It is currently Tue Aug 22, 2017 9:49 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 12 posts ] 
Author Message
PostPosted: Mon Apr 25, 2016 1:56 pm 
Offline
New Poster
New Poster

Joined: Mon Apr 25, 2016 1:41 pm
Posts: 3
Last month I had my 7th sub doc visit and every month I'm prescribed 16mg a day. Every visit has been great, perfect councling, perfect drug screens, etc. The doctors office sends all urine screens to an outside lab for testing and now my doctor says that even though my urines been great in the office my levels are way off.. the bup is fine but nalox comes back as zero.....! Obviously I take my meds or there wouldn't be the bup in there... I also take mental health meds so could they be the cause? I take lithium, hydroxyzine hcl, and prazosin.... please help because I'm scared I'll lose my doctor over this.. they only give 4 warnings then your out and I only have 1 over this


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 2:19 pm 
Offline
Moderator
Moderator
User avatar

Joined: Mon Sep 15, 2014 7:15 pm
Posts: 2310
Location: Tennessee
Hey pittylover,

I didn't know they even checked for naloxone, but I'm not very educated on the drug screens. I just thought they checked levels on bupe. Hopefully someone with more knowledge about this can help answer that for u.

Have u asked ur dr if anything can affect the levels, like other medicine ur taking or anything? There has to be an explanation for it if ur taking ur sub like ur supposed to and it's still not showing right. That has to be so frustrating. I really hope u get some answers.

_________________
Jennifer


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 2:52 pm 
Offline
Moderator
Moderator
User avatar

Joined: Tue Mar 11, 2014 10:48 pm
Posts: 1316
Hello Pitty,
Your the second poster in the last couple of months to have this lab problem.

What confuses me is that naloxone make a quick exit fron the body after being swollowed. It is destroyed by the liver though a process called First Pass Metabolism. Naloxone exits in a matter of an hour or two.

Dr Junig has written on this subject before. Ill do some digging around here and see where I can find it.

My guess is your doing nothing wroug here, why all this concern about naloxone puzzles me too.

Razor


Top
 Profile  
 
Our Sponsors
PostPosted: Mon Apr 25, 2016 2:58 pm 
Offline
Long Time Member
Long Time Member

Joined: Thu Aug 08, 2013 5:40 pm
Posts: 421
I would offer to take your medication in front of them so they can confirm that you are actually taking it. Yes, Millenium lab does test for Naloxone when Suboxone is checked as a medication being taken. Why, I don't know, seems like a waste to me. Both of resources and provoking anxiety.
If they are rigid and would kick someone out of the program over something like this I would start looking around for a new program, at least you have 3 more strikes.


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 3:14 pm 
Offline
New Poster
New Poster

Joined: Mon Apr 25, 2016 1:41 pm
Posts: 3
My doctor asked me at first if I had been selling them then at the end of our conversation he said he believed I take my meds like I'm ssupposed to and that maybe it's not being absorbed all the way


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 4:19 pm 
Offline
Average Poster
Average Poster

Joined: Sun Apr 24, 2016 10:14 am
Posts: 7
Suboxone doesn't show up on a regular drug screen. I'm pretty sure they have to specifically test for bupe or else it doesn't show up at all.

I got accused of selling my medication, too. I wasn't. I told them that it doesn't show on the regular 20-panel they have in office, and they said that I didn't know what I was talking about.

The internet seems to confirm this, and pharmacists have told me. I'm decently sure it doesn't show on the vast majority of in-office drug screening kits, especially the "dip-stick" or peel-panel ones, but I've also been shown the "more thorough" 20-panel tests, and it's not on there.

Unless technology's caught up with the prescribing of Suboxone, I think it's safe to say it *usually* doesn't show unless it's sent-off to another lab such as Quest which regularly processes bloodwork, or unless they specifically ask the lab techs to screen for plasma levels of it, such as in the case of a suspected drug overdose. But I wouldn't imagine they do that at most doctor's offices,

Although it's odd how this keeps happening across the country in offices WHICH PRESCRIBE the Suboxone, themselves.

But know that you are not alone. I don't know if they'll believe you. You might could call your local pharmacist and ask for advice, but I don't know. You can look up your local Kroger, Walgreens, CVS, etc. 's pharmacy numbers online, if you want to give it a go.

