Friday, August 19, 2011

Applying medical theory to conquering the drug test

To me the drug test really emphasizes exactly how much people don't research what they buy and how much the public falls prey to hopes of a magical solution. It reminds me of a similar scenario I once experienced when I worked as a teacher. I had a co-worker whose mother was dying of metastatic cancer, she set up a website raising money for a $20,000.00 treatment using massive doses of vitamin C in Mexico in order to obtain a cure. On principle I couldn't contribute, because I would be helping an organization that takes advantage of the uneducated and the hopeful. On a similar however less severe note, many herbal remedies and drug masking products do the same thing, and instead of offering a solution, they probably increase the chances of someone failing a test because they become falsely comforted by a product that advertises something that it doesn't do. Further, it may encourage using substances in the critical hours before a drug test with the promise of magical solution irrespective of risky behavior. I am well versed in the lab techniques used and will attempt to clarify what works, what are rumors are false, and give a detailed explanation of the whole process. Keep in mind the more you know about the process the more weaknesses you can exploit, so some of the discussions may be rather detailed, but what I am sharing is based on medical fact, so pick and choose as you wish, I apologize for the length so I've divided this up into sections for you to parse through and to figure out what's relevant for you.

Know what you're up against, it starts with the interview.
Worst case scenario, you landed a a dream job, you just smoked a blunt a week ago, and they slap you with the fact that in two days time you must take a drug test or risk not getting the job. Don't panic. You have a lot of research to do, but you're not SOL, so keep your cool. Chances are you have a slip of paper telling you where to go, this is the first advantage you have. 99% percent of the time you are going to have a urine test, and if you're not totally sure what type of test you're getting, call up the lab on the piece of paper and ask. You don't have to give your identification to ask a perfectly simple question like this. If you have used something around the time of when you expect to interview, the easiest way of reducing a failure is delaying your interview appointment as long as you can, not the drug test date. When you go to the interview that's when they're going to slap you with the drug test so at this point its too late because when they give you the drug test appointment, you have to show up at the designated time or your automatically fail. So to reiterate, avoid this time constraint by delaying the interview date as a method of delaying when your taking the drug test.

Figure out what type of test you're taking
You will most likely be informed if it's something else like a hair test, a blood test, or a saliva test. If it's a hair test, this is bad news, there's really no consensus on any solution that truly remedies this situation (things like bleaching have no track record and there is no reliable literature to confirm or deny such claims that it works). Shaving your head, means they'll pick it from your arm. Shave your arm they'll take it from your pubic hair. If you keep going down this logic train and shave all the hair off your body, this is suspicious behavior, and you most likely just failed. The same is true of the blood test, anything you do to change your blood will most likely kill you before allowing you to pass a drug test so call your head hunter back, because it's not going to work out. Finally, saliva tests are growing in popularity and offer a method that clearly reduces the risk of tampering, I will discuss this method later on, because its definitely a bigger challenge than the urine test. Also, blood and hair testing are extremely expensive to administer compared to a standard urine panel so most organizations opt for the urine test solely based on affordability. It's cases like applying for a CIA position where you might encounter a test like this so chill the F*** out unless you plan on being a damn spy. This being said, most of my discussion will be limited to the scope of the urine panel.

Which lab is testing you?
So now that you have established you're going to be peeing into a cup, the next thing you can consider is what  substances are you being tested for. If you are in fact this paranoid, look up the name of the lab administering the panel on your trusty slip of paper given to you by your employer and look on their website, most of these tests are outsourced to large companies that specialize in this, which makes it easier to know what you're getting yourself into. The most common testing laboratory in the USA is Quest Diagnostics so I will explain a little about their methods.

