Negative UDS.. how on earth???

[StillRN]

This is so weird I have no clue how this happened.. any ideas??

I had shoulder surgery on 8/29 through workmans comp. I injured myself lifting patients at work. I had SLAP repair with cyst decompression, debridement (sp?) of frayed rotator cuff, and AC joint decompression (part of collar bone at AC joint cut off). This was done under general anaesthesia. These are the meds I KNOW I was given .. clonazepam 1 mg before surgery, IV versed before nerve block, IV fentanyl 100 mcg and IV dilaudid 2 mg after surgery, IV Benadryl after, Oral Oxycodone after surgery. I have no clue what I was given during surgery.

Well ill of course I was picked for UDS that day.. so my Boyfriend drove me to the clinic and I miserably hobbled in and did the test about 6-7 hours after surgery.

I just checked and that screen and it was negative. How on Earth could it have possibly been negative after all of those meds I was given????

I am am completely stumped!!!

Any ideas? Has this happened to anyone? I do know I never test positive for dilaudid for some reason.. but the rest should have shown up!?!?

(if anyone is wondering, I've been given dilaudid scripts several times this year.. I've had a rough year. Just in the last MONTH I've had 3 surgeries (1 emergent), a root canal, and 3 trips to the ER. The emergent surgery was for a very severe oral abscess that went from my Cheek bone down my throat. I had a severe infection with 2 plus weeks of fevers up to 104.7 and constant rigors. My kidneys and liver started shutting down due to severe dehydration as well. It's been pretty awful).

[Big Blondie, ASN, BSN, MSN, APRN]

Option done may not test for those drugs.

[StillRN]

It was option 2... I can't imagine it wouldn't test for any opiates or benzo's... anyone know what option 2 is?

[catsmeow1972, BSN, RN]

I think if the program knows you are taking those things and/or have provided notice of the surgery or provided proof of the prescription or reason for it being given to you, then it gets logged as negative.

[StillRN]

I didn't provide the info until 2 days after.. the surgery was not approved until hours before because my work comp adjuster refused to answer phone calls from me or the surgeons office. It was a huge mess!! And the only proof I provided was script for oxy.. my monitor never emailed me back to find out more info.

But it does show positive confirmed every now and then for my clonazepam, which is a regular script. I barely test positive for that either.. which is odd.

[Lisacar130]

I looked up how long it takes IV opiates before they show up in a drug screen. It said 2-6 hours. Although it should have showed up by then, maybe it just didn't yet? Or maybe it was starting to show up in your urine but you were diluted enough from IVF to where it didn't flag a positive?

[catsmeow1972, BSN, RN]

I agree with Lisacar130. Based on the fact that we give people IV Dilaudid post op Q2h, it likely doesn't stick around very long plus the hemodilution. I would wonder more about the benzo effect of the versed. and clonazepam.

I honestly wouldn't worry about it. If you can legitimately justify with documentation every instance where you have been given anything that may be of concern, they can't claim all of a sudden that you are violating your contract.

I have learned at least with my program, if you try to make sense out of their idiocy, you will only succeed in driving yourself batti(er).

[Glycerine82, LPN]

Any drug screen that is positive for prescription meds taken with a prescription is reported as negative.

[KatieMI, BSN, MSN, RN]

While you were sleeping under, you were given a whole lot of NS. Anesthesia usually just runs a bag open wide at all times unless they know that patient has HF, KF of some other problem which requires fluid limiting, and ortho surgeons often want patient to be "a little diluted". I have no idea why - one told me that diluted blood doesn't bother them that much while they dig within the closed joint. Maybe it is so - the fact is that's what they ask anesthesia for and get it done. Patients pee a whole lot after that, of course, plus they might be given a touch of Lasix right before the gas is turned off. Plus, 6 to 8 hours is "pharmacokinetic blind window" for many drugs (quick-eliminating metabolites are already peed out, slow - eliminating ones are only getting built up, so all metabolites' levels are at the lowest at this time; later, slow-acting metabolites' levels may go up, and the latter ones are mostly targets of drug tests). Plus, you ate something soon after surgery and your liver was working on fresh fuel and blood and metabolizing stuff with super-speed.

Count yourself lucky :)

[noctanol]

This may sound weird but I know (as of this year) of 2 nurses that were drink during testing and still passed, I also know of a nurse who swears she hasn't had a drunk in 15 or so years and it wasn't even her drug of choice. She was on her second to last drug test and she tested positive for alcohol, the only thing she could think of was gum or mint breath strips because even her mouthwash is alcohol free. Anyway, due to the draconian law's of the TBON she has to re-enrol for another year of testing with her license going on probation for 1 more year. And the time from the positive alcohol screen to the new order was roughly a year, so we're talking her having to endure 2 years of testing in addition to 2.8 or so that she had already tested negative for.

[michelle4SN]

My group facilitator told me they don't always test/send in the specimens.

[Big Blondie, ASN, BSN, MSN, APRN]

I had tramadol post op and my drug screen showed positive on the site. They had copy of my script. So in Texas they don't put negative if you have script.