Love and best wishes, -S


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 4:28 pm 
Offline
Average Poster
Average Poster

Joined: Sun Apr 24, 2016 10:14 am
Posts: 7
Additionally, a small segment of the population are "ultra rapid metabolizers", who possess 2 or more copies of the CYP2D6 allele. It's not very common, I think it's present in maybe 5% of the population, but I think you can request a metabolic panel or some sort of specific test to confirm or deny whether you are or aren't an "ultra-rapid metabolizer" if multiple drugs seem to clear your system quick.

I think we have a doctor on board here, they might be able to tell you more about Suboxone and drug tests.


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 6:17 pm 
Offline
Long Time Member
Long Time Member

Joined: Sun Feb 14, 2016 9:40 pm
Posts: 628
Hey Pitty,

The recent prior poster questioning urine tests for naloxone had the opposite problem. Unlike your testing negative for it, s/he came up positive for naloxone and said the problem with coming up positive for narcan is now the bup clinic director suspected her/him of going back out to full opiates and used narcan to prevent OD. Given Razor's comment, it seems as if naloxone should test negative.

Dis, do you mean bup and pain mngt clinics do not usually in-office screen for bup? or do you mean do not in-office screen naloxone? Most of us here are/were in-office screened for bup plus many other drugs which are often sent to an outside lab for confirmation.

_________________
Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


Top
 Profile  
 
PostPosted: Mon Apr 25, 2016 7:49 pm 
Offline
Long Time Member
Long Time Member

Joined: Thu Aug 08, 2013 5:40 pm
Posts: 421
Quote:
Suboxone doesn't show up on a regular drug screen. I'm pretty sure they have to specifically test for bupe or else it doesn't show up at all.


There are now in office (point of care or POC) available in a variety of screening packages. I currently use an 8 panel that includes buprenorphrine and a variety of other substances. They now sell single use dip sticks for buprenorphine and many other substances. I will be adding the saliva test soon for the bashful bladder or "I just went before I got here" folks.
There is a company that tailors there product for sub clinics, providing a variety of urine or saliva tests.
It would make sense for an office that is prescribing Suboxone that they would include it in their POC screen. I'm trying to avoid the confirmatory tests because they are pricey and really don't give me that much more information.


Top
 Profile  
 
   
PostPosted: Mon Apr 25, 2016 11:28 pm 
Offline
Long Time Member
Long Time Member

Joined: Sun Feb 14, 2016 9:40 pm
Posts: 628
docm2,

This is why I like to come here - to listen and learn. Never heard of the 'bashful' badder till now. And the 'empty bladder' folks remind me of an aviation friend's comment 'Proper preparation prevents piss poor performance', which wasn't meant for drug testing, yet applies. The saliva test takes care of that! Pelican

_________________
Did well on Suboxone. Stopped May 2011.
Stopping went well -- its the staying stopped -- where the real work begins.
Coming here 'keeps recovery green'.


Top
 Profile  
 
PostPosted: Thu Apr 28, 2016 1:17 pm 
Offline
New Poster
New Poster

Joined: Mon Apr 25, 2016 1:41 pm
Posts: 3
The problem isn't with the in office drug test. Its that when they send it to the lab I have the bup in my system but no naloxone. How can I have one ingredient and not the other especially when I take two strips a day


Top
 Profile  
 
PostPosted: Thu Apr 28, 2016 7:34 pm 
Offline
Long Time Member
Long Time Member

Joined: Thu Aug 08, 2013 5:40 pm
Posts: 421
How can I have one ingredient and not the other especially when I take two strips a day

Razor answered that earlier. You are on a tiny dose, 4mg a day, most of which is not absorbed or metabolized very quickly. If you spit your saliva afterwards as many do, you could consistently be below the reporting threshold. That is why I said to offer to take the film in front of them. If back on a full agonist you would get very sick, if not taking anything you would be quite sedated. If it was your regular dose at the routine time then meh, nothing happens.
There is not really a rational reason to base treatment decisions on whether or not naloxone is present, as long as the buprenorphine is there and its metabolite, norbuprenorphine.
Consider that alcohol addiction when naloxone is used as part of treatment the dose is 50 mg daily.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 12 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

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

Powered by phpBB® Forum Software © phpBB Group