AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
Expert: Nigel Simmons Date: 3/14/2008 Subject: drug screening
Question I have been on methadone for 2 1/2years. The Dr. at the treatment ctr. where I recieve my methadone has told me that benzodiazipines and methodone when taken together can cause death. I have MS so I have been on Valium for a while, but havent taken any in weeks, still i'am testing positive for benzos on my drug screen, therefore I cannot receive "take home " doses of methadone like I have been for 2yrs now, resulting in my having to go to this ctr. every morning to recieve my dose. In a drug screen how much benzo is present to have a positive? I have taken 4 screens in the past 3 weeks, would the amount of benzo. decrease in each screen, if I weren't taking any valium? I need a clean screen from benzo. to earn my takehomes back, isn't there a way the last 4 drug screens I've had could show the level of benzo decreasing each screen, therefore showing that in fact I'm not taking any benzos.How can I prove this to them? I do not want to go to this place 30 miles away everyday to receive my methadone dose. How can I prove I'm benzo free, even when testing positive?
Answer Robyn
Based on the number of similar questions I receive, apparent false positive results are worryingly common. In theory the tests should be specific for the drugs they test for but there is some evidence that false results can occur due to other non-related drugs. Unfortunately there is no published list of drugs or tests, so it's impossible for me to give specific advice.
In addition, there is always a risk of poor storage or handling of samples leading to contamination or swapping of samples.
My recommendation would be to always see the sample tested in front of you with no others in the area to cause confusion. Ideally also get the details of the manaufacturer of the test strip and the batch number, as these may help if you do need to challenge an erroneous result. Keeping part of the sample for yourself (until the result is negative) would also allow you to get independent verification if you wanted.
Other advice would be to contact the manufacturers and ask them for information on false results with their product (your local pharmacist may do this if they won't talk directly to you); asking for an immediate blood test to confirm the result; and being extra careful to avoid any covert taking of drugs without your knowledge. If you can, getting your prescriptions from a local pharmacy rather than mail-order will also give confidence that the products are not adulterated by a dubious manufacturer. If at all possible, avoid taking any over the counter or other medicines (including herbals) and only use what a doctor prescribes - asking them to give you a letter to inform the clinic of what you are taking and why.
As you are in a methadone programme, I would suggest that you talk to the staff at the clinic and determine how often they get what individuals claim to be false results (especially for benzodiazepines as these appear to be the most common problems). If you can show that you are genuinely concerned and interested to follow up the problem, then they will hopefully be supportive. Remember though that they are working in an area where client honesty is all too lacking (hence why they screen), so you need to build their trust and confidence in you. Losing it will only make them think you are hiding something from them, whereas honest concern and total openness can only help.
