Addiction to Drugs/Drug Testing

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Question
Hi Jacqui, thank you for taking the time to answer my question.

Recently, I have had a routine drug test for work. I have been taking Tapentadol for about a month now, as a genuine prescription for pain proceeded by surgery.

Tapentadol is a opiod, so, will this show up on my drug test?

Also, is there any way to distinguish between tapentadol, and recreational opiods (like opium)?

Will the drug test be able to determine the amount of medication I take?

Answer
Hi Alaya,

Thanks for your question and I hope you are well.  Tapentadol isn't a drug that I have heard much about so I did a bit of research to find out more about it.  It is a relatively new pain reliever for moderate to severe pain and first came onto the market in the US in 2008 and in Australia in 2010.  It is similar to another medication called tramadol insofar as it binds to opiate receptors and also noradrenaline receptors (although unlike tramadol it appears to bind less strongly to serotonin receptors).  You would need to be mindful of speaking with your GP if you are taking any antidepressants with this drug (as some of them act on noradrenaline receptors also).  It looks like it has been scheduled as an S8 due to concerns about the risks of dependency/misuse.

I am not a fan of drug testing in the work place, unless in roles where there are genuine safety risks (i.e.: airline pilot).  However it does seem to be a thing that employers like to know about.  Given that it is a relatively new drug it doesn't appear that it will show up on standard workplace drug screening and from the information I could get, they would have to pay for a separate test.  However, I don't know the kinds of tests your employer is using, so anything is possible.  Generally the standard tests that are used have a category called "opioids" and if picked up, it would show up as a "positive" in this category.  Usually they then do a futher test to see what kind of metabolites are in the urine which can indicate the type of substance used; tapentadol results in N-desmethyltapentadol metabolites which would have to be interpreted by a pharmacist of medical practitioner with knowledge in the area.  Other opiates metabolise as morphine or codeine metabolites and the fact that it doesn't come up as either of these makes me think that they won't find it - but I am not a pharmacist so keep that in mind.  Drugs like heroin show different metabolites over time, but it can read as morphine, codeine, etc.  You could get ready for the potential of a positive test by seeing your prescriber and asking her/him to write a letter stating that you are on it for medical reasons, then if you don't need the letter you can just hang onto it in case.  In answer to the last part of your question, to detect the amount you are using they would need to order another quantitative test and I doubt an employer would have access to this.  It seems very specialised.  The 'half-life' of this drug is fairly short also (although there is a sustained release version which would be longer acting), and I could only find one bit of information about how long it would last and that suggested approximately one day - although this was via a drug forum not a research website.

It is good to be mindful that this medication is likely to cause dependency in long term use which means you would have to be weaned off it.  If a medical practitioner has decided you need it they will have hopefully weighed up the pros and cons of this and decided that the benefits outweigh the risks, but still worth thinking about, especially if you have ever previously had a substance use problem.

Anyway, good luck!  And please don't hesitate to let me know if I can help with anything else.

Take care

Jacqui  

Addiction to Drugs

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Jacqui

Expertise

I am a psychologist committed to Harm reduction, a philosophy that acknowledges people will continue to use drugs despite all of the effort put into stopping it (case in point - US government drug war ... trillions of dollars spent fighting and more people using). I advocate to support people who use drugs by reducing the harms associated with their use through needle and syringe programs (NSP), advocating for drug law reform, non-judgmental health services and reducing the stigma associated with drugs. I have worked in harm reduction in Australia (NSP, primary health care, drop in centre) for 10 years and also have 18 months managing a service providing care coordination for people with multiple and complex problems. I spent two years living and working in Cambodia as a Harm Reduction Advisor for a local Khmer NGO, primarily focusing on methamphetamine use. Now I am back in Australia and have worked in a prison providing drug treatment and currently work as a psychologist in a dual diagnosis service (for people with mental health and substance use problems). I have a Masters in Clinical Psychology so can also answer questions around mental health and drug use. Happy to answer questions about blood borne viruses such as HIV and hepatitis C, questions about opiates, amphetamines, cocaine, benzos and other substances. Questions about treatment (particulary methadone and buprenorphine). Questions about harm reduction and why it is the best approach. I will try to answer questions about drug tests. I DO NOT JUDGE PEOPLE NEGATIVELY DUE TO THEIR DRUG USE, AND DON'T DEMAND PEOPLE MARCH STRAIGHT OFF TO REHAB! If anyone has taken a sip of a coffee, or drunk a beer, then ... well we are all drug users, and I don't think we are going to see an end to it! Deal with the real.

Experience

Worked in the field in Australia and Cambodia for 15 years. Psychologist with Clinical Masters. Two significant research projects on drug use (one on HIV risk and its link with trauma and one on drug related stigma). Presentation at two international conferences and two Australian conferences.

Organizations
Registered as a psychologist with the Australian Health Practitioners Registration Agency.

Publications
Conference proceedings - IHRC 2004 (Chiang Mai), 2005 (Melbourne) & 2010 (Bangkok). Anex Conference 2005 (Melbourne) Stigma-Pleasure-Practice conference 2006 (Sydney).

Education/Credentials
Bachelor of Arts (Humanities), Bachelor of Psychology (Honours), Masters of Psychology (Clinical). And a multitude of training courses including advanced first aid, pre & post test counselling accreditation for HIV, significant amount of training on hepatitis C, etc.

Awards and Honors
Have presented at international conferences including the International Harm Reduction Conferences in Chiang Mai Thailand; Melbourne, Australia and Bangkok, Thailand. Also national conferences in Sydney and Melbourne Australia.

Past/Present Clients
I maintain confidentiality about my clients.

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