Question
I take adderall 30 mg i time per day for add. and duragesic 50 one patch every three days. two parts to my questions, the  first is the patches are not working more than 48 hours like I have extreme breakthrough pain and I talked to my doc about this ...anyway he does drug level testing at his appointments . . I had a patch on 12 hours prior to the test and had taken 1 adderall at 9 pm the evening prior to my test. I tested CLEAN not either drug in my system!! How can this be? Is it possible that I am metabolizing it really quickly>>>  I am a 110 pound super active lifestyle..one thought I had Is I know they are effect by heat the patches... I get hot and sweaty at work every day.. I coach a gymnastics team could that be making me metabolism it faster or can adderall mask it? any help would be appreciated I have been searching for any info online and have not found any..

Answer
Hi Katrina

Very interesting question. I don't know that I've ever heard of Adderall masking the presence of another medication or vice versa.

There is a lot of variability in how people metabolize medication, although some doctors don't really know how to address that. It is entirely possible that you are a fat metabolizer, certainly sounds like it from your description of yourself and your activities.

It would be best for your doctor to assess how quickly you are metabolizing medications and adjust your regimen accordingly. That would probably help with the breakthrough pain.

The important thing is to recognize that this is a very valid possibility, and that you are not imagining it. Hopefully your doctor will work with you to accommodate your drug metabolism.

Barry