Hey I didn't see this comment back when you posted it, but better late than never. Just wanted to say that you might be able to get around the need for a positive opioid urine test by claiming to be addicted to fentanyl analogs. That's how I got my Buprenorphine script to prevent relapse despite not actually actively using at the time.

The newer RC opioid analogs are getting very weird and numerous, it's impossible to test for all of them. There's a good chance your doctor will just take your word for it in that case. Tell them you're worried you'll accidentally OD soon and really need help.