offer. If your new PCP wants a recommendation in the chart, we may be able to do a comprehensive review for him/her if I am contacted directly from your doctor to jeff@paindr.com.

  32. I go to a pain clinic where I receive 4 oxycodone 10 mg to take a day along with my 3 – 300mg neurontin 3x a day. I also take Kratom which is legal in the state of TN where I live, to help with my painkillers. Sometimes I don’t even have to take them. This has never happened in the 3 years I have been with them but I popped positive for a muscle relaxer called soma? I have never taken or been prescribed this drug. They treated me like a criminal and like I was a liar. They said the test was 99.9% positive for soma. I have no idea how it might have gotten there but have heard horror stories of people having false positives for things. When I told them I had never taken soma and I don’t take things that aren’t prescribed to me, they asked me if I brought in someone else’s urine. I was appalled.
    I was just wondering, with this drug combination if there is any way that soma could be possible to pop up? It also crossed my mind they either got MY urine mixed up with someone else’s or my test results one. I’m so embarrassed. It would be different if I had done what I’m being accused of but I haven’t. Please help.

    1. Lola, It sounds like a chromatography test, so the answer to a false positive is no. BUT, the lab column could have been contaminated. Ask your doctor to contact the lab to ask them if the previously run test was positive for carisoprodol.

  33. Hello my question is I’m going to a pain clinic I’m on hydrocodone 7.5 mg and Neurontin 100mg 3 times a day. I take it just like it says. Today they gave me a warning and said that it was not showing up in my urine test. I do not understand I take it exactly the way it says. I tried to ask questions and asked them to do a blood test but was told they do not do that. The urine test is what they do in the state of nc. Can you tell me why this would not show up?

    1. Hydrocodone usually will not show up in the urine at that dose if the test was immunoassay. If it did, your doctor should be concerned that you’re taking something else. Ask them to have the sample sent for defiitive testing by chromatography. If it’s just a couple of days, the lab probably still has the sample. See http://www.remitigate.com/urintel.

      1. Hi Dr.Fudin! 1st of all thank you so much for your blog & the info you provide. I have a form of cystic Kidney disease called MSK & it causes many problems but chronic kidney stones & gravel & daily flank pain are a real problem! I live in Florida & the laws are very strict now & make it very hard for legit pain patients. I am prescribed oxycodone 30mg every 6hrs. I hate taking meds & I’ll admit I push through pain & don’t take it unless I absolutely have to but with the new laws it is very likely that I could lose my pain Dr as well as medication I do need when the pain it unbearable. I didnt take it for nearly a week
        & Then took it as prescribed Sunday thru yesterday (Friday) I went out of town & forgot my meds on the kitchen counter & have not had it all day & I won’t be back home from my fishing trip until early Monday morning around 6am. I have an appt & the usual drug test at 8am. I’m a small female 5ft2in & weigh 107lbs. Will my meds still be in my system after not taking it since midnight Friday night was the last dose I had. I’m not chemically addicted as I only take it as needed & I push thru pain I can handle that doesn’t disrupt my life too bad. If I’m not positive though I could be under suspicion. The type of test they give me is a 12panel cup that is also a test. What is the likely hood that that type of test will pick up the oxycodone from last week until midnight Friday night?

          1. Please doctor help me understand something…I go to the methadone clinic and have passed all drug test for 9 years and I got a call from my counselor for a bottle verification and she told me I failed my drug test for opiates and I haven’t taken any drugs in 9+ years so I sent off for a confirmation urine test because I haven’t touched an opiate in almost a decade and worked so hard for my 2wk. Take homes. I would never ever risk what I worked for. The nurse there said the lab has been screwing up a lot lately on drug test. So I should have to pay for there mistakes I guess. I was wondering because I don’t know how the lab works but under the impression they have to take 2 samples one for an IA test and one for the confirmation test. Please tell me there’s not a way they could have contaminated my samples with someone else urine who was dirty. What is the possibility of them dropping someone else’s urine samples in mine and it being in both samples or dropping someone else’s in mine from the start causing all my samples to be bad….please tell me that cant happen and the 2nd sample will prove it???

          2. Samantha, The chromatography test is definitive, so that should prove you didn’t take any opiates. I doubt they mixed up the sample, but there are false positives with IA testing.

  34. Dearest Dr.Fudin I want to tell you what a wonderful person you are. I hope all of these people that write to you and read your answers and comments know how very lucky we all are to have someone like you advocating for us by helping explain the very complicated world of medicine. You are a very smart man and I am honored to be allowed to speak with you .

      1. Hello, I am on an opioid contract with my healthcare provider and have been for over a year. I have been prescribed Norco 7.5 every 8 hours. I take them like clockwork for my sciatica and went for a drug test about a week ago. I got a call the next day saying I needed to go to the lab for another urine drug test because it came back negative! I went as soon as I got the call and left another urine sample. I got a call from her MA the next day that it was normal. That was on Friday. Today I got a call from the office saying my prescription was denied because my second test came back negative for opioids!? I’m so confused. I take them every 8 hours. How could this happen? I thought maybe I drank too much water before taking the first test, but when the second one came back negative as well has me totally confused. I also don’t understand why the office called and told me it was normal Friday and my doctor called today to say it was negative. Should I ask to go to a different lab? I will be out of my meds tomorrow afternoon and my appt with her is Wednesday. If it didn’t show up when was taking them every 8 hours for the last year, is it going to be negative again after not taking them for a day?

        1. That dose of hydrocodone is expected to be negative for “opiates” on an immunoassay test. If it were positive, it’s indicative that you were taking something else. Your medical provider is interpreting the test incorrectly. If there is any questions, your provider should have the sample sent for definitive testing by chromatography. The lab probably still has the sample. Call your provider’s office ASAP and ask them to contact the lab and send it out as suggested above.

  35. Hello, I’m on a pain contract and prescribed monthly oxycodone, ibuprofen and tinzanidine (?) as needed. 5 days prior to doctor ua I was prescribed augmentin, benzonanate (?) cough pills & pseudoephedrine for severe sinus infection.
    Is there any chance any of these meds will have adverse effects with one another? Normally I get the ok from dr within days but it has been almost 2 weeks now.

        1. This happened to me at my suboxone doctor. I was kicked immediately. I’ve never taken methadone in my life.

  36. If you take 20mg. Hysingla twice a day how can there be a peak time to detect it in urine if its in you all of the time anyway?Does it show up as hydrocodone like the fast acting kind? I ddont understand why they even made it. Whats wrong with taking the regular kind that you can understand?The regular kind you can tell when you took it and know what to expect.

  37. I just want to pass some info that may help someone with chronic pain and aren’t familiar with a drug called Subutex. I broke my back in Iraq in 1991. Docs did no xrays and said it was muscle and gave me 800 mg Motrin to take 3-4 times daily. After a couple of weeks I could deal with the pain without anything although it was not totally gone. Long story short, it kept getting worse over time and I had back surgery and had 8 rods and screws in my low back. Surgeon said I should have been paralyzed. The pain was worse after surgery. It got to the point I was taking 90 mg morphine sulfate and 60 mg oxycodone to keep the pain level to a 4. Then, a doc put me on 2mg Subutex two times daily. Amazing!! It took all my low back pain away and I have no craving for anything else. No withdrawals. So, if you’re in pain all the time and tired of all the harder pain meds, ask about Subutex. I’m out of my depression, have energy, and think clearly.

  38. Dr. Fudin,
    I’ve got a quick question. Probably too late for me on this but may help others. I’m prescribed 4-10mg oxycodones/day. It’s been a long month and I ran short so I’ve only had 2 for the last 2 days, taking the last one last night. I may be tested today.
    My question is, will they know how much is built up or in my case, not built up in my system?? I’ve been warned previously about running out early so i’m a little concerned. Thanks in advance.

    1. Jim, I’m not here to help you trick or mislead your doctor. If you need more medication than prescribed, or you find yourself going down a slipery slope in terms of oxycodone usage, NOW is the time to have an honest discussion with your prescriber.

      1. Your advice is more than appreciated, but how is Jim’s question asking you to “trick/mislead” his doctor? I felt he was asking if he’s going to show not using his meds as prescribed. Of course, per his own submission he isn’t, but will that show on a test?

        1. I thought the same thing as Jamie. I didn’t read it as Jim trying to trick or mislead his Dr. Sometimes when my pain level is at an 8+ with my condition taking 2 or even 3 at a time is the only thing that gives me relief and stops the tears. So say this happens for 2 days with a really really bad flare, that causes me to be short 2 days. IF I had to take a test every month and I needed to have a positive result I would be asking the same question. My only question from Jamie’s post is Where do you live that you can even get that type of pain script? I have a bladder disease there is no cure and it acts like someone with cancer on chemo and it is sometimes debilitating and I’m prescribed Tramadol 1 50mg 4x a day. Even getting that is a challenge as I moved to the highest abused Meth/Opioid State in the Middle of the US from a less judgmental state who takes my condition seriously. I appreciate your Advice to everyone MR Fudin however your reply back to Jim is how I feel every Dr I’ve seen here in this awful state responds to me when they look at my past records and see back in Md I was treated with 5mg oxycodone 3x a day and assume it didn’t take years to even get to that point in my treatment. It’s why people sometimes look elsewhere for pain relief. I’m not there yet and I hope I never am. I’ll move back before I let that happen! But seriously, How do you get a Dr to look at you as a PATIENT and not a PILL Junkie? Serious question. Thank you!

    2. I am 63 yrs old and have chronic pain. I have never taken oxycontin in my life. I was precribe it in the beginning of being prescribed pain meds could not use it. I was so confused I took it to my Dr. My new pain Dr gave me urine test. It showed I had oxycontin. When I was given that was ten years ago. I think he wanted to get rid of me. The only pain meds I’ve used is hydrocodone.

  39. A bit off topic but I have wanted to ask this for several years…back in 2012, at the age 53, I became quite ill, confused, in a mania then almost unresponsive, ended up diagnosed with viral encephalitis, two hospitals and four months off work. When I began to become quite sick my adult daughter took me to the emergency room. They told her I was high on PCP! I had no clue what it even was nor knew where one would buy it at the time. My question I always wanted answered is “what could have been in my system that could show up falsely as PCP?” I read a few things on line and the only thing I read that sounded remotely possible was Benadryl as I do take it frequently. Any thoughts on any other possibilities? Luckily I have a great daughter who took me to my Dr the next morning (I have no recall of most of this) he admitted me after watching me shuffle in like I had Parkinson’s and him doing a eternal rub on me which I barely responded to. He said he had little hope I would come around, I was very ill. Anyways that’s my off topic question….

    1. Venlafaxine (Effexor), and antidepressent frequently causes a false positive PCP. If there was any question at the time, your doctor could have sent the sample for confirmatory testing by chromatography.

  40. Amber,

    I do really do understand your dilemma, but I cannot advocate for you to take any drugs that have not been prescribed. That can be dangerous and even cause death as you know.

  41. Wow, thanks for providing all this info and helping people. I had 12 surgeries last year on my groin and i’m left with excruciating pain now. I’ve been given a ton of different pain meds and pushed from dr to dr. My last pain dr wrote me a script for methadone and told me he couldn’t help me anymore to try the black market. Florida passed the toughest pain med laws last year and no one wanted to help me. I finally found a pain dr who gave enough meds to just barely tolerate the pain. He tried a spine simulator and it didn’t help at all for my groin area. I think he was upset when i came back a week later letting him know it didn’t help any. I keep telling him my pain is still not being managed, and he would switch meds and increase 5-10mg a day, and that doesn’t help. I asked about trying the pain pump implant and have it scheduled in a couple weeks. I’m currently on Morphine IR, and my insurance denied continuing the Morphine ER, and wanted me to try Fentynal patches instead. So the dr did write them, but he didn’t give me the equivalent of the Morphine ER that I was on. When I went to my last visit last week, he told me my urine from January showed THC and Percocet. He took urine again and told me if it comes back dirty he’ll have to quit seeing me and cancel the procedure. I’ve been prescribed Percocets over the past year, and they don’t help much. And I haven’t smoked weed in over 15yrs, it gives me severe panic attacks and sends me to the ER. My primary dr, urologist, and my disability coordinator all wanted me to try weed for my pain, but it’s extremely expensive, and i’m terrified of the panic attacks it would cause. And I haven’t taken Percocet since sometime last year and it was prescribed. I grew up in a small town in WV when Oxy’s came out and they took over a lot of lives. I moved away to get away from it at 15. And now that everything is being laced with Fentynol and i’ve lost family and friends to it. I have 4 nieces and nephew who lost their dad a couple years ago to it. I don’t do illegal drugs, and I’d be terrified of buying anything off the streets in fear of it being laced and dying. I know for a fact that I haven’t used any form of weed or percocets, and i have a feeling when I go back he’s going to say the urine was dirty. I asked him if I could go right across the street and buy a urine test kit from Walgreens and do it instantly in his office, but he told me they weren’t accurate. I’m barely managing my pain with the meds I’m on. If he takes me off and denies this procedure, I won’t be able to live with the pain. And it’s going to be in my file and no dr will want to help me. It sucks, because I know for a fact I should only have what’s prescribed in my system. I’ve never failed any drug tests from other drs and such for over 15yrs. I even quit drinking because it interferes with my pain meds.

    1. Russell, You should insist that your doctor do a definitive test by chromatography. There are many substances that can cause a false positive THC by immunoassay testing.

      1. Today is Sunday March 10, 2019 , I have a random drug screening tomorrow & Tuesday for family court purposes’ IAM a recoverying addict but I f-ed up Thursday and took a 30MG Percocet along with a 15MG on Thursday March 7th do you think it’ll be out of my urine by tomorrow which is the 11th of March

  42. Hi I failed my drug screen showing I didn’t take any of my Percocets I am prescribed even tho I took 3 (10mg) the day before. My doctor told me to not over take them, well I somehow managed to fail AGAIN my last visit. I go back in 2 days. I have 4 pills left. I NEED them to show up! How can I make sure they will be positive in my opiates and oxycodone panel? If I failed twice now, I’m terrified I’m going to be kicked from the program! Can I ask them to do a saliva test, blood test, or hair follicle test to prove I’m taking them, or will that sound desperate for them to believe me that I’m taking my meds? I’m female 5’8 around 240 lbs (yes overweight , but my pain prevents me from exercising)

    1. Tell you doctor to do a definitive test by CHROMATOGRAPHY,

        not an immunoassay

      test. You will be fine if you’ve taken it within 4 hours. Do not take extra medication just to pass a test that you will otherwise pass if the correct test is done.

  43. I took one 5mg/325 oxycodone pill last Saturday. I was randomly drug tested today (Friday). What are the odds it will show six days later. The test was a urine test and I have been drinking a lot of water. (Gallon a day minimum)

    It was one of my old pills from a few years ago from surgery. I took it because I hurt my back. I only took the one. I don’t have a bottle or anything to show it was mine. The test was a random one at my job. I’m just worried because I don’t know if I would be able to prove that it was mine at some point. Any advice (besides getting rid of the other pills because I already did since I can’t prove they’re mine) would be welcome.

      1. Also, thank you for the advice. I did call the pharmacy and they have a record of it. That makes me feel better having that proof. I just wanted to be prepared if for some reason it showed up and I had to prove to my employer that it was mine. Although from what I’ve read here, 2-4 days is the norm for a positive.