Ok I know it's a urine test, what drugs are they screening me for?
Possible tests administered by Quest Diagnostics (taken from their site).
So there are several different types of urine panels. First and foremost, if you're a health professional chances are you know what you're being tested for (which is basically every illegal drug plus every prescription drug family with a potential for abuse) so I see little point in expanding upon this, however if you do need more information here is the exhaustive list. I am reiterating what's on the Quest Diagnostics site so I'll briefly sum up the other panels. The standard urine panel which is probably what most people are being subjected to comes in two flavors the 5 drug panel = marijuana, cocaine, pcp, codeine/morphine, and amphetamine/methamphetamine; or the nine drug panel = 5 panel + barbiturates, benzodiazapenes, methadone, and propoxyphene (links have been provided for the generic names of specific drugs if one of the constituents was listed as a drug class as opposed to a specific drug). These two panels may be modified to include MDMA (ecstasy), other opiates list here (this may vary if its not Quest so make sure you know what an opiate is and if its tested for by your lab), and if you're an athlete -- performance enhancing drugs list here.  Now that you know what you're getting yourselves into, you may or may not be in the clear already. For example, if you're able to figure out that you're getting a "five panel drug test" and you're buddy passed you off a methadone tablet, you're good to go. If this is not the case, keep on reading. 

The drugs themselves.
At this point, you know what you are at risk for failing so you must educate yourself about the nature of the drug. Knowing the drug means knowing its weaknesses. There's several  variables to consider that can affect the outcome: how the drugs are broken down, how fast the body can break them down (ie the metabolic rate), how they are excreted, and where they are stored all give you clues on how to beat them.

In general, you can follow the 7 day rule. Most illicit substances are metabolized out of the body within about 7 days, so if you have a drug test, to be on the safe side, you'd probably want a week to 5 days just to be sure it's out of your system unless you're suffering from renal failure or liver failure, which in this case you're probably not in the market for a job. Below is a more exhaustive list of metabolic rates of drugs:

Taken from Erowid.com this list shows when drugs leave the system
Half Lives
As you can see there are some exceptions to the rule. First lets talk about Benzodiazapenes. The most commonly abused drugs of this class are valium (diazapam) and xanex (alprazolam). The reason it says 42 days has to do with the half life of the drug. Briefly put, the half life is the amount of time it takes for half of the drug to remain, for Benzos, the Quest diagnostic test is screening at around 300ng/mL. The half life of diazapam is 20-100 hours, meaning that at roughly 4 days half is left (5mg would be common at this time). A rough approximation using a 70kg person with 60% body water by weight, at a first half life you'd have a blood concentration of around 120ng/mL. You are safe right? Nope, they also test for the breakdown components which have a half life of 200 hours, so you can see the detectable period just increased substantially. Alprazolam is metabolized much faster so this isn't as much of a worry, but if you've taken something in this drug class what is important is to figure out what benzo you took, so you can track the half life of the specific benzo. This can be found here.

Lipid Solubility and Clearance
As I mentioned there are a couple exceptions to the rule, from the list above the most noticeable are benzos and cannabinoids. Beyond the discussion of half life with the benzos both of these drug classes have another characteristic in common. Lipid solubility. Just like oil and water don't mix, the same concept applies to drugs. Most of your body is water, so anything in your body that is made of fat, is in a sense trapped in the body, and generally tends to stay in that material for a longer period. This is part of the explanation why some benzos, cannabinoids, and also steroid based drugs (testosterone analogues for example) stay in your system significantly longer than the average water soluable drug.

So this means that if you're overweight, and a chronic user of one of the above mentioned drugs, you are at a higher risk for failing a drug test. Women general tend to have more body fat then men, so the ideal patient is to be a super lean, highly muscular male. The only thing you can do is speed up your metabolism, exercise, do some cardio. This will speed up the metabolic process of breaking down the substance, and also decrease your BMI. But again, this effect is probably minimal at best.

Using specific metabolic pathways to your advantage.
There are many ways that drugs are metabolized in the body. In medicine there are two main ways that are relevant to our discussion. Phase 1 and Phase 2 metabolism. These don't imply a sequential order, they are just general references to two mechanisms of drug clearance from the body. Knowing what drugs are metabolized by which pathways, offers you a loophole to passing a drug test. If you know for example that drug X is metabolized by a phase 1 pathway, there are substances you can take to induce the enzymes that break down these drugs. In other words, there are substances that allow you to speed up the clearance of a drug out of the system. So lets examine each drug on the general drug panel and see what affects them. There are also a couple other pathways that might be relevant and will be discussed accordingly.

