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 Post subject: Odd UA results
PostPosted: Tue Jun 27, 2017 3:50 pm 
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Hi everyone this is my first time posting here but I'm perplexed about a situation and not sure who to ask. It seems in my last UA my Naloxone amount was higher than the bup. Amount. I don't understand how this could happen but now my doc wants me to start doing randoms and sub counts. I'm compliant with my meds. Though some days I take 3 other days 1 per my doc depending on if my fibromyalgia is acting up or not. I'm obviously no angel..I've slipped up on cocaine but not on opiates. Is this just a witch hunt to "prove" I'm doing something wrong or is there a reason Why my UA would show this result? Thanks to anyone who can help.


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 Post subject: Re: Odd UA results
PostPosted: Tue Jun 27, 2017 5:19 pm 
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Hey Raindrop welcome! Cool username btw!

Well I haven't ever saw this question before personally.

'Though some days I take 3 other days 1 per my doc depending on if my fibromyalgia is acting up or not'

So on days u have more pain than others, ur doctor tells u to take more than u would on a day that ur not having pain, is that what u mean? I'm still not sure that would cause ur naloxone levels to be more than ur buprenorphine levels. I have to admit, I don't know much about testing levels or even if my doctor tests for naloxone. What would be the point of testing naloxone levels?

As U can tell I don't know enough about this topic to help ya but hopefully Dr Junig or docm2 will be able to help u more since they obviously know sooooo much more than me :)

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Jennifer


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 Post subject: Re: Odd UA results
PostPosted: Tue Jun 27, 2017 5:31 pm 
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Ive have heard or read this before but as Jenn said it makes no sence to test for it.
Naloxone doesn't store in the body. It is only swollowed and pasted though your system in a matter of hours. This is what ive resd here from Dr J. It is called First Past metabolic. Distroid at the Liver..,

Sounds like a witch hunt to me. Type in Naloxone in the Search box Rain over in the TalkZone..l Dr J has written about it there..


Razor


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 Post subject: Re: Odd UA results
PostPosted: Tue Jun 27, 2017 7:20 pm 
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Yes that's correct..she gives me the option to take more if needed for pain..after I had my baby she also allowed me 3/day as needed to manage pain. Thanks I will continue to look into what I can find out. The username came from watching alot of Disney fairies with my daughter. Lol!!


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 Post subject: Re: Odd UA results
PostPosted: Tue Jun 27, 2017 10:23 pm 
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Prior to my coming to my current position my clinic used to do a panel that would include quantitative buprenorphine, norbuprenorphine and naloxone levels on samples, and the usual survey for abused substances. I asked why, got some cross eyed looks and eventually was told that Millennium Health and then later Quest suggested it. I reviewed with their toxicologist. They didn't have a rational beyond they ran the test because it had been ordered. During treatment testing is controlled by the LADC's and not physicians. Another problem that I hope to have more input as time goes by.
The Naloxone levels have since been dropped.

So what if its level is higher. There is no correlation. Do they think you are taking Naloxone tablets, overdosed and got Narcan or started Vivitrol?
The ignorance is high at your clinic, I would start looking for somewhere else, unless I totally missed your question and need to rethink my response.
I'll let others weigh in on the sobriety and cocaine piece, but that may be the reason they are putting the extra counts and such in place.
I'm not a great fibromyalgia mind but PRN buprenorphine is not a typical strategy for management.
You should be on a set dose and stick with it. If you were under 8 mg a day then a couple of extra mgs occasional may help.
So, I started this post at 4:30, the power went out and went to dinner then a soccer game.
Hope the OP comes back.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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