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Thread: Metabolites and their pain clinic uses?

  1. Default Metabolites and their pain clinic uses?

    Does anybody have a list of common metabolites that are tested for in pain clinics? Codeine, for example, metabolizes into morphine. Hydrocodone metabolizes into hydromorphone. Heroin can be distinguished by its unique 6-AM metabolite. And so on.

    1) Does anybody have a complete(-ish) list of the metabolites of drugs commonly tested for in pain clinics?

    2) Does anybody know how sensitively pain clinics are drug testing? [Insert your "Since when are pain clinics sensitive?" joke here.]


    For example, let's say I go in for my monthly humiliation-and-shaming session (or my "med check," as it's called in the biz), I know they can test just for opiates broadly, but I assume they're routinely testing for the specific metabolites of the at least the opiate that I'm prescribed, right?

    Are they also testing everyone for heroin and for every other opiate under the sun to make sure you're not only taking the one you're prescribed, but are they also, say, testing for codeine to make sure you haven't been sneaking in a little Cheratussin there on the side?


    I'm sure the only 100% correct answer is that it depends on the clinic, the doctor, and maybe on the specific patient (though honestly I think most doctors nowadays believe we're all junkies, and if they don't believe that, they best act like they do if they know where their career bread is buttered).


    In short, if I'm prescribed, say, hydrocodone, and I happen to have taken some oxycodone in the days prior to my piss test, what's my likelihood of getting caught? Assume for the sake of argument that I have also taken the prescribed hydrocodone in that time frame as well, so I will test positive for the one I am supposed to test positive for.

    It doesn't seem very time-effective nor cost-effective to test every single pain patient for every single opiate under the goddamn sun....but, then, when was the last time logic or facts entered into pain medicine?

    And yet....let's make this an even more innocuous scenario, given that oxycodone and heroin are both common drugs of abuse, so maybe clinics do routinely test for both those....but let's say I did have some Cheratussin in the medicine cabinet and I took it prior to my drug test. Do they test every single goddamn patient for codeine to make sure nobody sipped any forbidden cough syrup?

  2. What lab does your pain management doctor use for toxicology test? I don’t think they are supposed to but mine has sent me the complete list of what is being tested for a couple times. I guess I could put pics up if everyone was interested. Long story short it’s epic ridiculous how much shit they test for , And the test is over three grand. I remember seeing even methaqualone is there I think which is crazy because 99.99% of people can’t get their hands all that shit in the USA.
    Likes calgal99 liked this post

  3. #3
    I can only comment on my own experience as I go to a pain clinic and my results are done by AIT labs in Texas.

    I am prescribed Tramadol and Hydrocodone, plus a lot of other non narcotics.

    They test me for damn near everything. Fent, Oxy, Codiene, Carisidopral, Methadone, etc... also test my creatine and other structures in the piss.

    The CT will determine the exact metabolites found. Right? So if I go urinate and it’s tested positive for opiates, that is expected because hydrocodone has a roughly 5% giveoff for codiene. So that CT is done to alienate what causes the opiate positive and they see what particular drug did that.

    So if you sneak in an oxy or two the day before the test then yes, they will know (in my case). They also know how much I am taking as well, or a rough estimate. So if I decide to not take my meds but keep maybe a couple so my test shows it, I better have saved a decent amount over the course of a few days so those levels are in range.

    Testing is pretty narrowed down in scope for me.... I think there are a few substances I may be able to swing by. I know Kratom gets by. I have wondered if I took tap if that would show because they don’t actively look, in my case again, for tap. So I wonder if it would flag the opiate as expected, but since the CT shows hydrocodone, they would end it there.

    And even though hydrocodone does have a small amount of codiene in a byproduct, it’s so small that I doubt I could really take much codiene and skimp by because the levels would be too high.

    I usually get tested only once or twice a year though... but I’ve went so long now that I have a lot of records I can look at.

    Funny thing is half the time they run the tests as a full health check for your iron, vitamins, etc because insurance is more readily to pay for that as opposed to a strict drug test.

    My best answer would be to expect them to see exactly what is in your urine.

    Last comment I can make is no matter what I put in my body, opiod / opiate wise, if I give at least 5 days of discontinued use and continue on a strict schedule of what I am supposed to take, my urine tests and the CT have always been safe and either 0 or under 50ng/100ml

    Soma I would give at least 7 days and I’ve passed marijuana only 10 days after a weekend binder... maybe 2-3 uses over a weekend. I’m by no means healthy or hydrated enough either.

    You would be amazed though how many chronic users of marijuana will fail 90 days after discontinued use. It’s really just a how often how long game.

    These days I don’t play around with my drug tests like I used to. Why risk it anymore... even though I am not prescribed enough I am at least prescribed something and the pain clinic is the only thing that is somewhat sheltered from the constant abuse of the DEA.

    So I now go in every 90 days and only 60 of those days do I supplement online.
    Helpful songsiren Rated helpful
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    @Azzamean I would love to talk to you in more depth about this. I have some questions about testing?? Im running into that now and could use a friend :-) Is there a way to friend you or PM?

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