Alcohol
Chances are you're not going to be screened for alcohol consumption, and that's not the reason why I made this section. What is important to know is that acute consumption has one affect on drug metabolism while chronic alcohol consumption has the opposite effect. In general acute consumption of alcohol shuts down phase 1 metabolism while chronic consumption increases phase 1 metabolism. I'm not saying to become an alcoholic, so use this information at your own health risk ... Anyways keep this information in mind as you read below.

Amphetamines
Amphetamine is metabolized by an enzyme called P450 2D6. This qualifies as a phase 1 metabolic mechanism. Two known compounds will increase the breakdown of amphetamines. Glucocorticoids are one family (this includes things like cortisone, dexamethasone, prednisone etc). These are not easy compounds to obtain, and that holds true with a lot of the compounds I will be talking about, however maybe your lucky enough to have one of these laying around. Also, some of the drugs I will be talking about must be dosed specifically, and if you don't know exactly what you're doing you could hurt yourself. The safety of these drugs is outside the scope of this discussion, however I highly suggest thoroughly researching anything you may consider taking because you don't want to end up putting your health at risk. Another drug that can induce metabolism of ampetamines is rifampicin. One other thought here is this, if you know what drug you need to take to speed you your metabolism for amphetamine, you could try faking an illness that requires the usage of the drug to obtain it. Again I am not recommending this practice, I am against this idea but I am here to tell you how to pass a drug test, what you do to your body is your choice, just make sure you educate yourself and know the risks before trying someting that could potentially be stupid. Just as important as knowing what speeds up your metabolism is avoiding substances that could slow down your metablism. The list of inducers that we just discussed is relatively short, however the inhibitors (the ones that can slow it down) is a relatively long list. So rather than list them all here, I'll provide a link that lists all of them here. A lot of the drugs on this list are more commonly consumed that you think. For example cimentidine is an anti-acid medication. My point is look at what your taking, check out its generic name and see if anything on the list matches its name. It's important to look at this list because you may be abusing or may even be prescribed one of these substances which means you need to stop taking them as quickly as possible before your test (again consult your physician before abrupt cessation of any drug). One other factor should be mentioned here. The amount of P450 you have in your body that can break amphetamine down varies with your genetics, in general if your of Middle Eastern or North African decent, your body most likely gets rid of amphetamine really quickly. Blacks have the greatest frequency of poor metabolizers, whites and asians have less of a chance of being a slow metabolizer.

Barbiturates
Barbiturates are broken down by both phase 1 and phase 2 metabolism. Ironically, they also induce phase 1 metabolism, however as far as a drug test goes, it obviously makes no sense to speed up metabolism by using a drug that will cause you to fail the test to begin with -- however, if you have been taking barbiturates chronically, you probably will get rid of them much quicker than someone who's a recreational user (the downside being that there's probably more net drug in the chronic user's body). As for what you can take to increase phase 2 metabolism you must take substances that increase the availability of the enzyme glucuronosyltransferase. A known inducer of this enzyme is pregnenalone. However there's not much literature that states that inducing this system speeds up barbituate metabolism specifically, theoretically it should work. Additionally, you can speed up the natural synthesis of pregnenalone in your body by taking ACTH, which may indirectly induce glucoronidation (by increasing the enzyme desmolase which makes pregnenalone), however again, this is a theoretical concept that not much literature has specifically proved. So the bottom line is while a lot of theory exists, its hard to do much about slowing or speeding up the metabolism of a barbituate. Once caveat, secobarbatol actually slows down its own metabolism, so avoid this.

