Getting past the urine drug screen while taking Vyvanse

A colleague writes in . . .

I am an RN in a recovery nurse program secondary to ‘emotional condition’ . . . I had some mental health issues that were not being treated. My psychiatrist, who is an addictionologist, prescribed Vyvance for ADHD since Strattera was not effective and led to flattened affect and other symptoms. He stated that Vyvance would not be addictive. As part of the recovery nurse program, I have to take random drug screens. Will this be a problem. What is the half life, and how long would the metabolites detectable in gas chromatogrophy drug screen.

Now, just out of curiosity . . . let me see a show of hands here . . . how many of you REALLY think that I am going to tell you how to fool a drug screen?????   AhhhhhhHHHH!!!  Away with you . . . back to your X-Box, Cheetos and diet Pepsi . . .

Look, Vyvanse is dexedrine.  Plain and simple.  If you shouldn’t be taking dexedrine, you should not be taking Vyvanse.  I would disagree on the “addictive properties” of Vyvanse.  The primary advantage is that you can’t snort Vyvanse and get high . . . the enzyme that cleaves off the lysine from the base dexedrine is not up your nose, its in your gut.  Take enough orally and you will feel the effects of too much speed.  Some people like this.

BUT, if you need it, you need it.  And if your addictionologist feels you need it, I will assume that you need it.  AND the nursing board will need to understand that you need it.  I have had patients in professional recovery programs that have had to take benzos because that is what worked for their anxiety when nothing else did.  I have truck drivers that take benzos, and some that take Adderall.  To pass their drug screens, they get a note from me saying that I prescribe it and the patient is responsible with the medicine and is not abusing it.  That is good enough.

Doing anything but being straight forward about it is lying.  Lying is part of the addiction process.  Don’t go there.  If you need it, you need it.  Check with the recovery board about how you go about documenting safe and appropriate use of medicines to treat your illness and let your psychiatrist support you.

–Dan Hartman, MD

6 comments to Getting past the urine drug screen while taking Vyvanse

  • Dustin

    Vyvanse is not dexedrine.

  • Lena

    I have been taking Vyvanse 50 mg- 1 capsule a day for almost a year now… I have to do random drug screenings and they’re telling me I don’t have the amfetamine in my system. I’m not sure what test their using, but how can this be happening? I take this and my birth control every morning religously with a glass of milk and a pb & J sandwich. I feel like I’m being accused by my dr of being unresponsible with a controlled substance… Any suggestions?

    • I would just be consistently honest with your doctor and call him/her on their accusations of your non-compliance. If you really are taking it (I believe you), they should believe you. If you don’t have a relationship with them that allows that degree of trust, then the trust becomes the issue between you two. So, anyway, how can it be that you are coming up negative on your screens? It could be that you metabolize the medicine so quickly that there is really not that much in your system. Remember, the assays that are used for the drug test don’t test for ANY amphetamine. There is a threshold amount that must be present for the test to be “positive”. You can get a quantitative assay (that is, one that gives a specific number rather than a positive or negative) but even then, I have seen cases where the level is “zero” even when the medicine is taken. Be straight forward and up front with your doc. If you suspect the doc of not believing you, call them on it–you can’t get good treatment unless you have a good relationship with your doc and a good relationship is based on a certain degree of trust.
      –DH MD

  • brooke

    my husband took a adrug test for life insurance and he took a vyvance will it show up?

  • Brooke–

    Yes, it will. As an amphetamine. This may not be a problem if he has a doctor’s note saying he uses it as prescribed. Otherwise, he is screwed.

    DH MD