  44. I took half a 5mg hydrocode on Sunday around 12PM, I have a drug test today… it’s been about 48 hrs… the medication is prescribed to me but I really dont want to explain myself to my command. I’m in the military. Will it show positive? Can drinking tons of water help?

      1. Hey I took around 60 mg of oxycontin instant last dose I have terrible back pain chronic Sunday night I have a drug test Wednesday morning I used to get prescribed but with my insurance I haven’t been able to see a doctor my first appointment for evaluation is a month from now. Will it show up?

        1. Jesse,

          This is so similar to the post by Allen, it makes me wonder if one of these is an alia. Look back and see my reply to him. I’ve pasted it below…

          Allen, Taking someone else’s opioids is extremely dangerous, irrespective of whether or not you’ve had a different dosage form of oxycodone previously. It is because of this behavior that chronic pain suffers, such as your wife, have difficulty obtaining their medication and also why several state governments, community pharmacies, and insurance providers have begun limiting quantities. An injury such as you described should have been treated in an emergency room or urgent care. If it was bad enough, it may have required an antibiotic or other treatments, and if opioids were appropriate, you’d have a legitimate prescription. For the record, the FDA approved indication for OxyContin is “an extended-release (ER) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment for which alternative treatment options are inadequate”. Now that you’ve listened to me, if it’s an immunoassay employment test, t probably won;t show up. If it’s chromatography, you’re right on the boarder tomorrow for positive versus negative. Lesson learned, I hope!

      2. Hey I have a pre employment urine screen Tomorrow(Tuesday) at 10 am. Pretty sure it’s a lab test. I burnt my hand on a stove Saturday and took my wife’s prescription of Oxycontin I used 2 pills each day about 60 mg total my last dose Sundaynight I’m very nervous about my test. I don’t smoke weed or use any illegal drug for that matter I was in a lot of pain. I used to get prescribed oxy for my back surgery a couple years ago then got hudrocodone. I don’t have any of the scripts bottles from back then and I can’t see my doctor till early April.

        1. Allen, Taking someone else’s opioids is extremely dangerous, irrespective of whether or not you’ve had a different dosage form of oxycodone previously. It is because of this behavior that chronic pain suffers, such as your wife, have difficulty obtaining their medication and also why several state governments, community pharmacies, and insurance providers have begun limiting quantities. An injury such as you described should have been treated in an emergency room or urgent care. If it was bad enough, it may have required an antibiotic or other treatments, and if opioids were appropriate, you’d have a legitimate prescription. For the record, the FDA approved indication for OxyContin is “an extended-release (ER) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment for which alternative treatment options are inadequate”. Now that you’ve listened to me, if it’s an immunoassay employment test, t probably won;t show up. If it’s chromatography, you’re right on the boarder tomorrow for positive versus negative. Lesson learned, I hope!

          1. Hello, I was prescribed 10mg hydrocodone 2x daily or as needed for a fib/tib break. My last dosage was only a half (5mg) Friday morning at 0900, that was 55 hrs ago. I’m taking a urine drug detection test on Monday morning 0500 at the hospital. Will they be able to detect the hydrocodone in my urine analysis? It’s for a scheduled surgery, they asked me to stop taking it prior to surgery as I will be tested, prior to my surgery that day..

    1. I’ve had gastric bypass and recently started on adderall xr 10 mg. My reg doctor is out for a month and his sub had me take a drug test for it and it came back negative. Unfortunately it was 6 days after my script ran out. Is my bypass a factor in it not showing up as well as the time between my last dose and the test?

  45. I have a question about my Oxycodone 7.5 that I take 1 every 8 hours for pain. It is my medication. It is prescribed to my from the VA hospital as I am a Veteran. I take my medication daily and it is rare that I miss. I am overweight. I am at 300lbs at 6’tall and 55 years old. I have multiple problems as well as kidney issues and blood clots. I take a boat load of medication. Here is my question. I had to go to the VA for blood work and urine test. I know I have to be tested every so often because I am on the Oxycodone. I went in on 02/13/2019 and just received my results today on 02/16/2019. My results showed negative for opiates? How can this be? Is my body eating up the medication? Am I not taking enough for my body weight? Is it not showing because of my Rhabdomyolysis? I have a appointment to see my PC Doctor on 02/25/2019 she will think I am selling my pain medication? I am not. However the one pill every 8 hours does not do the job, I still take my meds like clock work. Can I have a opinion on what’s going on? Thank You

    1. It was probably an immunoassay test. They should send the sample out for definitive testing by chromatography testing or do a specific test for oxycodone on the urine, called an “oxycodone screen’> What they likely screened for is “opiates”, and oxycodone won’t always show up.

      1. Hey, so I have a probation urine lab screening my first one Thursday at 11am. I’ve been taking instant release oxycodone 30-45 mg daily for the past month. My last dose was Monday at 11pm 45 mg and I have a test Thursday at 11 am. I am 5”11 170 lbs is there a chance if I work out And drink plenty of water I will be clean by Thursday morning?

  46. Hello again. I have spoke with you numerous times lately, and I hope I am not becoming a pest. This willbe my last question I can assure you. My doctor wants me to try something called belbuca 75mg. film strips. Is this an opiate drug? Is it extended release and drags on forever or does it work fast? He said he could call it in but I thought you had to hand deliver.

    1. John,

      Belbuca is an ATYPICAL opioid. It has opioid properties and works the same way, but it has a ceiling effect on carbon dioxide accumulation and is therefore safer than traditional opioids. Yes, it works within 3-hours, but is intended for chronic use around-the-clock, because it sticks around for a long time. It is not a strip. It’s about the size of half a tic tac, a small square “film” that sticks to your cheek. When dispensed by the pharmzcist, make sure you speak to him/her for directions on how to use it. See Buprenorphine, so misunderstood.

  47. If the urine test is a chromatography one and you take 1 20 mg hysingla at 7pm tuesday and another at 8 am wednesday and 1. 10 /325 mg hydrocodone at 1pm. and the urine test is at 4pm will this hydrocode dosing show up or not?

  48. My daughter as well as myself both take hydrocodone.she said that if she took one of her 20 mg hysingla tonight it would still be in her able to show in urine 24 hrs later and I disagree. No one pill can do that. Whos right her or me?

    1. John,

      It will show in her urine if the test is a chromatography test. It may or may not show as “opiate’ by an immunoassay test. Remember, Hysinglas is a 24 hour release dosage form, so a 20mg dose is like taking hydrocodone 5mg 4x per day.

  49. My doctor gives urine test where the results are ready in 20 minutes right there in his office while you wait. I took 3 10 325 hydrocodone yesterday and 3 today. My appt is in 1 hour if it comrs back negative does that mean he is just wanting to run me off so he wont have to be bothered with me anymore?

      1. I have been in pm for about 4 yrs now and I am prescribed hydrocodone, 2 10mg tabs twice a day as needed for pain. Sometimes I take it exactly as prescribed but most times I only take a total of 3 a day. My question is When I give my urine samples do they show the difference in levels? I’ve never been talked to about my test results so I guess that’s good but after reading some of these posts it just made me wonder.

        Thank you!

        1. Urine levels will never hold up in court to predict specific dosage taken – for that you need blood levels. Also, immunoassay urine screens, if they test positive, just tell you that there is “opiate” present, not that it is hydrocodone. A chromatography test is more specific and tells you that hydrocodone is present, how much is present, and how much of metabolite is present.

          1. So, I think my clinic does the 2nd one you said because they have to monitor each medication you are on. They always ask if anything has changed and when the last time I took my hydrocodone and the last time I took my tramadol. So if this is the case, they can tell whether I’m taking my full doze or half of me dose, correct?

    1. Thank you. I dont know the difference between the names of the test, I have no experience with any of this
      It just seems like no matter what you do if a doctor gets tired of you then they will nit pick and lie to be rid of you
      Personally I do not see how it couldnt show up no matter which test they give. But its there office.

  50. If you take hydrocodone and eat poppy seed bagels constantly because I love them with cream cheese, and you take a urine test where the results are ready in about 20 minutes will it really come back as morphine.mix with the hydrocodone or just be opiates?I have never heard of this before. My friend told me this and now I am very confused.

  51. I took 3 5 mg oxycodone pills Saturday ( between 11am -10pm) I have a urine drug test Tuesday at 1pm will it show up in my urine?

      1. Yes But not recently. I was prescribed them November of last year for my tooth ache but I never used them all and Saturday I took the last 3 because of really bad cramps. It’s a urine test for pre employment

        1. Towanda, First let me say that if there were menstrual cramps, NSAIDs such as ibuprofen (at the correct dose) work far better than opioids. That said, whether or not you test positive in general depends on the type of test. The good news for you is that this dose will not stay around for more than 24 hours assuming normal kidney function.

          1. I did this as week. I got one 7.5 Monday and another 7.5 Tuesday. My tear if this Friday? Will that still be in my system as well? I too had mine for a previous medical issue but didn’t take all of them.

          2. It’s possible it will test positive up to 3-days following your dose, but it depends on the type of test. Why don’t you just tell your doctor that you had an old prescription and bring in the bottle? If you feel guilty about taking them, you probably know you should not have. If something bad happened to you, how do you think your presribing doctor would feel? Not having a trusting relationship with the prescriber is one of the reasons we are in this mess. Nobody prescribing opioids should have to be a detective or mistrust their patients. But, reading through all of the comments on this post really helps to justify why prescribers are fearful of writing controlled substances. On the other hand, I certainly understand why patients are justifiably paranoid about telling the truth. It is really a dilemma.

  52. If you have a urine test at 3pm wednesday when is the best time to take hydrocodone for it to show up positive?they said the test came back negative last time. I dont take it constantly so when is the best time. It is a 10 325 mg hydrocodone tablet. Thank you

    1. If you don’t take it constantly, why not just tell you doctor that? Also, depending on the type of test he/she is doing, and your daily dose (up to 40mg per day), it might not show positive anyway.

      1. How does a person get benzo out of the system withi 2 day’s?Not asking got me ,buy a friend who has a job interview.He took a Xanax today&has a urine test Sat.

      2. You’re not allowed to take pain medication as needed per my doctor. The written prescription states to take 1 every 12 hours period. It’s ridiculous because somedays I need one every 8 hours for extreme pain and other low activity days I can get by on 1…if I told my Doctor he would just cut me off. It’s a no win situation these days and hard to stay In compliance.

  53. I recently had a surgery and i ran out of the vicodin, as i havent been back to the dr. I took half of a 10mg percocet which i was prescribed before the surgery on sat and had a mouth swab for a job today (wednesday). I have a UA tomorrow. Do you think i will fail either one for the percocet i took on saturday?

  54. Recently had an accident at work, i was not drug tested untill 3 days later, after the ER and hospital stay, and on prescribed medication..recieving numorous meds while in the ER and hospital, such as Morphine,a Dex something … because i did not like how the morphine made me feel so they gave me a different medication, antibiotics,and recieving numorous pain meds in the overnight stay at the hospital,along with meds in the ambulance,and I was prescribed oxycodone and Tylenol..now they are saying I failed drug test , (of course i would 3 days later) for opiates, ..hydrocodone ,and oxycodone…will the oxycodone or morphine give a fasle positive for hydro? I dont take hydrocodone ,i dont know why it would show a positive, unless it was some of the numorous medications i was given or a false positive…???

  55. Recently had an accident at work, i was not drug tested untill 3 days later, after the ER and hospital stay, and on prescribed medication..recieving numorous meds while in the ER and hospital, such as Morphine, … because i did not like how the morphine made me feel so they gave me a different medication, and recieving numorous pain meds in the overnight stay at the hospital,along with meds in the ambulance,and I was prescribed oxycodone and Tylenol..now they are saying I failed drug test , (of course i would 3 days later) for opiates, ..hydrocodone ,and oxycodone…will the oxycodone or morphine give a fasle positive for hydro? I dont take hydrocodone ,i dont know why it would show a positive, unless it was some of the numorous medications i was given or a false positive…???

  56. My question is I have been on pain management for 8 years I have been taking 310 MG of Hydrocodone and I was on hundred fentanyl patch as of July doctor reduced my medication wean me off completely of the fentanyl patch and changed my hydrocodone a Percocet I was able to backlog some of my hydrocodone because I have a mail order pharmacy and I was told by my doctor’s office they could not give me extra medication only 30 day supply so it might be a good idea to put some away for when your medication did not arrive on the day you run out of Medicine the time I was switched over I had approximately saved up 20 hydrocodone tablets and this was in October I had a drug test in December and I tested positive for hydrocodone in my urine when I was prescribed Percocet these are all medications that were prescribed to me I do not trade sell or give away my medicine I am just afraid that my doctor is going to dismiss me because I tested for something else and I can understand why it is so strict now I have read some of your blog’s most of the people on your blogs have a legitimate fear of being dismissed but I can see on here that there are people that are trying to see and work around the situation which meat has made it so difficult for legitimate people false positives and other situations doctors do not want to even hear it anymore because people have manipulated the system so badly that they’re in fear of losing their license what should I do if I lose my doctor and how difficult is it going to be to find another doctor

    1. i had same thing happen and yes i got kicked out..not hard to find a doc but they wont usually treat u with narcotics again because the old doctor usually flags u..it took 4yrs for me to find a doc that would treat my pain again..good luck..u just have to keep looking

  57. I would like your professional advice. I was given a 28 supply of my pain meds. I should have enough for 7 more days. Due to the holiday schedule, I am being seen a week early. I took my last dose yesterday. While cooking on xmas, I severely burned my finger. The pain was terrible and for several days, I doubled up on my meds (5/325 Norco). Should I be up front with my doc or just keep my mouth shut and rough it out until my new script is able to be filled?

    1. I can’t predict how your doctor will respond, but you should not have doubled your dose regardless of reason. That is how people end up with problems and then the prescribers are left accountable. It sounds like you know you did the wrong thing. My advice is that you are always honest with the person prescribing your medications because if there isn’t a mutual trust, neither one of you are safe. If you told me and you were my patient, I would put you on a medication to prevent withdrawal for a week and I would provide a new prescription for your Norco when it was due, with increased monitoring and closer follow-up until I was ensured that there is not a behavior problem in order to keep you safe.

      1. Hi I was wondering does codeine show up when testing for Percocet whats the difference between testing results for norco & percocet?

        1. It depends on the test. If it’s immunoassay, that tests for “opiates” and codeine will always be positive, but low doses of oxycodone may be negative and require a confirmation by chromatography. If the test is chromatography specifically for oxycodone, codeine will not show up. Generally if chromatography tests are ordered, codeine and oxycodone will be included in the order, and therefore both would show up as separate findings. There will be no difference in lab findings between Percocet or Norco.

      2. Like Dan Fogelberg says……Your conscious awakes and you see your mistakes and you wish someone would buy your Confession……..