Benzodiazapenes
If we haven't talked about this class enough, there's still the topic of their metabolism which is another important consideration. Diazepam is glucoronidated just like barbituates so the above discussion may also apply here. However, these are also metabolized by Phase 1 reactions involving the enzymes Cytochrome P450-2C19 and P450-3A4. Compounds that induce these enzymes include rifampin, carbamazepine, glucocorticoids, pioglitazone, phenytoin, and St. John's Wort. Things what will slow it down include fluconazole, azamulin, diltiazem, erythromycin, clarithromycin, grapefruit juice, intraconazole, ketoconazole, ritonavir, troleandomycin, and acute alcohol ingestion.  A confusing list to say the least, however its worth looking up to see if you are taking them etc.

Cannabinols and Marijuana
According to the research these compounds are mainly broken down by phase 1 enzymes, specifically P450 enzymes, CYP2C9 and CYP3A4. You will begin to see some patterns as we work through these drugs, and this is because several enzymes we've already listed are major metabolic pathways for many compounds that the body encounters. Thus the same inducers and inhibitors mentioned in the previous section also apply to this section. Additionally, tienilic acid and sulfaphenazole can slow the metabolism of THC (the most common active cannabinol).There have also been reports that eye drops added to the urine sample can help mask THC by emulsifying the compound, this method is more effective for acute abusers rather than chronic, and these substances will keep the urine within its physiological limits (which are tested by the labs).

Cocaine
Cocaine is a drug that is metabolized relatively quickly by enzymes that are ubiquitous, and due to how fast its metabolic profile is, there isn't much use in trying to induce enzymes etc. It undergoes tissue esterase activity, and if you want more details on the process this is a great site. However a quick search on google did yield cytochrome enzymes esp. CYP34A (as explained above) that can be speeded up.

Opiates
This describes a wide variety of drugs which have many pathways of metabolism. Methadone for example is degraded by CYP2B6, this enzyme is induced by cyclophosphamide, and inhibited by ticlopidine and clopidogrel (most likely medications you shouldn't be taking and are hard to access). Codiene, hydrocodone, and oxyxcodone are metaboliszed by CYP2D6 which has no known inducers but can be inhibited by both quinidine and paroxetine so avoid these. Fentanil and related drugs such as sufentanil are metabolized by CYP34A again this discussion was mentioned above in the benzo section.

PCP
This drug is known to be metabolized by the CYP34A system, again as mentioned above.

Steroids
Steroid drugs, usually things that are use as performance enhancers are also metabolized by the CYP34A pathway (inducers and inhibitors mentioned above). Additionally, many of these drugs are excreted from the body via bile secretion. This offers another avenue of elimination out of the body. Bile acid sequestrants offer a source of elimination for such drugs however this is a theoretical consideration and I won't claim that this method is proven, but in theory it would work. Statins offers another theoretical route of lowering levels of detectable drug in the body. By increasing the proteins that take up cholesterol and cholesterol related compounds such as steroid related drugs, you may lower available detectable levels in the body, again this is a theoretical consideration which as far as I know, does not have experimental proof, but it hasn't been disproven either. Finally, sex binding proteins (SHBG) act like mini-sponges absorbing free levels of steroid related compounds. The production of these proteins can be increased by phenytoin, primidone, carbamezapine, oxycarbazenpine, and valproate.

Known Masking Agents
Diuretics
Diuretics are commonly prescribed and include the following families: acetazolamide, thiazides, loop diuretics, mannitol, and potassium sparing diuretics. These drugs make you pee more frequently and essentially cause you to dilute your urine. Diluting your urine means that the drugs being tested are harder to detect. Many labs test for these drugs because they are used to evade drug detection, so research your lab and see if they test for this substance. What are not tested for are naturally occuring diuretics, which are easy to obtain. Caffine is pretty powerful, here is a list of some other things that can help.

Probenacid
This is a drug that is commonly used for gout. It is known to minimize the excretion of several tested compounds. Again many labs screen for the use of this drug so this is another question you may want to confirm with the lab.

