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Pharmacy/positive drug test for cocaine, but never used cocaine


QUESTION: Dr. Bhaskar,

September 2014, I came up for a random UA, as always I submitted my urine sample. According to one of the nurses in the office, my sample was tested in the office and then sent out to an outside lab; the results from the lab had an issue of some sort, so my Dr sent my sample back out to another outside lab. The findings were positive for cocaine, I am in shock! I don't know what to do. I have never tried cocaine ever. The medications I have been prescribed for over 5 years now are morphine one is time release and the other is instant. The only other thing I have ever been given by my Dr was "lidoderm Lidocaine Patches" I apply at-least one patch everyday to my problem area. There is absolutely nothing else I take. And I KNOW FOR A FACT I DO NOT USE COCAINE!! At this point I do not know what to do about any of this. My follow-up/refill visit was today,This is when I was told about this positive result for cocaine. I spoke with him for a good 15 minutes. He claims he understands, but refused to do anything about it, also I gave this urine sample over 3 months ago, and has written refills every month since the test, until today. What can I do about this? I have read that lidocaine patches can give a false cocaine result. I have never had an issue with his office in the 5 plus years I have been under his care. He is still willing to give me my fawcett and epidural injections, he did not drop me as a patient, which is a good thing I guess. However I need both treatments injections and medications. My DR told me he can never prescribe me pain medications anymore. He did not even offer a safe step down, nothing. I just don't know what to do. In two days I will be death dipped in misery, and I strongly feel like nobody really cares as well as my DR. Never had ONE single issue before and during his care. I went with out my meds once before due to an insurance gap a couple years ago, I thought I was going to die! I went to the Hospital 3 times and every-time, I went, everyone at the hospital looked at me like I was a drug addict, and they treated me like crap. They refused to do nothing to help me. They just told me I would be OK, and sent me home. I had a small taste of what I will be going through in a couple of days and I am scared to death. Fluttering heart beats, it would beat really fast and then slow to a very faint beat. didn't sleep for 5 days during that time period. I am scared. i really believe that it should have never taken over 3 months to tell me about the test, and i would think that my records with-in his office would have been used in deciding what he wanted to do, or at-least given me an opportunity to provide another urine sample since there was some sort of discrepancy with the first lab it was sent to.

I apologize for going on and on here, I am still in shock dreading my next 3 weeks. What can I do at this point? The facts: my urine sample was collected over 3 months ago, it was tested in their office, and then sent it to an outside lab, this lab had some type of discrepancy and sent my urine sample back to their office, and at this point they sent it back out to a second outside lab, and 3 and half months later I get my results. Something is not right with this scenario. It should have never taken so long to get these results,and after the first lab had a discrepancy with my urine sample which is unknown to me,as they wouldn't tell me what it was.IN A NORMAL CIRCUMSTANCE shouldn't I had been given a chance to submit a new urine sample for testing, since the lab had an issue. Besides if I was a cocaine user it would be in the new specimen too right?

What can I do and what are the steps? I am absolutely terrified about the withdraws I am about to go through, and then my only activity will be laying in bed, I can do nothing with out my treatments. I strongly feel I am entitled to a second test, solely because the sample they tested was over 3 months old and it went through so many different hands. And I never saw the urine cup sealed, nor did I initial the sealing label, the bottle was clear no handwriting,no name and as mentioned, it was not sealed in front of me and never signed off on anything pertaining to the urine sample. For example I took several pr-employment drug screenings and everyone I took I was right there in person and watched the cup closed and seal with tamper proof tape and then I initialed it, this is standard procedure so that the I or whom ever can not say someone tampered with it somehow.. I did not partake in sealing the urine cup, nor did I witness it being sealed; I did none of this and I saw none these procedures.