  58. I need to know I took valium instead of my Klonopin here and there no more than 25 milligrams spread out mid November to mid December 2 5 milligrams ;ast dose others just 5 spread out week or 2 . I have Pm apt 23 January but thinking of going late and doing a deep permanent clense . Will they see metabolites like oxepam in urine drop right there in office visit before sent out to lab being that’s the last to leave your system and show you used valium ….. I would think the parent diazepam and nor diazepam should be out after 7 weeks . Worried about temazepam and oxepam should be out making it an extra week 7 and 4 days to clean out but still keep my meds in have time but not sure with other toxins if its enough time. THis will be a close one I cant exercise do to pain much another bad thing . What should I do at this point I have a different doctor prescribing me my benzo’s ive been on 225 yrs therapeutic dependence and brain injury so I cant be taken off of it by my Pm. Im conserned about being able to function walk take care of my child if they terminate me on a dirty . Plus don’t want those records to go to another dr seeing as no one in my state since im on benzos want to prescribe or are willing …. I lucked out with her and don’t want to let her down I ran out of and lost a few of my klonopins and didn’t want to go in benzo withdraw plus its dangerous …. No I didn’t have a script for these valiums had no clue how long they take to get out of system inn a way they are worse sticking in you than thc …. I would have never risked losing her and toughed it out . Im not sure if I should tell her I accidentally took one of my fiancés because of my night terrors just in case it was late at night and lie just in case she detects one of the metabolites in my system …… what is my best bet in this situation im almost out in need a parking sticker have trouble walking …I also ha ve lyme disease ……. mentally im a wreck right now please help

    1. Nikke, It is never a good idea to take medication that was not intended to be taken with or without your currently prescribed medications. My suggestion is that if you ever feel like you need a higher dose of Klonopin, you should discuss that with your doctor in advance of panicking and taking other meds. You place your doctor in a very precarious situation by doing this and you also risk danger to yourself. Often times it is the anxiety and panic that drive a person to take these medications. I suggest that if you need to take these, that your primary care doctor communicate with you and a psychiatrist in order to establish the best next steps. You are correct that abruptly stopping benzodiazepines could be dangerous, but you fail to mention the potential poor outcomes to you of taking more than prescribed, other than disappointing your doctor and losing an opportunity to remain on these drugs. The biggest issue here is danger to you. It is therefore my recommendation that you be honest with your prescribing clinician rather than dig a deeper hole if he/she finds out you were dishonest.

  59. Background Info: I’ve been seeing my physician every month for 14 years for lower back pain. I was drug tested every visit, Surgery is not promising and physical therapy, acupuncture, nerve blocks, etc… does not seem to work. At one point I was prescribed (4) 10mg hydrocodone / day. It was too much, but over a couple years of trial and error, I found that (2) 10mg per day worked perfectly. Since the war on opioids, my medications has been reduced by 60% to 7.5mg / day, Now my doctor cut me off completely because I failed a drug test. The UA showed that there was no drugs at all in my system. NONE. My last drug test at work also show a negative result for opioids.

    Is it possible that taking a 7.5mg dose of hydrocodone 24hrs prior to a UA would show as a negative result? If not, why did the results show as negative result?

      1. My husband has been a chronic pain patient for a while. When he recently did his regular urine test, it came out negative and we’re not exactly sure why. He took his norco just 20 minutes or so before doing his test, so shouldn’t it have shown up?
        He’s prescribed 7 pills of 10mg norco per day, and takes it regularly.
        Now that I think about it more though, he did have a pretty nasty stomach bug just prior to the test. I’m not sure if he took his norco or not while he was stomach sick for those couple days.

        Do you know why he may have gotten a negative test result?

        1. Rae,

          At 70mg per day, it should be positive for “opiates” on an immunassay screen – there is a small chance it wouldn’t. If instead the test was chromatography, it would be specifically for hydrocodone and should show up, as long as he took the daily dose you stated and within 5-6 hours of his last dose. But, if he took the urine test 6-8 hours after his previous dose, and took the most recent dose just 15-20 minutes before the test, especially on a full stomach, it’s possible it would not have tome to be absorbed into the blood stream and get filtered through the kidney. That would account for a negative test.

  60. Im prescibed suboxen but had a tooth pulled and took 25 mil grams of oxycodone that was 5 days ago will it show up on a 7 pannel drug screen for urine

  61. Dr Fundin,
    I am prescribed 7.5mg of norco bid, baclofen 10mg tid, tamoxifin qd, effexor 25mg bid, and diazepam 2mg tid. I just recently went to my physician and she said i wasnt taking my norcos and that i was selling them. This came about that my urine test did not show the metabolites for long term use. I have cervical stenosis, osteoarthritis and recovering breast cancer patient. I have to take my meds if I dont I cant function. I do not sell my meds it is illegal and my husband is a LEO. What could possiblly be going on? I can truly say I am taking my medication as perscribed, but she thinks other wise…Help!

    1. Make sure the test done was liquid random chromatography. Perhaps they are doing what’s called a semi quantitative test. Also, if any questions remain, I suggest a serum level of hydrocodone by Quest, Labcorp, or Firstox. And you could also do a pharmacogenetics test that will explain your metabolism, but be sure it includes cytochrome P450 (CYP) 2D6 snd CYP3A4. Those are the enzymes responsible for breaking down hydrocodone.

      1. Don’t you so hate when they tell you what you’re not doing. I’m facing the same thing. I have liver disease, COPD, neuropathy both feet, kidney prob, and take morphine sulfate ER with several meds for diabetes and depression anxiety plus others. One said I showed Narcan which is overdose med they just have me. Those metabolites are screwy. Cuz I have the Narcan still not opened and I’ve been sick for 18 yrs. Why would I screw up and take it knowing it would show. They had just changed test companies and so many things not right. I offered lie detector test, to prove innocent. I have to have these meds to have a decent life. I read on treatments, new meds, try to understand metabolites and stay informed for my knowledge. I’ve got family.I don’t want to die, my body is addicted to meds but not my mind. But they don’t even give us the benefit of the doubt. Soooo maddening to be in the right and they won’t listen. Still trying to prove it after a year. Looks bad on me to other docs. But I did read that my sleep aided can be a false positive then another med for opioid constipation throws off metabolites like they found. Still arguesxwith me. So now we wrote it all down what we’ve found. I will find a reliable person to help me and they will put it together. I don’t want illegal drugs and I have to have meds to get by. Its so very sad that people get treated. I go the ER And I feel like I have to take facts for doc to prove all this. I cannot be in this pain. I will end it all and come back to haunt their asses. Hope to all others that going thru this. I hope you can find that one person to help you. If I just could to and get on with my life. Is love to play with my only grandson.

        1. I just had the same thing my doctor told me I had fentynal in my system, but I don’t, the only thing different from what she prescribed is kratom which I take to get up in am.

          1. I also take Kratom and tested positive for fentynal. I was shocked and didn’t know this could happen. Why is kratom coming up positive for fentynal? I’ve never taken that in my life.

          2. KMW, I wish I could answer that question. I can’t think of any theoretical reason why this should happen unless the lab equipment was contaminated.

  62. Hello,

    I did not realize that after Oct 2018 you would now be required to take a piss test to continue with norco ( 5/325 ). My prescription is for 30 so I have to go in usually once a month… sometimes every other month. The prescription is for sciatica and tendentious ( upper left shoulder ). Seems ludicrous that i’d have to do this. I take them exactly as surprised… it seems like i’m being treated like a drug addict and I do not like it 🙁 I don’t do illegal drugs. Sometimes alcohol and marijuana ( the edibles takes care of the pain… albeit I obviously don’t want to be at work using that for pain. ( marijuana is legal in CA ). I guess what i’m trying to ask is: Is there anyway around this and still get my prescription ?

        1. I don’t know what happened at your appointment but I’m going to respond as if you are still looking for an answer. Usually there is a stipulation in your chronic opiate therapy contract about agreeing to take a urine test within a certain time every time your prescriber requires one. If you don’t, they can terminate your opiates and even discharge you from the clinic. Really, the doctor is doing it to protect themselves, bot because they think you are selling your meds or misusing them. If, at any point, it came to light that you were selling/misusing your meds the doctor could be held responsible.

          Regular drug screenings for chronic opioid patients is included in the CDC’s guidelines for prescribing chronic opioid therapy. They are probably checking your state’s Prescription Drug Monitoring site as well, you just don’t see them do it. It’s simply standard practice and we all have to go through it.

  63. I have a question. I think I have either a stomach bug or food poisoning. I can’t keep anything down, including meds. I have an appt tomorrow and am concerned that if I have a drug test, it won’t be positive because I’m sick as a dog. My prescription is for 5 325 of Norco.

    1. If you’re visiting your doctor because you’ll ill, I’m sure he/she will understand. If you’re not taking your opioid and previously took it regularly, what started out as nausea and vomiting from a bug may now be withdrawal.

      1. Definitely not withdrawal. I think I was a victim of our holiday potluck. I became ill not long after lunch. No vomiting, just terrible diarrhea and nausea. I’m actually afraid to eat anything, but crackers and ginger ale. My appointment is my normal monthly appointment. I’m reluctant to cancel since they have a short schedule with the holidays coming. I figure if I don’t feel better by Wednesday, I will see my primary. I know if it’s just a bug, they are going to tell me that it needs to run it’s course. I just don’t want the pain doc to think I’m diverting meds if I test neg.

  64. i have been perscribed hydrocodone for twenty years 3 times a day 7.50 mgs if i stopped taking them for two weeks will i test negative for them

  65. I had foot surgery nearly 8 weeks ago, I’m still in an air cast. I’ve had many surgeries in my life and generally pain medicine makes me sick to my stomach and feel like vomiting so I try to cut it off asap. I have no addiction tendencies because they make me so sick. As a result, I still have 26/40 pills hydrocodone acetaminephen 7.5/325. This afternoon, My back pain (seeing a chiropractor regularly) from the uneven shoes (left cast and right shoe), was aggrivated by a heavy lifting task, and associated stumble in the dark. So i took one of the hydrocodone and acetaminophen pills for the first time in 6 wks I would guess about 5pm today (Monday). I feel like vomiting now so I’m stressed out. Anyway, afterwards, I remembered I have to take a drug test at my discretion at some point before the end of business on Friday. Will I be clean from the one pill by Friday?

      1. If I took Norco 7.5 on a Saturday and then half on Tuesday and Wednesday will it show on urine test Thursday morning?

  66. Nikki, Nothing you are taking should result in a positive for hydromorphone. It is a minor metabolite of morphine (and therefore codeine), and also hydromorphone. The only possibility would be contamination of the lab equipment, in which case the levels should be extremely low.

  67. Hello, Dr. Fudin. I sent this to you in an email, because I originally missed how to post it here. I’m hopeful this will reach you in a timely manner.

    I was diagnosed with Reflex Sympathetic Dystrophy 14 years ago; since the onset of RSD, I’ve been prescribed oxycodone, 30mg x5 daily (from 4 to 5 earlier this year) and fentanyl patches 75mcg every three days. For the first ten years after onset, I lived in NJ and was a pain management patient with a contract, with random UDTs. For the last four years I’ve lived in Florida, am a pain management patient with a medication management specialist, on a contract and monthly UDTs. I don’t know what the test type is and unfortunately, the restrictive nature for chronic pain patients here makes it inadvisable to ask what type of test they use lest I be suspected of gathering information in order to “beat” the test.

    For the 14 years I’ve been subject to UDTs, I have had two “issues.” The first was two years ago; my best friend from NJ was visiting and we had a beer at a club. My pain management appointment was the next day and, at my subsequent appointment, my specialist asked if I had had alcohol, said that it showed up in the test, and basically wagged his finger at me. Abstaining from alcohol isn’t a problem for me and I haven’t had alcohol at all since that time. The second issue with a UDT was last month, and it’s this that I hope you can shed some light on, because I’m actually fearful of my 12/6 appointment, at which time I’m sure there will be a conversation and questions I legitimately can’t answer.

    After my UDT at my November appointment, I got a call from a PA at the specialist’s office, who asked me if I could explain why the UDT was positive for hydromorphone. I had no explanation, as I take only the medication that’s prescribed to me. My access to the meds I need in order to have even minimal quality of life feels precarious under the best of circumstances; I would never do anything that might lead to my being fired by my doctor and blackballed so that no other specialist will take me as a patient and no pharmacy statewide will fill for me.

    In addition to the oxycodone and fentanyl patches described above, I am prescribed 100mg gabapentin daily, 75mg amitriptyline for neuropathy caused by a herniated disc that presses on the sciatic nerve and 200mg sertraline for major depressive disorder. I know for a fact that there was not hydromorphone in my system, it is literally impossible. My next appointment is 12/6/18; could you tell me if there is anything in the meds I take that would cause this false-positive, and what my response to the questions I expect might contain.

    Lastly, I have a question about levels. There are some days that I don’t need five oxycodone in a day, perhaps over three days, and if I’m having a good pain week, I sometimes don’t need more than three a day several days running. I wouldn’t even be asking this question if I didn’t have some trepidation about my next appointment; if I take three pills a day in, say, the week before my next UDT, could the resulting levels of oxycodone possibly create a suspicion that I’m not taking my medication?

    I hope to hear back from you, and I thank you for your attention and your generosity in answering questions like mine.
    Nikolette Adams

      1. Nikki, There is nothing you are taking that would cause a positive hydromorphone. And why would you anyway, since you have RX’s for other opioids? Taking you at your word, the only way this could happen is if the sample got mixed up (not likely) or if the lab equipment (columns) were contaminated from a previous sample. An extremely low, almost non-detectable level would be indicative of that. The lab could be contacted by your provided to see what samples were run prior to your test to see if that is a plausible explanation. By law, the lab has to cooperate.

        1. Thank you so much for your reply,, Dr. Fudin. If you don’t mind, I’d still like your input on how medication levels may be affected if I’m having a good pain week, and I take three pills a day instead of five, in, say, the week before my next UDT, could the resulting levels of oxycodone possibly create a suspicion that I’m not taking my medication?

          I feel fortunate to have found your site. I’ll be sharing the information with my pain specialist and I’ll be a regular visitor. Thank you again.

        2. Thank you for your reply, Dr. Fudin. If you have the time to address my question about med levels, whether before or after my 12/5 appointment, I would appreciate it. I ‘m prescribed five 30mg oxycodone per day, as needed for breakthrough pain. if I take three pills a day instead of five in, say, the week before my next UDT, could the resulting levels of oxycodone possibly create a suspicion that I’m not taking my medication?

          I appreciate knowing that the lab has to cooperate if my doctor doesn’t accept my opinion that the UDT’s finding of hydromorphone is a false-positive. While I am fortunate to have a pain specialist in Florida that doesn’t automatically fire a patient for “dirty urine,” I’m keenly aware of the potential destruction of quality of life should that ever happen.

          Again, you have my gratitude. Nikki

          1. Nikki, It certainly is possible with a savvy provider, but predictability of dose is far more accurate by blood than by urine. The bigger question is why are you taking 3 per day instead of 5 per day? These are the sorts of things that drive me crazy when my patients come in for follow-up and aren’t telling me the whole truth (I needed less, I’m keeping some for a rainy day, or whatever the reason is). I find out eventually, so it’s always better to just tell me up front.

          2. Dr. Fudin, I’m prescribed the oxycodone for breakthrough pain. The nature of RSD is that pain can be at 7 for ten days and 3 for five, etc. Sometimes the fentynal patch controls it well and I have less breakthrough pain. I don’t understand why any chronic pain patient should be expected to take the maximum allowable dose every day if pain levels don’t require it, any more than I can understand why I shouldn’t feel comfortable telling this doctor that.