Adulterants
Adding things to your urine is simply a bad idea. They test for many physiological limits of your urine, and if they are outside normal reference ranges, you automatically fail. It's just a risky and stupid practice to do. Additionally a list of common adulterants and perameters tested for are:  Nitrite, Chromates, Halogens, Oxidizing Adulterants, Creatinine, Specific Gravity, Acids, Bases and Glutaraldehyde. Eye drops as mentioned above have shown some success as an effective masker for THC.

What can be done to fake your urine test?
There are many kits out there that claim to use dehydrated urine, warming kits, and fake bladders to pass a drug test. These items may prove useful, I don't claim to be an expert in this area so I will not provide information I don't know about. However be careful what and where you get your kits because if you have urine from the wrong species, or give urine of the wrong temperature, you will fail. One thing to consider if you do choose this route is to think about what is contacting your skin. Chances are if you're using a fake set up you're nervous and you're sweating. If this sweat contacts a fake bladder that's touching your skin, the sweat will diffuse any drugs in your body through the plastic into the fake urine. I have a friend who was taking adderol and used a fake bladder and the test showed positive for amphetamine, so these tests can pick up this type of thing. Luckily he had a prescription for this so he was in the clear, but this is just an example of something you might not think of when going in. Use a diffusion barrier such as a napkin between your skin and the bladder to prevent this kind of effect.

Also, make sure your urination is not the first of the day. This urination usually contains the highest concentration of metabolites that are picked up on a drug test. Drink lots of water, use a natural diuretic, piss as much as you can, and slow this process down maybe 1.5 hours or so before your test so your test isn't rejected for dilution (determined by creatinine concentration).

Also to give you an idea of what goes on at the site, here's a link from a blog from Quest Diagnostics with some common practices used so think about these factors as well before you go in.

Drug testing solutions
About 99% of this is BS. The drinks etc that you find in head-shops make claims that haven't been proven. Many are high sugar, high vitamin B compounds that have absolutely no effect on the outcome of a drug test. Their claims are mostly false, and you're better off drinking caffeine and or some other natural diuretic rather than putting false hope into these products that just steal your money. They'll make your urine highlighter yellow, which can be cool to look at ... but that's about as effective as it gets ..

False Positives
There are lots and lots of things that can cause a false positive. Use this reference list to possibly come up with a valid explanation for why you failed, but otherwise avoid these substances if you don't have a prescription or a valid reason for taking these substances. Exhaustive list here -- this is pretty reliable and has cited sources. There are also many urban legends that relate to false positives, some of which can be found here.

The Saliva Test
This is a new animal and seems to be becoming more popular. I honestly think that this is an evolving test, in the sense that people are still trying to figure out what works, and what doesn't. Again the discussion on metabolism definitely applies to this section as well, however doping the sample is not only harder since you can't conceal the process in a spitting panel nearly as effectively as you can while urinating, so unless your slight of hand is up-to-par this isn't a viable option. Interestingly enough though, there is no discussion on Quest Diagnostics web site that I could find saying that they test for adulterants or for physiological norms as is done with urine. They did however say the following:

ADULTERATION
18) Can an oral-fluid test be beaten?
• We have not found any adulterants that can beat the test at this time. Of course, donors
may attempt to introduce something onto the pad or collection vial. This risk is
minimized because every collection is directly and easily observed.
19) How does the laboratory determine if the specimen is human saliva?
• With every specimen, the laboratory performs an IgG test. This test will determine if the
specimen is human saliva and if there is sufficient saliva to perform the drug testing. The
IgG test is a specimen validity test.

This being said if they don't test for adulterants, I see no reason why the adulterants that physically modify the specimen shouldn't work here as well. These include Nitrites, Chromates, Halogens, and Oxidizing Adulterants as mentioned before in the urine discussion. In other words the fact that Quest tests for the presence of these adulterants in the urine panel suggests that they do interfere with detection, and this has been corroborated, so this idea may be usefully applied to the saliva test. My logic has to do with the techniques used for saliva versus urine. Urine is typically done using chromatography techniques while saliva is almost exclusively with ELISA. However, the idea of using an adulterant involves chemically modifying the substance in question, so I see no reason (as long as the adulterant does change the substance) that it shouldn't interfere with both lab processes. Again this is not proven, and I invite further discussion and research into the idea. But it is important to point out that it won't hurt your chances if it does nothing so why not try it? However, I think I should restate is that the issue isn't as much whether the aforementioned adulterants work, it's more of the issue of introducing an adulterant to the sample in front of a chaperon administering the drug test ... slight of hand isn't really something I can coach you on, talk to Copperfield for this one.

