Lorazepam testing and tapering advice. Please help

Posted by anthony5518 @anthony5518, Dec 29, 2022

After suffering a series of panic attacks in the mid 2010s I was diagnosed with panic disorder and generalized anxiety disorder and prescribed 1mg lorazepam daily which I’ve been taking for about 7 or 8 years now. The lorazepam helped A LOT and I’ve been able to live life relatively panic free. Recently my doctor informed me that there had been a change in protocol and that I’d need take a drug screening every 3 months when I go in to see him which I had absolutely no issue with. Ive always taken my lorazepam as prescribed and never used any illicit drugs. When the results of the first urine test came back, I tested negative for everything including benzodiazepines which was obviously a surprise considering I’ve been taking them daily for so many years. We did a follow up urine screening and once again the results came back negative. Confused as to why the lorazepam wasn’t showing up, he had me do a third urine screening but this time the sample was also sent to a different lab where they preformed an lc-ms/ms (mass spectrometry) examination. For the third time the regular urine screening showed a negative result but the MS showed a positive result of 469 ng/ml. The doctor was unsure why we had gotten contradictory results from the same urine sample and order another regular urine screening which again came back negative and then finally a blood test which AGAIN came back negative. Now he is threatening to ban me from the facility and cancel my prescription cold turkey which scares me to death because I’m aware of the dangers of quitting benzodiazepines without properly tapering off. After doing some research, I read that lorazepam and clonazepam are more difficult to detect through regular drug screenings and almost require an MS examination for accurate detection. This would explain why the MS result was the only one to show a positive. I tried to relay this information to my doctor at which point he became extremely defensive and didn’t want to hear it. This entire situation is causing me severe stress and anxiety. Has anybody experienced any issues like this with lorzepam/benzodiazepines? Ive decided to taper off the lorazepam but at this point I’m really not comfortable talking to my doctor about it. Does anybody have any experience/advice on tapering off 1mg? I’m really not sure what to do at this point.

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@anthony5518 Lab tests are never 100% accurate. I'm with you on your confusion and how you are being treated by your physician. I was once treated in a nasty way by a practice (occupational medicine) when I was taking cough medicine that contained codeine. I get that they see many people who abuse drugs but why assume this of everyone who walks in the door that they have seen before?

Assuming you are taking the medication as prescribed I'm surprised that the prescribing physician did not send the urine sample to a different lab altogether. From the two negative results your physician is "assuming" that you are not taking the medication and are giving it to someone else or you are selling it. That's the purpose of testing for controlled medications.

I agree with @jilliannw. Find a new physician and have a frank discussion about your medication. It is very possible that there is a different medication you can take that will be just as effective that is not a controlled substance.

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My Doctor makes me see him every 3 months due to the addiction of xanax per gov regulations. I should be off soon and will save me the hassle of a co pay and visit even if virtual. What racket they have. This came up as first hit searching testing for these drugs. Sounds like an honest but ignorant mistake on part of the doctor. If you were looking to increase your dose, I would suspect you, but that is not what you told him you are trying to do.
Truly outrageous.
https://www.practicalpainmanagement.com/treatments/addiction-medicine/drug-monitoring-screening/demystifying-benzodiazepine-urine-drug

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I always found out that dealing with psychologist when it comes to antidepressants is really a guesswork diagnosis. There’s so many side effects of these drugs but I found just taking diazepam when I need it occasionally does the same thing without taking a steady diet of these type of drugs.

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I can certainly understand why your doctor is not being very understanding. That’s quite a few tests coming back negative. Try calling the lab directly and see if they can come up with an explanation.

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