            I don’t save meds for a rainy day or otherwise. I’ve been taking these meds for 14 years. If I were still in NJ, I would feel totally comfortable telling my doc that I had a good week, because in NJ, pain management specialists aren’t paranoid that every patient might be a drug seeker that could cost them their practice. In Florida, that is the reality. I can be fired for any reason here, and if that happens, I am blackballed. No other practice will treat me and no pharmacy will fill for me, because I have no recourse.

            I don’t like taking these damned meds. I would so much prefer that I could go back 14 years and never contract RSD. I take the meds as prescribed: for breakthrough pain. In Florida, the relationship between a chronic pain patient and their doctor is a tenuous one, in which the patient always loses.

            Thank you again for your reply.

          3. You should try telling this to your doctor and bring your medication with you, so you can prove that you have them. But I would be pleased that you limit yourself when you can.

  68. My dr prescribes ultram for my hip pain and trazadone for sleep. In order for her to refill my prescription I had to provide a urine sample. It’s the 1st time I have had to do this. Recently my pain has gotten so bad I will take a whole or half of a Norco 10 that she does not prescribe me.
    I received a call back today to come in and discuss my lab work. Do these 3 meds show up the same or different. I do not know much about this type of thing and I’m just anxious to know what she may want to discuss. I do not abuse any of these meds, m pain has just been really bad lately.

    1. Hydrocodone shows up differently. It is in part this type of behavior that gets doctors into trouble if they continue to prescribe your meds. It also places you at risk of harm. These drugs require a prescription for a reason.

  69. I’m scheduled for a urine test soon and been on medication for years. Born with extrophy of the bladder and having my hips and pelvis broken and reset to walk when I was a child. This also lead to having to have my back fused because the disc are deteriorating. I never been tested before but I know having a bag often changes the results.i have been working for over 40 years and I have been seeing a doctor or doctors my whole life. They treat me for the hip and back pain along with the new feet pain. Been to many feet doctors and now because of nerve damage in my back my feet are extremely painful. Still I go to work every day. I have had over 14 operations in my life to date. I’m afraid I’ll lose my job because the pain meds that I don’t abuse but know the less it will show up. The bag also gives crazy results. Not sure what to do at this point? Any suggestions?

  70. I have a much similar question to most of these……. similar. I am prescribed hydrocodone 10mg/325mg, and soma 350mg. I normally don’t take more than prescribed, but last night i ended up taking 2 hydrocodone instead of 1. It seems it’s losing its ability to provide relief. To try and avoid taking more pills I did something really stupid and smoked some pot. Is my doctor going to test for the pot, and will my doctor know i took more than 1 pill? I know I should just tell him about the pot, but how will that affect my pain management contract?

    1. Bob, You should tell your doctor to stay safe. You did two things that might drag you down a slippery slope if you lose control It seems that at this point you’re thinking rationally, but that could change. I don’t know iof your doctor tests for marijuana or what the outcome will be regarding his/or approach to this.

      1. Thank you for such a fast reply. It’s not like i get a large prescription for either of my medications (10 day supply to last for 30 days). I go in for a med check today and am worried that I will get tested. I don’t abuse my medication, and really don’t even want to take it. I guess I’m just wondering how in depth the rest actually is. Obviously doctor will test for the meds prescribed, but what about thc? I guess that’s the only thing I’m concerned about.

        1. Bob, It’s hard to know. Some doctors test everything with very accurate tests, and others do screens. Also, some have stopped testing for marijuana since it is so prevalent, but in order to maintain due diligence, most still include it because whether or not it’s legal in your state, it is still a drug interaction and could be indicative of “chmemical coping”.

  71. What happens if you have PTSD and can’t give a urine sample…… and you have doctor excuses and no alternative was given……. ????

  72. I took one hydrocodone 5mg yesterday for my toothache and I have drug test coming up tomorrow. Will that one pill show up in my drug test? I don’t take these regularly

      1. Hi I’m prescribed Norco 750 for pain in my knee I ran out and took a few Percocets the night before and took a drug test today it’s a five panel will I fail that test?

          1. I understand your concerns. My concern is that you took a drug that wasn’t prescribed – that is dangerous. Most general screens test for opiates only, and do not distinguish between hydrocodone or oxycodone, and it may even be totally negative because both of these are synthetic opioids. But, if it tests opiate positive, the policy might be an automatic confirmation – if that happens, yes, they will find oxycodone.

        1. Did you take it within 72 hours before your test? You could test poss for it. They are 2 Different pain meds.

  73. Does having a gastric bypass affect how long drugs are in my system. I had a Roux N Y which bypassed a large part of my small intestine. They also created a small pouch out of stomach. This causes malabsorbtion in food, but does it cause drugs to exit the system faster?

      1. I take 10-325 hydrocodone 3 times daily, I took my.medication the morning prior to my visit with my pain management doc..was given a drug screen and informed it came back negative and was discharged! I do drink plenty of water.. could this be the issue? I let her know that I took my meds and had no idea why it wasn’t showing

        1. This is difficult to answer without knowing the exact kind of test that was done. if it was not a chromatography test, it may be a false negative. if the doctor or lab still has the sample, you could request it be sent for definitive testing by this method.

          1. Ok thinking back I took my medicine the early morning day before and nothing up to visit the following day.. crazy work day and forgot my meds.plus drink lots of water due to polycystic disease.. screen was a dip test and was negative

        2. Ok thinking back to my visit, I actually took my meds the early.morning the day before and nothing after up to my visit the next day.. crazy work day and didn’t have my.meds..also drinking large amounts of water as I have polycystic disease..if doing only a dip stick test could this result in negative screen?

          1. Ok got the actual test results from doc and says creatine dilite and non compliance for my medicine? Does this mean my urine was deleted? It showed no compliance for my Xanax as well and I took it the morning before. I’m confused because she is stopping my treatment o we this and not sure what to do

        1. Hydrocodone is pretty readily absorbed in the small intestine and stomach. The absorption is usually fine. If it’s an issue, they can do serum levels. Depending on the dose, there are other good options by alternative delivery systems such as Belbuca or a topical transdermal patch.

  74. So I gave birth 2 months ago and have gone back on my pain meds since. I take 5/325 percocet 4x a day and I have been having health issues lately one is vertigo and up until a week before my appointment I was throwing up maybe 5 to 10 minutes after I would eat or take any on my medication and I had an urine test to show that the only drug in my system was the percocet and I’m afraid it won’t be since I was throwing up my pills. I took one pills a little over an hour before my appointment but I’m not sure if it’ll show up or not.

  75. My daughter found out she was pregnant and at her first doctor appointment her urine tested positive for fentanyl. She takes claritin and prenatal vitamins. She won’t even take a tylenol, has never used drugs or alcohol. Fast forward to the birth of her son and they tested him as well and he also tested positive for fentanyl. How is this possible?

    1. The only way this is possible is if she ingested heroin laced with fentanyl. If she uses marijuana or cocaine, it’s possible they were laced with an illegal fentanyl derivative. If that’s the case, could wake up call that can save both their lives in the long run if she stops.

      1. She won’t even take a Tylenol. She has never done drugs. We are completely shocked at this result. The only other thing we could think of is she worked at a register and handled money. But she stopped working the beginning of August so how could it be in the baby’s urine? She is just devastated that something like this can happen.

        1. Perhaps at a party something was slipped into food or drink. If it was just her, perhaps an argument could be made that the sample was contaminated or mixed up, but since baby tested positive, she would have had to ingest it somehow whether she knew it or not. Do you have a blood level for mom or did they just do urine?

  76. Hi! I have a script for 1-2 Norco 5mg PRN at bedtime for a jammed up hip from a wreck. Sometimes I take none, a half or two. When I picked up on Halloween I had my random drug screen with no fear (this is my PCP). I had been sicker than a dog but during the night before I broke a sweat and started feeling better. I had been taking many OTC meds to combat the crude (body aches, head ache and chills). Anyway…I think that night I only took a 1/2 a norco. I was spending more time in the tub for the aches.

    Fast forward a week: my UDS came up positive for a med I’ve never heard of in my life and negative for my Norco. I take high BP and cholesterol meds also. The med is called “nucynta”. Do you have any idea how someone could be positive for it and not their Norco? I’ll try to remember the OTC meds I took: generic MucinexD, menthol afrin nasal spray, asa, Advil, Benadryl, melatonin, valerian, loratidine. I think that was all.

    Any help would be appreciated. It’s a mystery to me.


  77. My wife is prescribed percocet 7.5/325 and ran out. I gave her a couple of oxycodone 30 mgs. She has a urine test for her dr in 2 days. Will the oxycodone show up differently than percocet? And can they determine how much you have been taking in a urine screen?

    1. This is how people die from opioids and one of the reasons why prescribers (and pain patients) are in such a pickle these days. You gave her 4-times the dose she was taking. The answer to your question is probably not. Blood levels are the easiest way to determine dose taken, not urine.

      1. Jeffery will oxycodonde show up as opiate like hydrocodone or will they both show differently in urine test? Also how long does oxycodone stay in your system as far as being able to detect in urine?

  78. I took one 5mg oxycodone yester and I have a drug test today. I never take pills. I am 5’6 and 145lns. Will it still be in my system

  79. I take ms contin 15 mg, 3 times a day. If i take 10 mg hydrocodone a few times how will this show up on a urine drug screen?

    1. It depends on the type of test done. General employment screens usually just test for “opiates” by immunoassay, and with that it may or may not show up, but probably would not. If it’s a more specific test for hydrocodone, it will show up.

      1. Thank you for the fast response. I am new to pain management and have only had one appointment, so I’m not sure what kind they use, but they said it tests for illegal or illicit drugs. I passed my test (I was already prescribed hyrocodone, Gabapentin, and cyclobezaprine) and they gave me a prescription so I’m just a little concerned about losing it after reading some of these posts. I honestly don’t think I’ll need to stay on them more than 6 months as the good doctor was the first one to finally pinpoint what one of the main sources of my pain is. I had back surgery 3.5 years ago, herniated disc L4-L5 causing spinal stenosis. Evidently, my more recent pain is due to several things emanating from my back pain/surgery. The base of my spine is no longer curved but at an angle (I think is the way they put it?), I have degenerative damage in the surgery area, and the thing he (pain specialist) figured out was severe pain/tightness in my left iliopsoas muscle (I know I probably spelled that wrong). I also have always believed the surgeon did a horrible job. But I’m in PT now, doing the “torture table” (I can’t remember the real name) and doing lots of stretches/exercises at home when I can and trying to research the different problems on my own. It seems they just want to give me pills now and I only want that for short term relief. He talked about a spinal stimulator but said he would not recommend that at my age (39). I would like to keep getting them for a few months, it’s not the end of the world to me if I don’t, but when I have bad days I can’t even walk right now. I recently had to use a mobility scooter for the weekend to make it through something my husband and I paid for a year ago and didn’t want to miss. Other days I may take less than the 4. I just really don’t want to have to take 4 every day for several days before my appointment if I DON’T absolutely need to just to make sure I don’t lose them from testing clean. If that’s what happens though… I’ll deal with it. I have a really great husband and family for support.

  80. Hi Dr. Fudin,

    I have Ehlers–Danlos 3 and am 1-month post-op for first hip (2nd coming soon). My joints dislocate often and I have severe pain in my back, neck, hips, ankles, and knees. Chronic unrelenting pain I guess from torn weak ligaments and torn labrums. I’m on 15 mg morpabond 3x a day and I take up to 20 Advil a day. Even that barely helps. I go to PT but used to have 2 physical jobs and workout every day. I’m now bedridden for a year. I’ve always had anxiety disorder and prescribed klonopin for 10y at .5 mg steady. But my pain dr wanted me off it. I also take ambien as needed because I can’t sleep generally from the pain. I had klonopin initially with the morphine several months and noticed it greatly helped with the pain maybe relaxing surrounding muscle pain to injured labrums? Since I don’t use drugs or drink recreationally at all and have a steady history of responsible Rx usage, shouldn’t it be ok and in my interests for pain management to have klonopin again since the combination of the 2 meds was more affective? I’m desperate because my quality of life has plummeted in just 1 short year! I had to quit teaching because I can’t walk but was able to keep my other job and work remotely. This is so hard and even my Psychiatrist of over a decade seems to be suspicious. I don’t want to take anything at all but can’t even sit up barely without excruciating pain. (I just learned about my disorder).

    1. Krissy,

      As you probably know, opioids (like most drugs) carry inherent risks; in this case respiratory depression. Neither Klonapin nor zolpidem are absolute contraindications to use with opioids, but the addition of each a single agent, and then combined in the presence of opioids increases the percent risk of opioid-induced respiratory depression. There is more and more recent good scientific literature to support this. I can’t give an opinion as to whether the combination of 2 or all 3 of these are appropriate for you, but hopefully this will help you understand why your doctor is reluctant. Overall it comes down to benefit versus risks and it seems that as of late, patients are not given the same choices to make that assessment and choice with the doctor, at least in part due to liability.

  81. Hi Doctor, every time I take a urine test since 2014, my urine test comes out as negative for opioids. It is strange because I started drinking alkaline water and I stopped taking it after the negative result once again on October 3rd when I changed the pain doctor. After the urine test result, he won’t see me anymore. And I am left with no pain doctor because my last good pain doctor retired. I have been taking antidepressant, Cymbalta, and other bipolar disorder medicine since 2014 and I am thinking if that has anything to do with the negative results of my opioids negative test result. I take fentanyl patch 50mg every 3 days, morphine sulfate 30 mg 3 times a day, and hydrocodone 10/325 3 times a day. And plus I am a huge water drinker. Could drink a lot of water has to do with the negative test result?

    I need your help desperately! Thank you so much.

    1. Ceri,
      Fentanyl will not show positive for opiates on an immunoassay urine screen. Morphine will always show up at that dose regardless of hydration, and hydrocodone may or may not show up at that dose. If the test was chromatography, all of these would show positive. Drinking alkaline water will also not affect that dose of morphine, which by the way is also a weak base. There may be another explanation but it’s not a lab error.

      1. Hi Dr. Fudin,

        Could you explain to me if kidney function may have something to do with the result being negative? Could there be any kidney disease that could bring about a negative result?

        1. Ceri, Usually kidney function will not substantially effect the urine test as long as the patient is making urine. If on the other hand, a patient’s kidney function is so poor that they require dialysis, yes, that would effect the results. Every case however is individual depending on kidney function and hydration.

  82. I’m trying to find out how long I need to wait before testing someone for suspected hydrocodone use. Would the medication show up in urine w/in a couple of hours? I’ve read conflicting information on the internet. Thank you for your help.

  83. I’m living in a lot of pain from fibromyalgia,. Any advice how I might express to my doctor to keep me on oxycodone as they really help improve my quality of life?

      1. Dr jeff, I take 3 10mg percocet per day. If I take 20mg oxycontin instead of the percocet. Will I fail my lab test?

  84. I just got diagnosed with fibromyalga and I’ve been on opioids for about a year. It seems that oxycodone works best for me. Do you think I can be kept on this permanently? Is that unusual? Thank you for your help sir.

  85. How long does it take for one vicodin 7.5 to show up in a urine test in an adult? I’ve read you have to wait 24-48 hrs after taking it, for it to show up in urine. Other words if an adult takes one vic 7.5 will, will it show up w/in a few hrs in urine testing? Thanks for response, hope to hear back soon!

