Pot Smoking and Nursing - page 19

Im angry. I work for a small clinic in Northern CA. There are three RN's on staff at all time. Recently our Office Manager decided to start drug testing of all staff including Doctors. Well, one... Read More

  1. by   xtxrn
    Quote from MunoRN
    The metabolites of marijuana are detectable for long after marijuana is used, but this has nothing to do with how long a person is under the effects of marijuana. The metabolites of marijuana are fat soluble, which causes them to be stored in body fat and then released as fat is burned which causes a long, sustained released of metabolites into the urine. Opiates for instance are water soluble, and are therefore only detectable for a matter of hours, maybe a day or two.

    Alcohol goes through steady-state metabolism, which means that it's effects and duration of effect are directly related the amount consumed, the general rule is that one drink lasts approx 1 hour. Marijuana goes through a half-life metabolism, which means it lasts about the same amount of time regardless of amount ingested, the difference being the extent of effect. In terms of how lung someone is "high" on marijuana; it's generally considered to be about 2-4 hours (about the same amount of time someone is affected by a few drinks of alcohol).
    Yeah. And a reason someone shows up positive after NOT smoking for a while, if they change their diet, gain/lose weight. Watching the potheads detox was like watching paint dry. These were generally frequent/regular users. But they came in for pot-only rehab. There were more poly-drug addicts, but there were pot-only.
  2. by   Lifeofanurse
    I suddenly feel very very stupid.

    Ok...I had to go through a zillion background checks (seriously like a major that covered my whole state) to work my last job because it was with kids (not healthcare). Was drug tested before hire and signed an agreement that I would not partake while employed by my company. I could be sent at any time for a drug test...as they were random and if your name came up you had 2 hours to get it done or immediate dismisal. If you refused...your fired.

    My job before that...was at a major chain store. Again..rigorous background check, fingerprinting and drug testing. Again...random testing was the norm.

    And here I am working with a bunch of potheads?! These are the people entrusted with saving lives and taking care of our loved ones?!

    I am just shocked...plain and simple..shocked.
  3. by   xtxrn
    Lifeofanurse,

    I hear ya. I'm not shocked (worked drug and alcohol rehab, and saw a LOT of professionals of various sorts in for different addictions).... and i don't think all potheads are addicts. But by the time they realize what it's done to them, it will be too late. I had one coworker that I KNOW was smoking pot- and I regret not turning her in. Now, in TX, if you know someone is impaired (and that can be smoking the day before going to work- if it shows up, it's a problem) and don't report, the one who doesn't report can be in trouble with the BON. If that had been in place when my coworker was smoking , I'd have made the call in a heartbeat. With no regrets at. all.

    Folks are always free to disagree, as long as I'm allowed my opinions as well (based on what I've seen and learned).
  4. by   xtxrn
    two guests reading this .... wonder how long it takes them to let their friends/co-workers know?
  5. by   nola1202
    Smoking pot? Are you serious? This is halloween weekend...is this just a flashback to the 70's?
    I would never jeapordize my nsg lsc, it is the only way I get to eat. Food is important to me, so is not being homeless.
  6. by   xtxrn
    I'll get the strobe light
  7. by   nola1202
    Quote from xtxrn
    I'll get the strobe light
    COOOOl, can you bring a lava lamp and a black light for my peter max poster?
  8. by   MunoRN
    Quote from xtxrn
    Yeah. And a reason someone shows up positive after NOT smoking for a while, if they change their diet, gain/lose weight. Watching the potheads detox was like watching paint dry. These were generally frequent/regular users. But they came in for pot-only rehab. There were more poly-drug addicts, but there were pot-only.
    I've had many patients in the DT's and many opiate OD's, but never a withdrawing pothead. How exactly do you treat pot withdrawals? I thought it's been long since decided that such a thing doesn't exist. I know at one point it was thought that pot withdrawal consisted of being irritable, but it turns out that's just what happens when you take away someone's pot and put them in jail, rather than being a symptom of physical dependence.
  9. by   myelin
    " I completely disagree, despite what the research says."

