Concerned

[Quinntb]

Recently I was asked to take and did a drug test at work after forgetting to waste two medication and I take fioricet for migraines do I have a reason to be concerned about losing my job

[KelRN215, BSN, RN]

You should be ok if your drug test comes back positive for opiates, since you have a current Rx. If it comes back positive for benzos, nope, you're not ok.

Also, you're didn't follow policy on wasting the drugs. That alone could be a problem. I suspect you'll get some sort of "counseling" about doing what you're supposed to do, with bigger consequences if it happens again.

Not ok if the drug test comes back positive for opiates. Fioricet is butalbital, acetaminophen and caffeine. No opiates. Butalbital is a barbiturate. The meds missing are benzos and opiates so if OP tests positive for either, the prescription for Fioricet would not be a free pass.

OP, your prescription should say "X refills until X date." The date is when the prescription is active until. For most prescriptions, it's a year. For controlled substances (at least in my state) it's 6 months, unless the MD limits the number of refills to a shorter time than that.

[caliotter3]

If you have any questions about the validity of the precription, you should consult with the doctor that prescribed it. If an ongoing prescription with regular refills you should be ok, but sounds as if you are in doubt. Talk to your doctor.

[jadelpn, LPN, EMT-B]

AND just as a complete aside, do not ever, ever forget to do your wastes. Ever.

You could be on nothing as far as prescriptions and be called out because of this. If you drew up and wasted on your own in a room with a camera, then it would show you wasting--but not knowing the specifics, it is hard to say.

Going forward, always have another nurse witness your wastes. And be sure to waste in front of them, not a "hey, I gave that Ativan and forgot to waste, will you sign off on it" stuff--that puts nurse #2 in an awkward position that is unfair.

Even if your charge is the one who comes with you to witness your waste. If anyone ever said "waste it later" or you could not find a nurse to witness--THEN that is a process issue, and needs to be addressed. But you have absolutely no proof that you ever wasted the med, and you do NOT want your practice to be questioned. And it doesn't hurt to ask "in the instance that there's no nurses available to witness wastes, what is an alternate choice?" (ie: if your pharmacy has pharmacy techs, for instance)

I would also call my malpractice insurance. Get some direction from them.

[Whispera, MSN, RN]

You're right, Kel. I should have looked it up rather than trusting memory:

Not ok if the drug test comes back positive for opiates. Fioricet is butalbital, acetaminophen and caffeine. No opiates. Butalbital is a barbiturate. The meds missing are benzos and opiates so if OP tests positive for either, the prescription for Fioricet would not be a free pass.

[sallyrnrrt, ADN, RN]

controlled substance rx expires, ie: no longer valid from six months issue date