    1. Rox, It depends on if it’s an immunoassay (IA) test or a chromatography test. If it’s an IA, it may never show in the urine at that dose. If it’s chromatography, up to 3-days.

  86. Hey there, I was just wondering if tramadol shows up on a urine drug screen, and if so, what’s it show up as? I also take hydrocodone 10mg 4 times a day! Thank you!

      1. I have a question I take tramadol an I have ran out so a friend had gave me some hydros to last till I go to the doctor will the show up the same on my regular schedule drug test

  87. Jeff,

    I have been on opioids for over 22 years. I have a very long and well documented list of diagnoses that show that I am in severe pain every day. I can’t even get to the bathroom without help unless I have taken my pain meds.
    Currently I am taking Hydrmophone 4 mg. Q° 4hrs PRN, MSContin 30 mg. BID, Xanax 2 mg. TID, Phenergan 25 mg PRN (Suppository and Oral), Lasix 40 mg. BID, Ambien CR 12.5 mg. HS, Monafinil 100 mg. BID PRN (RARELY: MAYBE TWICE A MONTH), Tizanidine 8mg Q° 4-6 hrs PRN.
    The illnesses that I think may be messing up my UA’s are Gastroparesis, IBS (SEVERE), Polysicytic Kidney Disease, Biliary Duct Obstruction Disorder, and Lupus. I also suffer from Fibromyalgia, Degenerative Bone/Joint/Disc Disease, as well as other areas and issues that are minor…

    Now, here’s the problem: I keep on testing positive for Oxycodone!!! And it doesn’t make any sense!!! I refuse to take that medication due to the effects it has on me (I started craving the medication instead of pain relief). I haven’t taken any Oxycodone in over 13 years, and that was only for a week and a half…

    So, why is my UA’s coming back positive for oxycodone??????

    Please help… I am at my wits end…

    1. Both Hysingla and hydrocodone/APAP generally are just testing for hydrocodone, so they are the same. Your doctor May choose also to test for acetaminophen which is only found in the latter.

  88. Dr Jeffrey Fudin

    I have to take UA for my pain Dr. Does Oxycodone with or without Tylenol show up as the same medication on the drug test that they initially use in the Dr’s office and then when they send it to the lab?

      1. If I’m taking 15 mg MS Contin and 15 mg morphine or and take a few 7.5/200 viocodin after 10 days will the hydro still be in my urine not taking the hydro regular just found a few in my boat

  89. I’m a 51 year old female with CRPS since 2002. after 2 failed ankle surgeries this is my nightmare and it now covers everything except my right arm. I’ve gone thru all the blocks, fail spinal cord stim., epidural, you name I’ve let them try it. which has now left my back degenerating with more scar tissue and flairing of the crps too. I currently am down to 60mg oxycontin 2x day, 10/325 Percocet 1every 4 hours, tramadol 50mg 3x day, 100mg topamax 2x day, 15mg temazepam bedtime, baclofen 10mg 2x day, nabutone 3x day, and clonidine patch weekly. I just failed a urine test for the first time for norco? I haven’t taken that in 15 years how does this happen??? dr. change last month do to government changes I’m at a loss.

    1. while I know to most this sounds like a lot of meds but I’m actually cut in over a half I deal with the pain and know I’ll never be pain free and that I accept. what is hard to accept is being treated like a drug seeking lying criminal at every turn. I didn’t take vicon or any form of hydrocodone but how do I prove a negative? and if it is a result of my body processing meds and eliminating them or meds mixing with each other no matter what I do I’m going to fail again, hence my panic. please help.

  90. Appreciate all of the insight doc. I’ll be straight to the point. Been in PM for 4 yrs now, never a bad UA. I take oxycodone 10mgs 6x a day. I took a pre employment DS UA and they told me I tested positive for oxycodone and hydrocodone…I haven’t taken hydrocodone in years. My UA for my PM doc is tomorrow 15hrs away, should I be concerned because I only take what I’m prescribed and don’t want to lose my Doctor, he’s a great guy.

  91. I am worried that my Dr. Will take me off my hydocordone because of the new rules. I have chronic pain from several things. She has already cut me down from 4 a day to two a day. W have been in major pain for over 20 years. Why do I have to suffer because of people that misuse them?

  92. Dr Fudin, Really hoping you might be able to provide some insight…
    I’ve been seeing pain management doctor for several years, taking hydrocodone10/325 mg for Rheumatoid Arthritis. This past April, my doctor retired so I have seen my new doctor 3 times. I have taken a UA test each time and even though i take my meds as prescribed,my tests keep showing negative for the hydrocodone. At my last visit, my new doctor made it clear that i had better have a positive test on my next visit… so I’m a bit concerned. I am also in stage four renal failure and take 160mg/day of diuretic (Lasix) and was wondering if diuretics could be diluting the urine and giving the negative results? I want to make sure there is something showing in my urine and since what I’ve been doing hasn’t been working, do you think it would show up if I were to take one an hour or two before my appointment? Concerned about being discharged for something out of my control. Thank you

    1. There are several issues here…
      1. The dose you are taking may not test positive for opiates on an immunoassay test (if that’s what your doctor used)
      2. If you have chronic kidney disease, your kidney will not be filtering hydrocodone out, so there will be less or none available in the urune to test for
      3. and yes, large doses of diuretics will dilute out the sample

      1. Thank you so much for answering. His question as I’m having the same problem with my PM doctors. I’ve only seen this one doctor a few times but every time she has said my hydrocodone/10-325 isn’t showing up. I also take 160 mg of lasix daily due to Pseudotumor Cerebri with a VP Shunt . I researched this question at the advice of my Emory care team nurses in Atlanta. This is the answer I have been looking for since I thought this could be the answer!

  93. Hurt seriously on my job, left with chronic pain.
    2005 to 2017 started 12.5 mcg fentanyl patches, wearing 3 days and remove them, then put new patches on, this dose was increased through the years, By Dec 2017 dose was up to 150 mcg every 3 days.
    NOT once in 12 years did any urine or blood test show any of my pain meds. I had the 1st doc for 8 years (he left) and referred me to another in the same office, I was with this doc for 5 years. (he left)
    Dec 2017 new doc switched me to 20 mg tablets time release Oxycodone.
    This medication is NOT showing up on their tests either?
    I REALLY always take my meds. I told her I’m always that 1 or 2% that reacts weirdly to surgeries or medical tests. I told her I would come to the office and SWALLOW pill right in front of her, and she can retest me! She refuses to listen, will not retest, will not test my hair even.
    Do you have any ideas? I am broke since I am unable to work, so is there a cheap way to prove I really do take my medication?
    thank you for helping all us chronic pain people 😉

      1. Dr I have a question. On a drug panel that a Dr’s office will send into the lab does Oxycodone with and without Tylenol show up as the same drug??

  94. Hey dr I take a lot of meds I give half of the pills to my mom. If I take 3 days of my regular script will I pass the urine test they are asking me to do to check to see if one of the drugs are medically nessacary.

    1. This is the problem that legitimate pain patients are dealing with people selling, giving away, and trading their narcotics. Now after being on pain meds for 20 years for a spinal cord injury, herniated disc, and being double alleles MTHFR gene mutation my pain meds have been really reduced now I’m in constant pain. Thanks all you people just going for the high. PS this sharing and trading and selling can lead to someone’s death. Do you want to be responsible for it?

      1. I am so sorry. My spouse is going through the same thing. Are you being taper or just ridiculous drops causing detox like he is? Why are the people who really need this to have a quality of life being punished

    2. You’re the reason why the people, like myself, need these medications and cannot get it!!!
      Have your Mom go to her own doctor…!!!

      1. LLF, You need to take a serious look at what you’re doing, how people end up dying from opioids, and how it affects legitimate pain patients that are having difficulty receiving their medications. I have nothing personally to gain by recommending you get help for abusing medications by using them by an unintended route of administration. Get help please for the sake of your and your family.

      1. Completely at a loss. I tested positive on a dot screen for oxycodone/morphone. I DO NOT take either! I did admiringly take tramadol, hydrocodone after I broke my foot then of course had a random UA at work. I don’t do drugs usually but was in so much pain I had to take these. Now, my wife- a cancer patient does take oxycodone. She’s been on it for years and years. I help her apply her cream (she crushes a few pills and ads to biofreeze) and sometimes “handle” her medicine to bring to her. I’m dealing w an MRO who’s saying definitely I’ve taken the substance. I’m already fired now which is an entire other dilemma (4 kids, wife w health issues and soon no health ins) and a hit on my CDL which will be pulled. How did this get into my body? I need to know so when I apply for a new job this doesn’t happen? Desperate for help. My quant was 141-ng whatever that means. Please help.

        1. Ummm… I’m guessing that when you’re wife crushed her pills and put it in biofreeze and you rubbed it on her feet you were NOT WEARING DOUBLE MEDICAL GLOVES????

      2. Completely at a loss. I tested positive on a dot screen for oxycodone/morphone. I DO NOT take either! I did admiringly take tramadol, hydrocodone after I broke my foot then of course had a random UA at work. I don’t do drugs usually but was in so much pain I had to take these. Now, my wife- a cancer patient does take oxycodone. She’s been on it for years and years. I help her apply her cream (she crushes a few pills and ads to biofreeze) and sometimes “handle” her medicine to bring to her. I’m dealing w an MRO who’s saying definitely I’ve taken the substance. I’m already fired now which is an entire other dilemma (4 kids, wife w health issues and soon no health ins) and a hit on my CDL which will be pulled. How did this get into my body? I need to know so when I apply for a new job this doesn’t happen? Desperate for help. My quant was 141-ng whatever that means. Please help.

    1. I am a 62 year old woman I have been going to the same pm Dr for 4 years never had no problems. HE HAS had me on the same meds all this time Hydroccod/acetam 7.325and gabapentin 800 .I went to him last Thur and he told me he could not see me any more because my UR test show Oxycodone .I do not take that so how did it show up? The test they done was a LC/MS/MS Not only have I lost my Dr but my pride can you help I asked him to run the test again but he said he couldnt

      1. This happened to me. I take hydrocodone 5/325 and went for a ua and i tested positive for oxycodone and hydrocodone. Makes zero sense because i don’t take oxycodone. After research i noticed people taking hydrocodone sometimes test positively for oxycodone and even oxymorphone.

  95. I’m on pain contract 90 7.5 Percocets every 30 days, I took 1 xanax 4 days before my doc appt. I came up dirty for benzos, my doc asked me what I took, I told him ativan because I had a legit old script. They sent the urine to lab. He scolded me and told me to come back next week and you better pee clean then! I’m clean and my appt is tomorrow, Will he keep me on? Will I get my meds for chronic pain? Worried in Pomeroy WA.

  96. Will hydrocodone show up on urine test different from oxycodone? Meaning i ran out of my oxycodone two days early and they will be testing my urine to make sure i have the opiates in my system…i have some hydrocodone i have had for months. Can i take those and be ok? Or do they show up different?

  97. Hi Dr. Jeffrey,

    I was given a prescription of 15mg of oxycontin as recently as 1 week ago. I felt they were too strong and cut it in half. I would take 1/2 in the morning and 1/2 in the evening. Today which is Tuesday I took a full dose. I have a drug screening on Monday (6 days later) for a new job. will that show up in my test?

    1. Sally, I’m not sure why you’re asking this question if you have a valid prescription. The bigger issue is that extended release tablets should NEVER be crushed. Whatever handout material you received from the pharmacy should clearly outline that. When crushing such tablets, 12 hours of drug are released and that has caused harm or death in some people. If the dose is too strong, contact your doctor for a lower strength.

      1. Because the company that I applied to requires a drug screening and it didn’t want to jeopardise my chance to work there. I have a prescription but they may frown upon it . I did NOT know that I may have the job until today.

        1. Hopefully your job does not involve driving or operating heavy equipment. If it does, you have an obligation to let your employer know because it could effect your safety or the safety if others.

          1. Absolutely Right Jeffery Fudin!!
            Some people don’t have a clue what they are doing.. They want their cake, and wanna Eat it too.

      2. Also, I took my first dose and decided to CUT it in half, Did not crush it. I don’t like taking any medications at all. so my question is: Is 6 days absent from taking the medication long enough to clear the screening?

        1. If a 30mg extended release tablet is crushed, you get the while 30mg at once. If it’s cut in half, you get 15mg at once. If the tablet is crushed or cut, or manipulated in any way, it can result in destruction of the extended release dosage form and is therefore dangerous. I cannot give advice on urine drug screens for the purpose of “passing” a test for an employer or a clinician.

          1. Last oxycodone crushed and snorted 60mg 11am-1230 pm 1 more 30mg at 11pm ..10/13. ((total if 90mgs)) dr appointment monday 10/15. Used last thursday the 11th. Do i need to reschedule bupe appoint or will i be clean for oxy

  98. Hi dr. Jeff I go to a pain clinic once a month for my pain meds I get 5 mg of Norcos I’ve been going there for quite some time now I do have a drug test every 3 months or whenever they say the other month I dropped my urine and they said it came back that I was taking something for seizures and I do not have seizures I told them so why would it show that I’m taking some for seizures then the next month I went back they dropped me again now they’re saying they was cocaine and two other medications I can’t remember what he said cuz I was so upset why would cocaine show up in my urine.now they’re sending it out to a lab. Is going to show cocaine and the other two that they said what do I do help me please I’m 54 years old I live with my 80 year old mother I’m divorced I don’t know where to get drugs at I’m freaking out that they’re going to drop me and then I’m going to go through withdrawals on not have Norcos anymore what were they do to me if it shows cocaine again when they sent it out I go back next month to find out what the other lab says should I go or should I just say screw it and don’t ever go back again cuz how can I prove it it’s their word against mine please help me. Thank you

    1. It sounds to me like a lab error, but I can’t predict without knowing the exact type of test that was done in the office, what was done on the outside, and if it was chromatography, the levels. You would probably be better off asking your doctor to run blood tests instead of urine.

  99. I took a standard urinen test and it showed oxycodone and morphine in my system, the inly drugs I take that are narcotics are Clonanzepam and hydrocodone. They sent my test out to outside lab and it showed negative but my doctor wanted me to do another test and again it showed positive. I’m pulling my hair out because I am ACTUALLY INNOCENT!! WHY IS THIS HAPPENING?? PLEASE HELP.

  100. Good morning doctor. I’m in pain management and I’m prescribed Norco 10 325 I take a half a tablet in the morning and 1/2 a tablet at night before bed the last three drug test I’ve taken for them have come up negative I take my prescriptions could it be other health issues I have or other medications I have that are masking in Norco. I literally just took a pee test it says it’s negative and I took the Norco an hour ago. They’re going to send it out to a lab like they did the last one which came up negative. Why is it not showing up in my system.

  101. I go to a pain management Dr and am on suboxen…i ran out three or four days ago…ive had 3 spinal surgeries and now can hardly walk due to bulging disc pinching nerve in my leg. Went to e.r. and they didn’t give me anything. But, at that time still had some suboxen…on Tuesday I took one. 10 mg Norco. Then Wednesday took one more 10mg Norco. I do not usually take anything but my suboxtene. I go to See my pm Dr on friday…will the Norco show up in us since I don’t take the on the norm. I don’t want to lose my pm…thus is my 2nd visit….i just want to get regular seeing him. What do I do? Please help

  102. What is the most common type of urine test used in a pain Managment clinic that provides immediate results?
    I’m on a relatively low dose of hydrocodone. When is the ideal time to take a dose to ensure it shows of on the immediate response urine test?
    I believe you’ve said 3 hours prior to a test is when the dose should be taken to achieve a positive result?

