What Causes False Positive Results For Hydrocodone And Oxycodone?

Posted on Thu, 2 Apr 2015

Question: HI...I have been on Suboxone strips for over 4 months, other prescription medications I've taken are: Prozac 40mg-1xday, Concerta 36mg-1xday, Wellabutrin 150mg-1xday, Zantac 150mg-1xday, Klonopin 10mg 1xdaily Daily vitamins: Biotin 10,000mcg and Vitamin D 5,000mcg. Over the counter medications: Ibuphrophen 800 mg 1xdaily and Aleive 200mg 2xdaily. My Dr. would give me an oral swab test weekly at first, then bi-weeklky, and then monthly. All test of couse came back positive for the Soboxone (Buprenorphine and Norbuprenoorphine) and at the correct levels in my system for the amount I'm prescribed daily. I have a temporary filling in my tooth made by DenTemp and I sometimes rinse my mouth with Chlorhexidine Gluconate for my gums. My first 3 months of testing was perfect as far as results go. Then one test came back positive for hydrocodone AND oxycodone!!! The swab testing method used was "LC-MS/MS". The measured results showed "1" for both and the cut off is "1". The Buprenorphine measured "108" and it's cut off is "1". The Norbuprenophione measured "3" and it's cut off is "2". I was shocked and thought the Dr. was teasing me because I have not taken anything but what I've listed above for your reference. I have taken exactly what my Dr. has perscribed for me and nothing more since I started his program. To make matters worse, we retested again imediately and the results came back in a week positive for Heroin!!! How is this possible??? I told my Dr. that there is no way that those 2 tests can be correct. I opted, at my own expense, to take a hair folicle drug test, which I am providing. I want to prove to him, beyond a shadow of a doubt, that for the past 90 days I have been honest. When I go to my appointment tomorrow I'm afraid of the results from his 3rd consecutive weekly drug test. PLEASE, PLEASE, PLEASE, CAN SOMEONE HELP ME CLEAR MY NAME??? I need feedback on what substances or situation create this error in my results. If my next swab comes up positive...can the lab then test it further...or is there another way to contest the results that I know 100% to be false positives?

Answered by Dr. Dr. Matt Wachsman (54 minutes later)

Brief Answer:
That is one crazy combination of drugs.

Detailed Answer:
First, Klonapin 10 mg.... it only goes up to 2 mg.... 2 mg three times a day is a maximal dose. That's a lot. Sure it isn't ONE milligram?
Next Multiple overlapping medications:
Prozac, Concerta, Welbutin all work on the stress hormones and serotonin. An overdose like effect of either stress hormones (elevated blood pressure, heart rate, etc.) or serotonin syndrome (flushed, diarrhea, confusion, writing long blog posts) ae quite possible.

Ok...
Then your question
Heroin and poppyseeds is quite well documented. Otherwise, got no idea if it is LC/MS which is quite accurate.
Go for the hair follicle test, but if poppyseeded, then it probalby will also show heroin. Swab and conventional (from the pharmacy) lab tests are often inaccurate. There are some known cross reactants. But shouldn't be seen in LC/mS
http://www.ncbi.nlm.nih.gov/pubmed/0000
this is the bad results with the bad tests.
the advantage of You using the hair testing is...it's a different lab than the last one.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar