Drug screening anxiety

Nursing Students General Students

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Hello everyone,

I had a drug screening for my nursing program and am under the care of a couple doctors. I am prescribed Adderall 20 mg XR for the mornings, Adderall IR 5 mg for the afternoons, a Benzo for seizures (while I understand most docs won't prescribe Adderall to an epileptic, I have tried Strattera and other non-stimulants for my ADHD and nothing has worked, all over the course of 2 years and am seen VERY often to make sure my levels are normal). Then because I have a fractured skull and mild brain damage, I have Percocet to take as needed for pain. I am on Celexa for my mood instability to do the brain damage (my fronal lobe was injured and it is hard to function off of it). I take Midodrine, a blood pressure vassopressor because I suffer from Paroxysmal Hypotension. My college has all of the paperwork needed for proof that I am considered 'disabled' and they have all the doctors notes, and they continue to get current doctors notes on how I am progressing.

So here is my question, why would the DON want to see me in private about my drug screening? Will she kick me out? I'm so afraid because nursing school is everything to me. I am one of the academically strongest, (not to toot my own horn) because I put a lot of time and effort in to studying and practicing and take pride in it. During my recovery from my accident, it was the need to get back into nursing school that kept me going to physical therapy everyday, to cognitive re-training therapy 3x a week, and to keep up with all the other road blocks along the way. Should I be worried? I don't know who else to ask before sitting down with the DON.

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Specializes in Hospice.

You should bring your Rxs with you for sure, and I would also get a letter from your treating physician about what meds your are on and why. Just my two cents. Good luck!

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Specializes in ortho, hospice volunteer, psych,.

I'd suggest getting a note from your neurologist instead of your internist because it packs more of a wallop. My letters detailed every diagnosis and every med I took, the meds I took to prevent seizures from which other meds, and what tied it all together, if that makes sense at all. Good luck!

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Specializes in ICU.

I would definitely go to the meeting prepared with doctors notes and plenty of documentation as to why you need those mess and everything that showed up in the screen in legitimate, just to be safe. Does your school have a student handbook readily available. If so, I would read up on the policies regarding drugs and drug screenings. That way, you're well educated for your meeting.

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The way it works is they do a basic screen for "Illegal" drugs. Some of these screens show a false positive for drugs when you take a prescription drug. If there is a positive your sample is split so they can retest with a GC/MS. This device measures nanograms of the offending substance. Nano means 10 to the -12 grams. This is a ridiculously small amount to detect so they can isolate if it is in fact a legal drug. The doctor from the drug testing company is supposed to call you if there is a question. I would imagine if you tested positive for any illegal drug that would be sent in a letter to you personally. There is no way to beat these drug tests other than to dilute the sample. Typical thresholds are 100 nanograms to test positive.

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Specializes in Oncology, Critical Care.

They screen for classes of drugs, some of which are CNS stimulants and CNS downers. The program DON will probably prevent you from starting classes until your off the percocet and benzos because both can cloud your thoughts and create issues of safety for patients. Even having prescriptions doesnt help you too much with getting over the drug screen. I would explain to the DON everything, because if they see it, they may automatically dismiss you from the program without thought of why.

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Thank you for all of the responses. I understand the whole patient-safety issue especially when narcotic pain medication is involved. I am prescribed 90 pills per month as needed, and I haven't once needed a refill for the past 4 months. Don't get me wrong, I do have my bad days, and I definitely know better than to pop a percocet whilst in clinical or class. Usually a few ib profen will take care of most of the pain until I get home and I can then take one before hopping into bed. I am going to ask my pain specialist to take me off of the percocet since it isn't worth the trouble. My benzo is needed for my seizures indefinitely. I was off of it right after returning back to the program and while embarrassing to say, I had a seizure in the middle of an exam! My neurologist had a hay-day chewing my butt off for not taking it, and rightfully so.

What I don't understand is that I have been giving paperwork to my school all the time from my doctors. Sometimes I feel like my poor doctors get tired of writing the notes and even expect to write one before I leave. I'm just so scared. I have copies of all my doctors' notes and all the pill bottles and pills. The DON is very familiar with me and my condition, I guess that's why I'm so nervous.

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Is there a chance that your benzos were beyond a therapeutic level? I take 0.5 mg Ativan for test anxiety on exam days (once every 1.5-2 weeks) and have never even tested positive because its such a minimal amount.

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Try not to freak out too much until after you speak with her. If she has been aware of your condition and medications this whole time it could be something as simple as needing more documentation for a clinical site or something. Try to stay calm, and be prepared with all of your prescription documentation at the meeting. Good luck!

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They screen for classes of drugs, some of which are CNS stimulants and CNS downers. The program DON will probably prevent you from starting classes until your off the percocet and benzos because both can cloud your thoughts and create issues of safety for patients. Even having prescriptions doesnt help you too much with getting over the drug screen. I would explain to the DON everything, because if they see it, they may automatically dismiss you from the program without thought of why.

BS, and I don't mean the degree. If the OP is progressing normally after cognitive rehab and gets good grades, and has supporting documentation from treating physicians (OP: Have you had a neuropsych eval? That would be helpful documentation too), there is no reason whatsoever to expect that the program would kick her out.

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Specializes in Complex pedi to LTC/SA & now a manager.

Benzos for a seizure disorder is usually looked at very different than benzos PRN for anxiety. If the med that keeps your epilepsy under control happens to be a benzo or phenobarbital then it is a necessary drug just like a type 1 diabetic needs insulin to live.

You have the option of discussing you pain management regime with your treatment team to determine if your regime needs to be adjusted and possible options.

Get assistance from your treating neuro as your situation is very unique.

Good luck as you progress in your career.

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for reference. This is what they test for https://www.labcorpsolutions.com/images/Drugs_of_Abuse_Reference_Guide_Flyer_3166.pdf

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