Besides the discussion on the metabolism of the drugs themselves, the only other parameter I can think of is the salivary flow rate. By altering the flow rate, you can alter the composition of the saliva. This being said you can take advantage of some basic physiologic theory to help you pass. The sympathetic nervous system releases a thicker more viscous form of saliva, while the parasympathetic system makes a watery, dilute secretion. It probably makes sense to pick substances that cause parasympathetic activation versus sympathetic activation. In essence this is a way to dilute the saliva. A list of such parasympathetic activating substances can be found at this link under the heading of "agonists" while substances that slow down this system are under the heading "antagonist". In other words, use the agonists, avoid the antagonists. Also an important caveat, anytime you attempt to mess with the parasympathetic or sympathetic systems of your body, you are messing with something that won't only affect your saliva, but will alter the function of many aspects of your body. If you plan to take one of these substances, please ask a doctor or post a question here to determine if it's safe. Also recognize that some of the substances I am talking about may have abuse potential (whether that be something that gives you a high or a performance enhancing drug) thus may be screened for on a drug panel themselves, so please check this out as well.

Keeping the above points in mind you can think of activating the parasympathetic system as a desired effect. Conversely the sympathetic system has opposing actions to the parasympathetic tone of the body, so we want to stop the sympathetic system if we want watery saliva. This can be achieved using beta blockers, again if you are an athlete, this drug class can't be used because it is considered performance enhancing, a normal drug abuse panel shouldn't screen for this though. Again please be careful, these drugs can cause serious harm if your not sure about how much to take. In some disease states these can be harmful as well. Drugs to avoid activate this system and include a very large list and can be found A) here, B) here, and C) all drugs listed under indirect and mixed action. and caffeine. If you find this list a little too overwhelming, you can simplify things by avoiding any substance that also increases your heart rate, because such a substance may also cause sympathetic activation.

Finally there are substances that can alter saliva secretion that are outside the realm of the parasympathetic and sympathetic systems. The technical name for such compounds are sailagogues which increase saliva production (a desirable effect of the drug test) while anti-sailagogues do the opposite (avoid these compounds). The good thing about some of these is that they are readily available, but again some cross over into the realm of para/sympathetic effects so please, I beg you to thoroughly research any substance you may consider taking, many taken in large enough doses can be very harmful. These are not exhaustive lists, so if you are curious, inputting a google search of sailagogues etc. should bring up some more stuff. Just make sure to corroborate any potential claims that something is a sailagogue because the internet has a lot of misinformation especially when relating topics on passing a drug test.

Again, the discussion about diluting saliva by increasing secretion is not something that has been conclusively proven to pass a drug test as far as I know, however I think it follows that if you can dilute your saliva, you are making it more difficult to detect a substance in a given concentration. So I will say here that this logic is pretty sound and takes advantage of simple concepts in physiology. Additionally, it can't increase your chances of failing (unless a said sailagogue is screened for on a drug test which can be easily determined by the information provided by Quest Diagnostics), so may as well give it a shot.

This is about all I can think of, so if you have any questions please post them, otherwise, good luck.

8 comments:

  1. Hi, MC
    I came across your blog and found this post to be very helpful, even though it doesn't exactly pertain to my initial quest for answers. Yet, I still think that you could help me. I am having medical clearance testing done by Quest and listed on the q&a sheet given by doc. list the following test CBC, CMP, fast lipids, TSH, HgbA1c. My only concern is a phase 1 drug affecting the CMP test; or will its specific make up be discovered during these lab test? Am I going to be drug tested basically. Any information you can give or sites you recommend I look up, would be greatly appreciated.