Thank You for Your Time,

ANSWER: Hi Derrick,
Firstly I am sorry to hear of your plight, and hope I can help you. Let me add that  you are not the first to have such a fate, many and I repeat many citizens of your country come back with such experience. I really do not know why US with such an advanced medical and healthcare system should have such archaic rules of depriving people of their medication. I am not saying that we do not have such problems, we have our own set of bull headed idiots who run the system.
Some time back I was in the US for a conference, I  had the opportunity  to meet some representatives of the FDA, and I maintained touch with them for some time. I put these problems before them and they said a person can complain to FDA through their website, that is one thing you  should try.
Secondly US has a very good and fast legal system, I suggest you talk to a good lawyer and bring a stay order on your doctor. In India we call it stay order, I  dont know what it is known as in US, but such an action can be brought. If you get a stay, your  plea could be converted into a mass action suit, on behalf of a large number of people who have  been thus harassed. I have heard that there is already a suit in progress on very similar lines.
The last and probably the least effective way is to join a deaddiction program, where the truth will come out, you can  use the truth to sue the  hell out of the system.
These are my thoughts, I am not an  expert in legal affairs but I hope they will help you.
Wishing  you all the best for  the New Year.
Ravi Ghooi

PS. Bhaskar is my father's name.

---------- FOLLOW-UP ----------

QUESTION: I have been down every avenue to get my chronic Severe back pain under control. The only treatments that have helped me in the last 5 years, unfortunately the two types of morphine one extended release 60mg every 8 hours with a 30 mg Instant release every 8 hours as needed for break thru, with of course bi-lateral Facet-Joint injections every 3 months and an epidural injection inserted into the sacrum in between the other injections. Over the last 3 years I have noticed that the relief from the injections are only lasting up-to 3 weeks where the first couple of years the injections would last up-to 2 to 3 months.

in your opinion, and I understand it is only an opinion, should I continue these treatments once I get a referral from my primary doctor which will be on Wednesday or should I discontinue the injections since the relief period has diminished to only a couple of weeks at-most?

Also I know there are many different types of pain medications that will help me with my pain level, however in the US the law has put a serious scare in-to our Doctors and at-least 60% of doctors will no longer prescribe any type of pain medication anymore and or the law and DEA have scared them all. I know this has to do with crack down on prescription drug abuse and because of this many people in this country are being denied proper care all because of the DEA and new stricter laws that hold the doctors personally responsible if someone dies and or is seriously injured thru prescriptions they write; mainly pain medications. What are other medications for pain can I ask my doctor about on Wednesday?

I also wanted to thank you again for the information you provided, I hope to get some good use out of the information you have shared. Thank You again.

PS sorry for using the wrong name; the way it is listed on the web site it looks to be all one name, my apologies.

Hi Derrick,
Thanks for your letter. I totally agree with you about the availability of pain  medications for patients. These  are not easily available because doctors are concerned about  abuse  and so are the governments. If you think that situation is bad in  the US you  should see what happens in India. Some 16  years ago I had to sue the government for restricting pain killers  for cancer patients,and won the case only after a protracted court battle.

The truth is that most governments are scared of pain  medications due to  their abuse  potential.Add to this the reluctance of doctors in prescribing  effective medication, patients all over the world are in  trouble.
I would under these circumstances urge you to continue  the medication, because you dont  have many alternatives. In addition to morphine, we  only have  fentanyl and buprenorphine that have comparable efficacy. Other than these I do not see any drug  with similar efficacy.
You may talk to  your doctor about stopping the medication for a brief period during which you could use fentanyl or any other drug the  doctor suggests, and get back  on  these drugs after about a week, such gap usually  improves the action of the  drug.

If you wish  you  could try a cocktail of drugs that are  commonly used in your country like oxycodone, hydrocodone etc, we dont have much experience with these since we dont  have these in our market.
I  wish you all the best
Ravi Ghooi  


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Dr. Ravindra Bhaskar Ghooi


I can provide information on drugs and medicines, their actions, uses, interactions and adverse effects. To avoid confusion, generic names of medicines may please be provided. I am a pharmacologist, having worked on animal and human pharmacology, and presently I am the Dean of Bilcare Research Academy, where we teach courses on clinical research. We dont work on saturdays and sundays, hence questions reachng me on these days will be replied on Monday, please bear with me.

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