Doctors found vial of urine hidden in rectum of patient

Doctors at St. Paul’s Hospital in Vancouver, Canada, investigating a patient’s mysterious abdominal complaints were stunned to discover a vial of urine hidden inside his rectum. The man eventually admitted that he had put a friend’s “clean” urine inside his rear end to try to fool a drug test at his methadone clinic. The idea was to keep the liquid at body temperature and avoid suspicions that the sample came from someone else.

Hin Hin Ko, the gastroenterologist called in by emergency doctors at St. Paul’s Hospital to extract the object said: “I think he had done it before – he’d just go and grab that bottle from his rectum and pretend it was his. And I’m not sure he’s the only one - there might be many other people doing the same thing.” The patient had showed up at the St. Paul’s emergency department saying he had had difficulty passing stools and abdominal discomfort for a week. He neglected to mention any possible causes of the symptoms. When an X-ray revealed a foreign object of some kind, Dr. Ko was called in to help.



Using an endoscope, the tiny camera and light-tube employed in colonoscopies, she found an object wrapped in a pink condom. Dr. Ko then inserted a “loop snare”, an instrument designed to cut off pre-cancerous polyps in the colon, to lasso the end of the tied-off condom and slide it out. When doctors discovered the eye-dropper filled with urine inside the condom, the patient finally revealed the whole story, she said. The case also shines a light on the culture around methadone, a substitute opioid drug used to treat addictions to heroin and, increasingly, prescription painkillers like oxycodone and hydromorphone.

Methadone users begin by visiting a drug store daily and drinking their dose in front of the pharmacist, but are typically allowed to take home several days of the medicine after they’ve shown some success. If one of the regular drug screens they undergo shows they are abusing a problem drug again, however, patients can lose the coveted carry-home privilege, said Mel Kahan, a University of Toronto addictions specialist. “Cheating is, I think, pretty common, although usually not to that crazy extreme,” he said. “They may be embarrassed, they may be ashamed, but most of all they don’t want to lose their [take home doses].” Patients will sometimes even pay other methadone patients for a sample of their urine, he said.