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  2. The tests you are referring to are standard medical tests which do not screen for drugs. CBC CMP fasting lipids TSH and HbA1c are tests looking at your blood chemistry, metabolic function, your blood fats, your thryoid function and your long term glucose intake (typically measured for diabetics). These tests do not in any way screen for illicit drug use.

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  3. you seem to have a fair knowledge of this stuff. However, i was wondering if possibly taking mass doses of levothyroxine for a few days could help you metbolize certain things from your system, say opiates. i will be tested via a supervised urine sample administered by the courts. Now i have reason to believe their system is flawed as it is, since last time i was tested ( a week ago) i had benzo's in my system (quite a lot) and yet that tested negative, however i tested positive for opiates when i hadn't used. Sadly im the kind of person who when i pay for the ticket i take the ride, so i used, and i now have a 48 hour window before my next test. any suggestions? karaannw@gmail.com

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    1. Theoretically taking lots of levothyroxine would have some effect since it increases the rate of your general metabolism. Practically however, this is a very dangerous idea, as you would be putting yourself into "thyroid storm" like state. In other words you would end up dying from cardiac arrhythmia. This is no hormone to play with, not even a little bit. When you say you used, what drug did you use? Considering I don't know what you took specifically, my best advice is to drink lots of water and if you can, put off the test. Do the general tips that I told you about. My advice is if you're getting tested this frequently, stop using. I know that's annoying but you're going to get caught if your tested that much. There's only so much you can do.

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  4. MC, maybe you can help me... but I am not sure since you couldn't help the person who commented above me. I have to take drug tests in order to get my opiate prescription (I found this out today). I am prescribed Norco, and take Tylenol which is what I am trying to get my prescription for. I can't without passing a drug test. I managed to lie my way out of it today. I have been talking Norcos for a month and I injected Oxycodone maybe 3 days ago. Is my Norco use going to make the Oxy metabolize slower? Will I be able to take a drug test tomorrow and pass it? I have one Norco left and I am trying to stretch it, I REALLY don't want to go through withdrawal. I had to cry and moan to get my doctor to put me back on Tylenol 3. The Norco is for surgery and my script is up. Any advice?

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    1. Your question is a little vague to me, so let me see if I understand what you're saying. You take Norco and Tylenol 3? I don't think using oxy and Norco together will appreciably affect the metabolism of either, the main issue, as it seems in your case is how often you take opoids in general which means you're at least a this point an efficient metabolizer. I would say you need a couple days to clear any of the drugs you mentioned. You will not be able to pass a drug test one day after using any of the aforementioned drugs.

      If I may make another comment, if you're injecting oxycodone, I would honestly try to seek help. If you've been taking medicine to manage pain for a surgery that's one thing but oxycodone injections is obvious substance abuse. I suggest approaching your primary care provider about titrating down your meds, perhaps even replacing your regimen with buprenorphine or tramadol to taper your use, and mitigate a severe withdrawal syndrome. Injecting any pill is associated with significant health risks. There's a difference between casual use and serious addiction, it would lie badly on my conscience if didn't tell you to seek help. All the best.

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  5. Mc I am in hopes that you can give me some help.
    I was notified this afternoon that I was given a job and need to pass a preemployment drug test for it. I am happy about the job and it is a job that I really would like so I am trying to make sure that I will be alright. The test is a SAP 550 gc/ms.
    I am not much of a smoker, but almost three weeks ago I smoked with some friends after a night of drinking. A mistake that I obviously should not have made. But with that said I am highly active, working out as much as I can. Lifting for an hour and a half and burning at least 400 calories on the stairmaster afterwards.

    I am in hopes that you can give me some advice. I want to know what I need to do to guarantee passing this drug test. Thanks in advance

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    1. I would say your chances of passing are almost 100%. You're not a regular smoker, it was a long time ago, and your work out. You're good to go.

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