  103. So I see a pain management doctor that I’ve seen for over 8 years now and he prescribes me oxycodone and last week he drug texted me which i have no problems with. Well I texted positive for tramadol and was let go from his clinic, my question is can you have a false positive? I have never had any access to tramadol and I even have an allergy to it so i have no idea why i would text positive for it? I’m at a lost right now and really want to fight this but don’t know if I should at this point.

      1. Actually, you’re incorrect, Jeffrey,

        YES, Ultram (Trazadone) Will show up as an Opiate, mostly Hydrocodone (Norco).
        This is according to NIMH, NIH and FDA.

        I just had a False Positive and was yanked off of my Xanax… I have a Panic Disorder that has caused Hyperintesity (Heart Palpitations, Shakes, Fear, Isolating Myself, Unexplained Fear and Insomnia) In other words;
        Do You’re Homework before you give any more advice and end up hurting someone.

        1. Ultram is another name for the drug tramadol it’s, not triazadone nor is it even remotely the same thing and doesn’t even treat the same issues so I’m thinking that before you let your mouth overload your little butt and start speaking to people ugly telling them they don’t know what they are talking about. you might want to make sure you you know what you are speaking of before you become a keyboard warrior without a freaking clue. I’m sorry but this rubbed me wrong seeing as you think you know it all and it’s funny how you don’t have a clue

        2. Stefanie, I was told my Pharmacist and Dr., who retired, that Ultrum/Tramadol was an SSRO
          Selective Serotonin Reuptake Inhibitors, and should not be taken with another Anti Depressant. I took Prozac and Ultrum years ago., and the Pharmacist told me that it was not safe! To talk to my Dr. Taking both Meds together., Loads your body with too much Serotonin! And I spoke with an DEA agent, which told me that the reason they made Tramadol a Sceduled 2 Drug, was because it made the Top 3 most prescribed Medications! I was told that it’s not in fact from the Poppy plant/Opium. It’s an SSRI…
          However, because it was one of the top 3 medications taken, that’s what the DEA focuses on to eliminate, as they feel the top 3 Meds used, they consider it being Abused, so let’s stop it or make it more difficult to get! But I feel like if it’s in the top 3, them it’s probably working! Seems like whenever you finally get medication that helps, the Law…steps in to change, and causes more harm to good people who are simply trying to get proper help! I am not a Dr. However I personally believe that, Making Tramadol a schedule 2 Drug is Hilarious! People take it because it increases your Serotonin and over time makes you feel better! It has never ever touched my Pain! And here’s the Funny part., The Hospitals and Drs office usually only give you (Shots) of Tramadol! I went to Emergency Room with multiple Breaks of my Ribs and they gave me a shot of Tramadol! That’s unbelievable! I personally believe this was a Planning in the making to ( Get people off opiates) as claiming we’re dealing with this horrible opiate epidemic! My Dr was forced to Retire this passed Feb. and IU Health had a plan… every Dr in my Town, claimed Drs Were not taking patients for 6-12 months! So I still have no Dr.! And I’m in Last Stages of Levi Scoliosis and Dextrose Thoracic Scoliosis which every Disc in my back from C2-3 down to my Lumbar is permanently damaged! I also have Osteoporosis I’ve broken my ribs over 20 xs! I no longer go to emergency because they don’t help! I also have R. arthritis and Osteoarthritis! Along with Muscle skeletal, fiber myalgia, and Heart disease and my Left Lung and left side of my Heart is being crushed by my Scoliosis! My Heart hurts! list goes on! My Pain Management Spinal Specialist Released me as a patient after almost 20 years (without taking meds) because he said I was a High Risk Patient and didn’t want to be liable for high risk injury! He rated my Pain Disability at 78%! That was 5 years ago! I’ve seen 2 other Specialist, which told me the same thing! No Dr in their right mind would touch me! In 2007, I finally asked my Family Dr. Of 47 years if he could give me medication to help because the pain was too bad! After being on a pain Med with a Muscle Relaxer, for 10 years., Every thing changed and I’ve been living a nightmare as I can’t find a Dr., and where I live., Pain Management Do Not prescribe Medication either! It’s a joke! So many people are suffering! Sorry for talking too much!

          1. Tonya,

            Drugs are classified by the DEA based on their abuse potential ONLY! Opioids are not the only controlled substances; another great example that is a universe away from opioids is testosterone – it’s Schedule II. Tramadol is not derived from poppies; you are correct. But, it does nevertheless have weak opioid properties and is a partial mu opioid agonist plus it blocks reuptake of serotonin and norepinephrine. It is not an absolute contraindication with antidepressants, but there is an elevated risk of seizure or serotonin syndrome. For more information see Is Tapentadol a Glorified Tramadol? (https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/tapentadol-glorified-tramadol) and What Type of Withdrawal Symptoms from Tramadol Might a Patient Experience? (https://www.practicalpainmanagement.com/treatments/what-type-withdrawal-symptoms-tramadol-might-patient-experience).

          2. Sounds like a bunch of people fishing for ways to get high and not being detected but that’s my opinion and opinions are like assholes everyone has one I’m a full blown epileptic from birth and I take it with valium have been on valium since birth and sometimes the cons out the pros and my doctor is a neurologist

        1. Kim, I am not here to help people spoof their doctors. Taking medicine that you’re not supposed to is one of the reasons doctor’s are on the chopping block and reluctant to prescribe to patients who need their medication. If you believe that you have a problem with taking medication that is not prescribed, I suggest you speak to your doctor, work together, and get the help you need.

      2. I take a generic Percocet 4 times a day but my urine test came back for Percocet and hydocodon. How can that be I do not take that drug and I have not taken int in more than 19 years. I don’t want my pain doctor to dismiss me from the program because I am not taking Vicodin in any form.

  104. I’m stumped. I’m in pain management for fibromyalgia and take 10mg Norco, 30mg Cymbalta, & 2mg Tizanidine. Today I was drug tested and tested negative for everything. I’m taking my meds as prescribed why would it be negative? My urine was very pale in color could it have been diluted since I’ve upped my water intake? My doc said if this happens again I’ll be dropped from her care.

    1. The test was probably by immunoassay (IA). Call your doctor and ask him/her to send the sample for definitive testing by liquid chromatographic testing. Hydrocodone often does not show up by IA testing, and depending on your daily usage, I’d be more concerned if it showed up positive. See http://www.remitigate.com/urntel

      1. What type of urine test would a pain Managment clinic use for immediate results?
        I take 10/325 hydrocodone 2x daily. When should I take my last dose to be sure I get an immediate positive for hydrocodone on the urine test.
        After reading through all the comments, I believe you stated that taking the last dose 3 hours prior to the urine test is favorable for a positive test?

      2. Dr funding I’m in pain management for over 5 years and have been taking loratab as prescribed by pain management dr. I get tested every month this time they said I tested positive for OxyContin I don’t take that! Why would this happen? I told them send it out!

  105. I am taking a 7 panel drug test tomorrow And I have recently been taking suboxone as well.. will the suboxone show up in a 7 panel drug screen as an extended opiate or an opiate?? I have taken an over the counter drug screen ten panel and I tested negative for everything but I still worry that the suboxone will show up as an opiate for some reason because people told me that is possible? I also tested positive for opiates before and they were able to tell me that it was the Oxycodone I was prescribed ..how were they able to tell what it was with a 7 panel drug test??

    1. Jessy,

      My bigger concern is that you’re taking Suboxone and not sharing this information with your doctor. This kind of behavior is what causes distrust between patients and their doctors, and it is dangerous.

      1. Dr, I don’t mean to be offensive , but you really need to read some of these questions more closely before you automatically accuse people of things they may not be doing. Jesse was merely concerned if the suboxone may show up as an extended opiate . Jesee’s dr. may very well know about it or may be prescribing it to Jesse.

        Sally, another poster, was simply asking if Norco would show up in a urine test by 6 days. You never answered her and treated her like she was doing something wrong. She was simply worried about possibly not getting the job she wanted. Many employers may not hire someone because of the stigma of even legitimate pain med use, even for work that doesn’t involve work hazards.

        I do appreciate you helping people by sharing your knowledge of these tests and various medications, thank you.

  106. Hi Doc!
    How long does it take Percocet to leave the system so that it does NOT show up on a confirmation test?


  107. Hello Dr, Was wondering how long does it take for tramadol to be undetectable In urine lab screening? Thank you for your help

    I can’t find an answer to this anywhere. I take Ativan, Ambien, and tramadol regularly. Sometimes I run out of tramadol early and my sister will give me Percocet. I go for regular urinalysis every month. Yesterday I was told my test for the tramadol showed up as Methadone!?!? She also said that it wasn’t the first time it’s happened but it’s the first time they told me about it. I have NEVER taken methadone in my life and it had been at least 2 weeks prior to that test that I last took any percocet. Have any idea why I tested positive for methadone ? Could it be because of the percocet? I mean, 2 weeks it should have been out of my system right? They said if I test positive for methadone next month I will have to take a confirmation test. If I take percocet at the beginning of the month only, will it show up on my confirmation test?

    P.S. I do take a lot of benedryl for allergies and I read a few articles that said diphenhydramine can cause a false positive for methadone?

    Any help is much appreciated, thanks.

  109. Hey Doc,

    If someone were to take Percocet on a Sunday, by what day would it no longer be detectable in their urine?

    This has long been a debate at the clinic where I work, I’d like to create an accurate chart for my coworkers.

    Thank you!!

    1. I don’t know how to ask a question to Dr. Jeff Fudin.
      But …
      If you take oxycodone 40mg daily
      And your urine test came up
      Oxycodone. 1,445
      Is this a normal test result???

  110. Dr. Fudin, Thank you for this service you provide, I hope you can help. I’m a medically retired RN, but, but this chemistry and lab detail is way beyond me. I have ankylosing spondylitis, psoriatic arthritis, bilateral meragia paresthetica, and bilateral iliotibial band syndrome, and have been in pain management for roughly 25 years. My doctor had been doing the UDS in house until last visit, and as I was checking out the lady at the front desk handed me a prescription, told me they didn’t do them anymore, and that it had to be back in 3 days. I had a very late appointment on Thurs., my wife was booked solid with her work on Fri., so that only left Sat. to get it done (I don’t drive due to my meds, I feel fine on them since I’m acclimated, but if anything happened I’d be considered DUI.) We went to some new place we found in the phone book. They mailed me my prescriptions last month, no problem. This month we called and they said they didn’t have the UDS info, strange since they mailed last months. A bunch of phone calls and they finally got them, BUT, and a big BUT, somehow it said I tested positive for oxycontin which I’m not on. Itake methadone 5mg bid, neurontin 400mg tid, sulfasalazine 1,000mg bid, Topiramate 75mg qd, and hydrocodone/apap 10/325mg tid/prn. Is there any way possible hydrocodone can show as a false positive as oxycodone? I’m stumped. I gave up anything illicit in the very eary 1980s after college and only take what I’m supposed to take. Of course this was over a month ago so I can’t even get a blood test to disprove it. If you have any ideas I sure would appreciate them. Thank you, Will

    1. No, hydrocodone or methadone will not test positive for oxycodone. If I were you, I’d make sure the test is chromatography, and if it’s not and they still have the sample, they need to confirm it with a chromatography test.

      1. I don’t take pain meds any more I’m on subs and sleeping meds I went to see my psychiatrist and I took my piss test and she said that oxycodone and benzos are in my piss teat I have been clean for 2 yrs then she said some over the counter stuff does make urinalysis come up positive on those meds !!!! I was so nervous after being accused of getting high I couldn’t think what I had taken so I was out of my subs and had a bad upset stomach so I took Promethazine and Dramamine for nausea So they sent my urine to a lab to find out what it really is , my question is will they really find the upset stomach and Promethazine pills or still show up as Oxys and benzos????? I feel so bad not remembering at the time and not remembering that Promethazine has stupid codiene in it cuz I am allergic to codiene They also said they will call in my meds after they find out what I had taken to make a positive result and they also still called me in 5 subs and all my sleepers to keep me from being sick and the sleepers for my insomnia

      2. Hello dr. Jeff i didn’t know how I could get ahold of you so I’m trying it through someone comment in hopes you can respond to mine . I go to a methadone clinic for painkillers and I manage to go from 95mg to 73mg I told them to hold it there , as I was experiencing withdrawals symptoms. I weigh 170 at the moment and I’m 5’3 , female. I took opiates norcos to be exact 5 of them in all about a week ago . They check me through a uriane sample to see if i come up clean or dirty for opiates . I am prescribed Ativan, buspurion (spell check*), and I that vitamin a,b,c,d,e . They will check me (hopefully) two weeks from now as they always do. But sometimes they switch the weeks. My question is . Since I took it a week ago (I drink a lot of water) , will I show up in my system? Please help me . I’m very scared , I know I made a dumb decision, I should have never done it. I should have been stronger and just coped with the withdraws . But can you help me ????

      3. Thanks Doc, however due to a “backlog”, the results were roughly 2 months old. Somehow they had filled my 30 day refills without them. When I went for my appt. last Thursday the NP asked who I had used (I of course had no idea. My appt. had been late on a Thursday, my wife was tied up with work on Friday, and we only had 3 days to have it done including the day of the office visit and we just snagged one open on Sat. (I don’t drive since, hey, I’m on narcotics). The UDS used to be done at the pain management doctor’s office and that was the first time we had to go outside. The NP asked because evidently they’ve been getting some some “iffy” results from some of the labs and suspect they’ve just been looking at the patient’s list of meds and checking the boxes, and in some cases checking the wrong box.

      4. I have to take a pre employment drug test…its for a care giver position through a non profit ..I take between 10 and 30 mg of prescribed hydrocodone for back and hip pain. Will this show up and do I disclose this before the test obviously I have a legal scrip

        1. Charlotte, It may or may not show up. As long as you disclose it and have a prescription, it shouldn’t be a problem, unless opioids are forbidden for the particular job you are seeking.

  111. Hello,

    I may have recently ingested 2 to 12mg of diazepam over 6 days (2mg a day possibly).

    I have been testing positive on drug screen for benzodiazepines for the last 13 days. I’m expecting GC/MS to confirm this.

    I’m a 56 year old female, chubby and not very active.

    I’m being told that I took lots more of this drug than I have reported due to the “amount” in my urine.

    I’m also being told I can’t possibly be still testing positive after 13 days.

    Can you refute this please?

    Thank you!

    Kim B.

    1. Diazepam stays around for a long time, so yes, you could be positive after 13 days. Also, urine cannot be used to calculate the dose of diazepam, as of yesterday, and certainly not over 6-days. For that you’d need a blood level and that would only be helpful if you were on a regular dose.

      1. Hey I was just wondering if suboxone shows up in /ma seven panel drug screen? I get drug tested tomorrow for my adhd medicine and I have recently been taking suboxone but I am not prescribed…will this show up in the drug screen as an extended opiate or an opiate??