    It's quotes like these that make me a very sad panda. Critical thinking, people! Multiple anecdotes are not data.
  10. by   myelin
    "But A glass of wine with dinner doesn't impair someone"

    ... wow. Just, wow.
  11. by   xtxrn
    Quote from MunoRN
    I've had many patients in the DT's and many opiate OD's, but never a withdrawing pothead. How exactly do you treat pot withdrawals? I thought it's been long since decided that such a thing doesn't exist. I know at one point it was thought that pot withdrawal consisted of being irritable, but it turns out that's just what happens when you take away someone's pot and put them in jail, rather than being a symptom of physical dependence.
    This was in the mid-late 90s... Mostly they looked like the plants they admired so much, but more glazed over . Air amused them . Speech? Not so much. There isn't the "detox" in terms of a protocol to avoid potentially dangerous symptoms- but more getting the fog lifted, and the wattage reconnected to the bulb . Then, a few days in, (and these were not "social" smokers- these folks had clouds following them), it's like the lights go back on, and they look around- vaguely remembering why they were there, and slowly get more "normal". I don't remember them being all that irritable- maybe a bit sensitive to stim, but no big behavioral issues like cocaine/meth. But they also had it pretty good- it was an old hunting lodge turned treatment center, so open, no locked units, keys to their rooms, a pool, chef, etc.

    When they could get themselves to meals w/a 'buddy' (open campus & dining hall) without falling over, we were close I don't know that it was physical dependence- doubt that, as I also never heard of physical dependence w/potheads. More psychological along with being VERY loaded and having been so for a long time. The patients with less pot usage were basically "duly noted", and move on. They still had the 'negative consequences' associated with addiction, but not the mayhem the others went through physically.

    For the poly-users, the focus was never on the pot- but the stuff that could cause actual physical trouble. Opiate and alcohol detox would shake the cobwebs loose a bit faster than the potheads that ONLY did pot, and made it their life's work. And methadone detox? The worst of any of them... those folks suffered a LOT....and we tried to manage symptoms as best we could. That was just plain sad.

    (nearly all had the final fling before admission- either at home, on the plane, or while still in the airport/bathroom, and our drivers were instructed to hit up the convenience stores for 12-packs between the airport and the facility- 90minute ride gets pretty long with the tremors starting- and most of I-10 at that time was a wasteland for someplace to stop and get booze)

    Then there were the kids who would smoke pot laced with embalming fluid. Never did get a clear explanation as to what that was supposed to do .... help the mortician? Those were almost exclusively teenagers . They weren't admitted to the detox beds- just sent up to the Young Adult program ("adult" being used VERY loosely).

    But a bunch of them did go through some 'hot' drug tests after a few weeks of not smoking d/t the fat stores, and they hadn't had access. They'd be devastated. Fortunately, the docs were ASAM members- and had made CD their life work, and knew about the late positive testing. I was lucky to work at LaHacienda in TX (before Dr. Phil sent folks there). I loved it. I'd get so mad when I worked med-surg and we got someone from one of the rehab places... I'd remind my coworkers and the docs that the ones who don't get help are the risky ones. At least give them credit for trying

    And it ended up helping me a lot with LTC, believe it or not. There was always some doc who would cut off the benzos Gertrude had taken since the Nixon administration, and wonder why she got twitchy and unresponsive a couple of days in. "well it was a small dose"- yeah, in someone with decreased clearance, and physical tolerance.
    Last edit by xtxrn on Oct 30, '11
  12. by   xtxrn
    Quote from nola1202
    COOOOl, can you bring a lava lamp and a black light for my peter max poster?
    Only if you wear the cork platforms
  13. by   nola1202
    Quote from xtxrn
    Only if you wear the cork platforms
    on it. gonna wear my big hoop earrings and my bandana the way Rhoda did on the Mary Tyler Moore show. You wanna tie dye some tee-shirts while we listen to pink floyd?

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