  112. dear dr fudin ive been taking hydrocodone for a few years I get 10/325 mg I cut them in half and take four a day I was given a drug test at my clinic and they said it tested negative for me taking the meds but I have been taking them is there a false negative for a urine test

  113. Okay Doc…

    So… I take urine tests to pick up my prescription every month. A few months ago I tested for something that shouldn’t have been in my system. Retook the test later, and was fine. The doc wasn’t thrilled, but being that I’m new, gave me another chance. So this time around, I had that same substance in my system, and therefore subbed a friend’s urine. I took the temp (92). They call me back, say “you’re not in trouble, but….”) And they said they couldn’t get a temp read. Even said “not accusing u of using someone else’s urine). And just said I could come back in a few days. So I’m going tmrw, and plan on using a female friends urine.. do u think they will check to see if it’s actually male?? Being that they’re suspicious already? Or CAN they even check for that?? Are there any tale tale signs that it would be female?? PLEASE answer ASAP – – thank u so much 🙂

    1. For those of you writing for help in scamming drug tests, this is the actual problem that has even led to this practice. Online or in person this gentleman is a physician who spent many years in medical school and is now available to guide those needing help. He isn’t your lackey to help you beat drug tests. There are programs who can help you friend, one being Narcotics Anonymous. Your life can truly change if you want it to and you don’t have to have your every moment consumed with either getting more or trying to get out of how much you took. It’s available in every state and most cities and nearly every country in the world. When you next feel down and out, give it a chance. http://www.na.org will take you directly to your location and provide you with available meeting schedules. I wish you all the best and hope you make it there.

      1. Exactly! All of you bozos are killing us chronic pain patients who are trying to have a quality of life! Those trying to beat the system, tears it down. One day you’ll actually be in pain and due to your abusive actions NO ONE will have the god saving opiates! Get on cannabis! I’m a 16 yr chronic pain patient that could do so much more but since 2014 I can only get a fraction of my meds. It’s horrendous how people abusing this has lead to those who need it not getting it. Now it doesn’t matter when we have bad days, we can’t take that extra dose cause now is, the actual pain patient has been forged in with those who want euphoria. Trust me true chronic pain patients DO NOT GET EUPHORIC FEELINGS especially with spinal cord injuries. Please STOP USING, STOP ABUSING!! Cause they won’t work for you when you will need them, trust me.

    2. Wow Just wow. People like you make it hard on us that is trying to do what is right. People like you are making it hard on doctors

      1. Hello, I have been in pain management for about 4 yrs and I am prescribed hydrocodone, 2 10mg tabs 3 times a day. Depending on my level of pain sometimes I take the full dose but other times (most times) I take half the dose (total of 3 tabs a day). When I take my urine urine tests will these different levels show? I’ve never had them say anything to me but after reading some of these posts it just makes me wonder how in depth they look.
        Thank you!

  114. Hello so I am on probation and want to know if it is possible to pass a urine panel test today if I took oxycodone 30mg late last night?

  115. My urine tests always come back the same. My last one showed negative for Hydromorphone even though I know I took my meds as usual. What could be the reason?

  116. Hi DR Jeff. I have a first time appointment for a pain clinic, I am currently taking Suboxone and there will be marijuana in my system. should I stop taking suboxone or will that defer my chances of gettting a script back

    1. You should take whatever is prescribed and not take what isn’t prescribed (marijuana for example). If you are using illicit substances it will affect your provider’s ability to provide buprenorphine.

      1. i havent used marijuana in a few weeks, and im new to the state and understand my PCP cannot give me narcotics like Illinois did

        ive never been part of a pain management program. by a diffrent doctor i was given Suboxone until i got a script again for hydrocodone 10/325 . My question is, Will they see suboxone show up on a drug test, and will that defer from them giving me a new script. thank you

      2. i havent used marijuana in a few weeks, and im new to the state and understand my PCP cannot give me narcotics like Illinois did
        I am ging to pain management for a new script of Hydrocodone not Suboxone. Suboxone was given to me inbetween doctors, will it affwct me getting a script for hydrocodone?

      3. i havent used marijuana in a few weeks, and im new to the state and understand my PCP cannot give me narcotics like Illinois did

        the script that im getting back is Hydrocodone, will taking suboxone affect that decision?

        1. I can’t predict what they will do. Whether or not it shows up will depend on the type of test. I suspect one of the reasona you are on Suboxone is because of this type of behavior. You should be honest up front with the new provider so that you start out with an open an honest relationship.

          1. I don’t appreciate your assumptions of my behavior, this post send more than once because it said “it’s not able to post” . Everyone on here just has questions not to be judged. If you MuST know I have been on the same meds for 4 years. Suboxone was an inbetween doctor medication. My question was weather or not it would prevent me from getting a new script, but I guess I can ask elsewhere

      4. Hello Dr. I am took my DOT drug screen for work today (Friday). My last dose of was 40 mg of hydrocodone. From my understanding the methods of testing are GC/MS. Is there a possibility of my test coming back positive?

          1. If I take two doses of hydrocodone will it show up in my urine ? How long does it take to show in the urine?

          2. I took 1 Norco Monday and I have a appointment Wednesday a simple urinalysis will it show up

      5. I take Norco 10/325mg and i break them in half. I had a urine drug test that came positive for hydrocodone but also to hydromorphone but I hadn’t taken any dilauded since the er gave it to me on Dec 28th last year for cellulitis…why would it come up that it’s in my urine?

          1. Doctor I took 1/2 and Percocet Monday and I have a drug test Friday morning will it be positive. I have my prescription should I take it and tell them before?

          2. No, a metabolite will not show up in 7 months. With nail clipping tests, we see results up to 5 months. hair follicle is about 3 months. Urine is generally 3 days for most opioids, and marijuana up to 3 weeks, or longer.

  117. I have been using a 15 mcg/hr Buprenorphine patch, hydrocodone 5-325, fluoxetine, propranolol, Xanax .50, gabapentin, baclofen 10mg, NatureThroid and omeprazole for quite some time. Last year I had a urine test performed by a local hospital laboratory. The results were negative for benzodiazepines, positive for hydrocodone and positive for oxycodone.
    My doctor, who just recently review the 16 month old test, accused me of not taking the Xanax and of using oxycodone. I religiously take one .50 Xanax at bedtime every night or I do not fall asleep. Why am I negative for benzodiazepines? And the oxycontin? I have no idea why that would show up. I do not take Oxycontin. I think the last time I was prescribed that medication was over 20 years ago for a dental procedure.
    I felt accused of illegal activity by physician. This was very upsetting to me. He insinuated that I was trading Xanax for oxycontin. I will no longer treat with that doctor based on this experience. It’s a shame, he has been my doctor for over 12 years.
    He is not the prescriber of my pain medication (i.e. controlled substances) And I’ve not had a problem with urine drug tests with my pain doctor. I am scared to even bring this up with my pain doctor. I may end up with no medications at all!
    I just went through my first week without Xanax. It’s been miserable. I am now using Nyquil to help me sleep..
    Thanks for any insight you can provide on this situation.

  118. Hello Dr. Jeff, I have been taking Hydrocodone 10/325 for Fibromyalgia. My doctor told me that I could take 3-4 a day as needed for pain. My actual prescription says 3 times daily as needed for pain. I have run out before time to go back to the dr and I took 2 oxycodone from a previous dental surgery. I took them on Monday and go to dr on Thursday. Will this oxycodone likely show up on a drug urinalysis?

  119. Hi! I’m trying to find some answers to what happened at my Dr. visit today. I had been prescribed 80mg oxycontin 2 times a day- 160mg and 4 15mg a day- 60mg for breakthrough pain. I switched Drs and they changed it to 60mg 3 times a day- 180mg and 6 5mg for breakthrough pain- 30mg. This was about 2 months ago. Today the Dr told me that the levels of the oxycontin via my urine test were “low” compared to what my dose is. Firstly, I was not aware that a urine test could even provide levels. Can it? I thought it was just positive or negative. Second, if there is a urine test that can provide levels, is it accurate? And is there anything you know of that could cause it to come back low besides not taking the full dose? The only thing that has changed are the mg taken at once and the times I take them. I am right on the end of my previous dose and due for my next by the time I get to the appointment. Could that cause lower levels? Could the way my body metabolizes cause it? The Dr said she does not know if those things can cause it or not (how does she not know?). This is concerning because she told me to “consider myself warned” and that something needs to change next time I take my test. How can I change anything except what time I take my dose? I have no extra I can take to fix it. I can not take extra of what I have because I will run out early. I don’t understand what she wants.

    1. Emily, You are correct. Urine levels do not provide reliable data to predict amount of drug taken, nor would it hold up on a court of law. Consider that hydration status and concentration of urine alone can significantly affect the drug concentration. If your doctor is interested in monitoring your medication compliance and levels, he or she should do serum levels. The correlating serum levels to dose can be found on paindr.com under the RESOURCES tab, the select QUICK REFERENCES, and scroll down to find the PDF.

    2. I had a doc tell me that one time too. But hell I take my meds EXACTLY the way I’m supposed to for lupus and fibromyalgia and Sjögren. There’s no way I could go without them or skip a dose. Been doing the same thing for 7 years. But I was prepared to go to the extremes to prove I take my meds the way I’m supposed to. I would make a vlog. A video log of every time I take a dose and take a count and even keep a diary log of dose times. It’s a shame I feel the need to have to do something like this but that’s what happens when pain doctors deal with so many dishonesty and abusers. Dealing with the same pain clinic for 6 1/2years now and I have learned that being a good patient means absolutely nothing on your good word.

      1. Danielle H I totally agree with you I suffer from Lupus as well and I hate that we have to suffer because people abuse medication

        1. Those bad apples ruin the whole bushel, it’s a crying shame but the reality of the times we live in! Every time I get carded (I am 60 yrs old) to buy some cold medicine and even for a long lighter you use to light candles the other day, I get so annoyed these bozos make us all suffer the inconveniences!

  120. Hello Dr. Jeff! I have been on percocet for probably too long. According to other doctors and too high of a dose. 10/325mg 5x a day. My doc recently isnt coming back and sent me to a pain doc. Which is fine. He told me i had earn it. And i couldn’t just walk in and get perc 10s. So he significantly lowered my dose to 10/325 2x a day. Which has been a major change and very hard for me. I tried very hard but ran out early. I saved two. Is taking taking two before my urine test going to get me by? Im not used to even taking urine tests for my last doc. I will do better but this was really low and very hard. Thank you for ur help!

  121. Question more of curiosity than applicability. Can the urine test determine if you are taking 2 20mg oxycodones rather than 4 10mg oxycodones based on metabolites or something?

  122. I took a urine test that showed positive for opioids and it had been 3 days since I had taken them, how long will they stay in your system

  123. Dr. I am on Parole and will have a ua in the morning. I am currently taking Zantac, daily as well as Promethazine for nausea, Sudafed 24hr, and Robitussin cold and flu for a severe cold or allergy infection. I had a ua 2 days ago for employement and it came back positive for methamphetamine. What do I tell me PO so that they do jnot violate me for a dirty ua. I do not use any illicit drugs whatsoever. Is there a way they can have it tested to prove that it is not illegal drugs?

    1. Yes. If they did an immunossay test, they should take the sample and send it for quantitative confirmation by chromatography. My advise to you is to stop using decongestants for allergies and use an alternative such as an intranasal steroid which you can by over the counter – peak to your local pharmacist to recommend a product.

  124. Hello Dr I have to see a pain management group for chronic back pain. But tested positive for hydrocodone when I am prescribed Oxycodone 10mg 4 times a day.
    The thing is I’ve not taken any hydrocodone in about a year and it had stopped helping me with my pain. But my wife had surgery and ever time she needed to take it I had to breake it in halve for her to be able to take her medication that was 10mg hydrocodone. so could that of some how got into my system be breaking it in half for her?

      1. I don’t know the type of test done and I’m not sure they would tell me if I asked. The best they said they could do is retest the sample I’ve sent in.
        But wouldn’t that show nothing in my system since it’s been a few weeks? Or do they add something in order to keep it from vanishing.

      2. I don’t know what kind they did…but they said they’d re-run the last urine sample. Wouldn’t that last specimen test negative since it was sent off over a month ago?

          1. But how can I proof I didn’t take hydrocodone. Because apparently the test they do is perfect and incapable of making mistakes. I don’t have a clue on how those test works but I know there is nothing man or machine does that isn’t capable of making mistakes.

          2. Stevie, You are correct. Samples could have gotten mixed up, the columns in the lab could have been contaminated – if the levels were trace level, that’s more likely, but if they were high, it’s not.

          3. They just said it showed hydrocodone in my system didn’t say if it was high amount or not. I hope they figure it out since they are supposed to run the test again.
            Because I would know if I took hydrocodone and I haven’t I am prescribed 40mg ot Oxycodone a day so with that amount why on earth would I need hydrocodone.

          1. What causes that? I had RNY in 2000. And lost 150 lbs. But since then my narco dosent last.

      3. Hi , I’m scheduled to take a drug test tomorrow but I’ve been taking percocet 10’s these past 2 days i stopped this morning is there a way i could flush all of this out in order to pass my test ?

      4. What are your thoughts on shots they give in these clinics i will give you mine i think these doctors use that as a way to make thosands of dollars i have had them never worked but if you don’t do them they want to kick you out of clinic i am so tired of being there kinny pig i have cronic pain the meds they have me on does not work anymore been on same meds for 4 years they will not change just want to keep giving shots what should i do to get them to help me instead of guessing and giving me all these ahots plz help

  125. So if I take 5 milligrams of Oxycodone the night before my urine test it is still not going to show that I have Oxycodone in my system then why have they not failed me yet

  126. Hello Dr. Fudin,
    I am on felony probation for substance abuse. I was sentenced Nov. 13th, 2017, but put myself into drug treatment Oct. 27th, 2017, Oct. 26th, 2017 being my last use. Since then, i literally have given a flawless probation, complied with the terms of the court in every way, shape, and form, no missed ua’s, and no failed ua’s, until recently. I went in for a ua at 7:30pm one evening, but had ingested a poppyseed muffin and an avocado at 6:32pm, 1 hr prior to my ua. Unfortunately, i test positive for morphine and codeine. Later on finding out after taking it upon myself to research info to prove my innocence, i stumble across info finding out that the two substituants in poppyseed are morphine and codeine. I’ve also read that eres a glucuronide metabolite in opium that poppyseed lacks, amt4g if I’m not mistaken. So, i call my PO, explain to him that i have a positive test result, however, i tell him I want either a blood test, or a hair follicle done to prove my innocence. He says hes not going to pv me, but he’s not going to order a hair follicle, and if i want it done, i have to pay for it put of pocket. Saddest part is, 1 wk after this ua took place, i was due to graduate from rp, and be completely done with treatment. My BPA funding ended may 19th, they know i dont make enough money to pay on my own, and for my uas, and don’t have transportation, yet if i dont do this, he will throw me in prison. Now why would anybody whos abusing keep a fulltime job and be at work everyday, attent every drug class, show up for every ua, engage in every group, not relapse the entire 8 months, and then all of a sudden relapse with a substance that’s not never been my cod?? Yes i know that “every” opiate abuser uses the excuse of oh I ate poppyseed, but on the flipside of that coin, why would i go through the trouble of researching so I know my facts, volunteer for a follicle, and now pay for it out of my own pocket just to prove that im positive?? Is this the only way to prove that im innocent, and if so, which follicle would be of most benefit?? The 5 panel follicle with the extended opioid testing, the 10 panel, or the 12 panel??

    1. Aubrey,
      A hair follicle test won’t prove anything because if there was morphine in your urine, it will show up in the hair follicle. And, a single poppy muffin will not likely test positive for opiates, so the source would most likely be from something else.

    2. So if I take 5mg of Oxycodone the night before my drug test it’s still not going to show up then why have they not failed me yet for not having it in my system

  127. If a person is prescribed oxycontin 15mg and hydrocodone 10-325mg is their a way to tell in the urine test if they have also been taking oxycodone acetaminophen 10-325 (Percocet) as Well? Or does it just show up as oxycontin?

  128. This is all a very interesting thread. I came to the internet this evening out of curiosity really. I don’t have a particular concern about things showing up that shouldn’t or vice versa. I did take a test today and then began wondering if either of these two things would have any impact on results by way of chemical reactions. Menstral blood, so much in fact it appeared as if it was a blood test. Also, I have type 1 diabetes and run humalog through pump 24/7. I take Adderall, and the test is just standard, I’m sure for liability purposes. Just purely curious is how I arrived here. Any thoughts?

  129. Ok, so here is my huge,
    Massive problem… I am a new suboxone patient. I am not new to the suboxone
    Program, I am merely new to this particular doctors office, because I relapsed and dropped out of my last program about a year ago. So I am fed up once again and giving it a real go to see if I can finally make this work once and for all. I am currently doing a program where they are not charging me anything at all, contingent on weekly visits instead of monthly visits, along with a MINUMUM of 3 counseling sessions/NA meetings per week, in order to keep up in the free program. The alternative is to pay $160 within 4 weeks of starting this program up, and switching over to the paid version, which is once a month rather than every week because you are paying for it yourself. Currently I cannot afford to make the switch for the next week at least, so until then I have to go weekly, and do a Urine Screen every single week.

    Now, the first urine screen is always obviously a breeze because you are supposed to test positive. I tested positive for heroin and cocaine(crack). After a brief counseling session, they wrote me my script for the week, which was 14 8mg suboxone strips for 7 days. This states maximum amount for which they are allowed to prescribe a patient ever since the DEA decided to get involved with the board of health and decide that 3 suboxone a day per patient was just too much medicine. So I get my 14 and go home. I start to get really sick and take my meds. At this point I am cutting my strips into 4 pieces and taking 2mg at a time because the human body can only
    Metabolize 2mg of buorenorphine at a time, and anything beyond that is a waste. Anyway, long story short, I am taking the subs for 3 days, am
    Getting through the initial withdrawal period. I begin medicating on a Thursday.
    Come Sunday, I end up relapsing. My wife decides that she is enrolling into a suboxone program aswell, but only predicated on the condition that we use one last time before she goes in and gets herself her meds aswell. So like a dumbass I agree. I relapse after 3 days of using subs. So come Monday, I feel guilty. Not only that, but I am one of those people who get precipitated withdrawal even 24 hours after my last hit of heroin, so I wait another 2 days and suffer through, just to be sure, and had planned to take my next dose of suboxone Wednesday evening, before my next appointment. I make the mistake of miscalculating and realize that my appointment is on Wednesday, and I am in my car already and my meds aren’t with me, so I have to go straight in to the office and do my counseling and drug screen. I do get lucky though and a friend of mine is able to give me a piece of a sub, but because I am already there and it’s too late to take it and have it show up on my drug screen, when I go in to take the test I drop it into the urine cup. It tests positive for suboxone and cocaine. Now, I had admitted to them that I relapsed on Sunday, so they’ve already got a strike against me after only
    The first week. And I was told that since it only tested positive for cocaine and not heroin, they believe that I’m telling the truth and explain that cocaine takes longer sometimes to go away, so they’ll send my test out to the lab to check my levels on the cocaine, that way if I come back and still test positive, they’ll know what my levels were, and when they send it out again they’ll be able to tell wether or not I’ve used in the last week.

    So, now I’m stuck with a urine test being sent out to the labs to check the levels. I have a test that has been tampered with because i dropped a piece of a strip into the urine cup instead of ate it. Do they have to disclose to me wether or not they’re checking for metabolized suboxone? If they say they’re just checking the levels does that mean that they’re only gonna do exactly what they said they’re going to do? And if they check for metabolized subs, what is the likely penalty if I come clean and tell the truth after I’m caught? Or should I just die with the lie and hope for the benefit of the doubt and a “do over”?? Please help me with some advice here. Would really be thankful.

    1. They will be able to tell that the sample was tampered with. Anytime my sample was ever sent to the lab they just seemed to test it for everything. It didn’t seem to have specifications. I cannot tell you this 100% but I’m my experience the lab results will show everything regardless of dr orders. It will say the sub levels were too high as though directly added to specimen and not metabolized.

  130. Hey Jeff I’m on probation for possessing 3grams of marijuana. 6month and like terminate early if I finished the rest of the requirements 25 service hours had to see the doctor for a drug evaluation paying all my fines. I paid all my fines did my community service I saw the doctor and instead of the four visits he recommended I see him after the first appointment at the end of our second appointment he cleared me. I’m only 2 months into my 6-month probation a PO was about to send my early termination papers in for approval but I called her today she said my last urine test was positive for amphetamines and she wants me to come in for a retest Friday. The three tests I took prior show my THC level dropping in on the 3rd test it was completely out of my system but my fourth test came back positive for amphetamine. Do you have any advice for me? I have never does anything other than pot as far as drugs are concerned I have taking some over-the-counter cough and cold and congestion medicine in the past few weeks nothing for scribe and nothing from the guy on the street corner either. My test is schedule for Friday afternoon and I am worried I could fail Again I have taken over the counter medicine this week but nothing else. I was looking at being off probation in a week and now I’m what to think

    1. Call your PO immediately and ask that the sample be sent for quantitative confirmation by chromatography. If what you say is true, the decongestant(s) in cold products can cause a false positive amphetamine. Also, when you go in for retest, brinf your bottle with you.

  131. Dr. Fudin, I go to pain management once a month to get prescribed hydrocodone 10/325’s for knee pain. Most times I break in half because that supplies me enough relief to get around . Without these meds, I dont know what I’d do because my pain is bad without them to just get up and walk around. Pain management has just informed me that my last 5 urinalysis showed no signs of Hydrocodone ??? . Now im in fear of them cutting me off. I take 3-4 half tabs a day everyday. How can this NOT be showing up in my urine ???. I also take Lasix, Metoprolol, Losartan , Baby aspirin for blood pressure and prilosec for indigestion along with potassium supplement. Do you know of any reason my tests are coming back negative ??? Thank you Sir for any feedback. Eric

      1. I have A similar question with a 10/325 lortab if I took Half’s 4 night in a row making a total of 2 pills Sunday-Wednesday. Will it show positive on a Ecup Tuesday? I did A home test and it said negative I need To be sure because the Ecup is said to be high tech

      2. I have a question I take oxycodone15mg now for 5 years and have never failed a drug test is there a reason it doesn’t show on a 11 panel drug test what would it show up as on a 11 panel drug test? Someone else told me it should show up as oxy but that oxy is actually pharmaceutical heroin made could this be why my probation officer is unaware that I am actually taking my medication because to him it looks as if I’m selling my medication and I’m really not I’m taking it actually addictive to it couldn’t afford to give none away please help me understand this

  132. I’ve put myself in a bind and I’m not sure what to do. I have been going to a pain clinic for Suboxone for the last few months and at my last appointment they said i need to take a UA. Thankfully i got out of it cuz i had to go back to work. But the nurse just said come in before your next appointment. I plan on going on April 16th. I have been taking adderall and Xanax for the past few months recreationally. It’s been pretty consistent. I don’t know what to do. Should i call them and tell them the truth? Should i take the test and they can see the results? Should i try to see a psychatrist to see if i can get them to prescribe those meds? If i did that i would have to lie about being on suboxone. Anyways i don’t want to lose my script, i can’t. And ill be really sick without it. Any advice??

    1. QuickFix Plus. I’ve been using it for quite some time. It works. Cut a piece of your pill into it and follow its directions. It’s lab safe. Meaning equates with the Ph levels and creatine found in human urine they check for. I’m a pain patient prescribed Norco 10/325 and use Mary Jane for sleep and anxiety. This is your best bet at passing. Watch videos and read reviews on it. It saved me so I’m just trying to pass along the good antedote. No more than $30 at your local smoke shop. Very simple and easy to use. Hope this helps and God bless.

    2. Do not do that if you put just straight Xanax in your urine it will show that it have not been metabolized they will check do not do that if you put just straight Xanax in your urine it will show that it have not been metabolized they will check for 7 to 10 days you will get in more trouble cuz they will be looking for the Suboxone and the metabolites and they will know it’s a fight UA if you just put the pill in please do not do that just flash maybe get something from your local store or anything like that good luckchari

  133. Dear Jeff…i have been on vicodin for over 10 yrs now..never abuse my meds..i am missing 5pills but cant blame anyone cause not sure…anyway lesson learned an they will b locked up for now on..But my question to u is..my last dose was 10 mg an took it this AM…Have my pee test @ 12 noon 2mora..will i show poss on my test an b ok?

    1. Donna,

      It depends on the type of test they do. “opiates” can test negative with a low dose such as 10mg hydrocodone, even up to 40mg per day. But “hydrocodone” by chromatography would likly be negative past 8 hours. If you took 10mg 24 hours ago and not regularly, “opiates” will be negative and so will a specific test for hydrocodone.

        1. If we’re still on the subject of diazepam, it’s because diazepam has a very long half-life, so it stays around for a very long time. If you’re asking me about something else, please post a new comment and include the actual item you are questioning.

    2. Interesting missing pills-I get my hydrocodone filled at Wal-Mart have for years-I have always been missing pills-just kinda blew it off thinking I miscounted-well I started counting my meds when I got them-sure enough missing 5 or 6 every month for 6 months-well got brave confronted the pharmacist-he refused to correct the issue-said he would count his inventory at days end-he told me the next day his inventory was correct and he did not know what I wanted him to do-I requested the missing pills-after a few minutes and a few choice words I was given 6 pills and told I would be red flagged well I don’t fill my prescriptions at Wal-Mart anymore and I always count my meds at the table before.i leave any pharmacy-don’t like to be called a lier or thief-don’t trust any pharmacy

      1. That is crazy! I had that happen quite a few years back in the wrong direction there was quite a bit extra. I told them pretty quick because I didn’t want a careless error to result in it looking like someone had a problem they didn’t and I can’t remember off hand what they did/said but they changed the policy after that and they started a triple count. Once with machine, and then two separate humans. On the bottles each count is marked, computer and then two separate initials. Does not surprise me re: Walmart

  134. My father is expected to do a urine screening about ice a year. My question is he has one coming up im two days. He hasn’t taken his pain meds Denton sever constipation. He doesn’t want to loose his prescription, so how can he have the I died in his system for this test? Should he take like 6 right before, intermittent of course. We’re just wondering. His den knows he struggles with constant constipation and she also knows they don’t help his knee pain anymore but she refuses to switch. Can you help me so he has atleast some of this medicine in his system?

  135. Hello Jeff,

    I am in desparate need of answers. I have a rare genentic condition that causes sever scoliosis and bone fractures. I am 36 and have been on pain meds for over 10 years. I have to take methatdone 10mg 4 times a day and Norco 10/325 up to 5 times a day. However the Norco never shows up in my Urine and now I’ve been cut off. I also take Omeperazol 20mg twice a day, Norvasc 10mg daily, Lexapro 10mg, and Potassium and Iron. Is there anyway this can be explained? The Dr. Said if it didn’t show up in my system that means I haven’t taken any for 3-4 days but I read it could be out in 24 hours. Also I skip doses to be able to “double up” when needed which my Dr knows about. Without this medication I will have to quit my job and go live in a hospital/

    1. Kimberly, I cannot answer this questions without knowing the type of test your doctor performed for the hydrocodone. Also, assuming what you say is true, I would need to know what time the last doses were taken from the time of test, each time you tested negative. Also, it might me worth while having a pharmacogenetic test done specifically to test for CYP3A4 and CYP2D6.

      1. I do not take my pain medication daily. Its been a week. I take Norco 7. 5. I goto dr Monday around noon. When Dr.should I take my pill? I have one left. I’m disabled, don’t get but 60 a month. Its a 5 panel Urine Test.

      2. Dr. Jeff,
        I do not take my pain medication daily. Its been a week. I take Norco 7. 5. I goto dr Monday around noon. When ,Dr.,should I take my pill? I have one left. I’m disabled, don’t get but 60 a month. Its a 5 panel Urine Test.

        1. Jane,

          Even if you took that dose twice daily on a regular basis it may not show positive unless it’s sent out for chromatography testing. The ideal time to take it would be 3-hours prior to the urine test.

          1. Yes I have a job drug test tomorrow and I took a few oxy like 3 or 4 days before Will it show on a urine test

    2. I have multi-level spinal fusion. Opioids help in short doses but you honestly end up in a pain loop if you take them long term. I took them for years and I’d be in excruciating pain if I missed my MS CONTIN does by a few hours.
      I used Baclofen to ease withdrawal. I’m fine. Not saying pain free. I got tired of living in a manner that hurt my esteem to the core: constant drug tests, if something shows up then accusations fly without any confirmation, looked at like a drug seeker when you seek medical help for very real issues only to find out in the late big run opioids do only slightly better than placebo for non cancer pain.

  136. I live in KY amd have been going to the same Medical Dr Group for 10+ years. I am prescribed Adderall and Xanax. At my last appointment it was time to update my drug screen. I laughed and said I can pee on command (obviously I had nothing to hide). I fill my medications and go on with life. 9 days later I have to sign for a certified letter. The letter was standard and dismissing me as a patient and said I must choose a new physician. I finally get a call from the office manager today telling me my drug screen was positive for methamphetamine. I’ve always taken the same orange generic pill until last month, I was given a different generic and it was horrible. It made me agitated and angry almost. I even told my pharmacist I never wanted it again. It was white, hexagon with an M on one side and 30 on the other. Thats the only thing I can think of. Could that cause it? Also, will my Dr report the failed test to KASPER? I’m devastated.

    1. You must have received the Mallingckrodt brand of Adderall like I did, got severely I’ll and they didn’t work, I thought I was going to die but the pharmacy refused to take them back. We’re they crumbly as well? I think they were contaminated. I’ve always used Teva or Core Pharmacy they are a dark peach color. I think your labs are supposed to show amphetamine as this is what Adderall is.

    2. This is so crazy that they would do that to u cuz Adderall shows up as meth and they know that!! My brother was on Adderall for his narcolepsy and needed up going unresponsive and had to be placed on a vent and the dr came I and was looking at his toxicology report and him and the nurse was like well here is the problem he tested positive for meth and I told them no shit he is on Adderall but they legit wasn’t going to do anything for him cuz he had meth in his system rather than look at all the meds he was on!!! It is crazy all the stuff the people who truly need meds for chronic pain or stuff like this cuz of all
      The abusers and users out there!!!