Pre- employment drug testing

Nurses Recovery

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Hello everyone! I was just in a different area:first year in nursing, and there was an interesting post. So i went looking around the site and found this area.

The post was about being prescribed a narcotic, xanax prn for anxiety and the person was worried about it showing up on their preemmployment drug screen. This is a very interesting question and it led me to think about what are the rules for pre employment drug screening. If anyone could help, Id greatly appreciate it!

Do you have to disclose information as to what meds you are on?

If it is a narcotic do you have to disclose this info?

I know the med that I am worried about is confidential information, and it may show up on a drug screen, how do I deal with that? If i tell them what I am on, I am worried I will be judged and maybe the decision as to whether or not I will be hired wont be affected, but I feel like alot of people will look down on me and may find another reason to fire or dismiss me from the job.

I am not on an amt that will impair my judgement, I am actually on a VERY LOW DOSE and always have been- actually tapering down but that is a slow process- I just dont feel like I shouldnt have to disclose this information. I take my meds as prescribed, I see the Doctor regularly- if i couldnt function or the doctor felt my judgement was impaired, I would not be allowed to keep my license and get behind the wheel and drive. I never disclosed this info to my nursing school, as I felt it was none of their business- but there is nothing about being on this med effecting your scope of practice or being able to get your nursing license. I have never had any convictions or court cases or whatever- and that was the only thing that would effect the status of getting your nursing license where I am from. So it leaves me in the dark as to what are my rights and what is waived when it comes to employer/employee rights. Im a new grad and i think this is something every nursing school should take time out for: Your rights as a nurse and a potential candidate.

Thanks for any and all help and opinions

Specializes in research.

I'm a clinical pharmacist (weekends), a reserve Air Forse officer and an airline pilot by profession. Many have asked me to pee tp prove my innocence. Recently, the hospital where I have worked (part-time) for 25 years "requested" a random durg test for everyone inclusing me. I told the MRO that I would submit a sample if she )an MD) helt the cup in her teeth...sorry to be graphic.....so I assumed i was fired. I have Harrington rods in my back and take an occasional benzo/naco if needed. Bottom line: if you have a script, no problem. You do not have to release any medical info (why you are taking the rx or how often) for employment.........give your prescriber a letter to release that you are on a drug, nothing more.......................oh, and my situation was resolved; the doc who prescribed my drugs had a hissy fit and told the hospital that captain x was on drug Y and thats all you are going to get...................I don't want to work with druggies, but this testing nonesense is really nonesense

As long as you have a script number and the pharmacy number you are ok as long as it is a legal drug.But, they really cannot confirm the rx because of hippa laws,,so why they do it idk...

Specializes in Impaired Nurse Advocate, CRNA, ER,.
I don't want to work with druggies

Wow! How do you feel about working with diabetics, asthmatics, or anyone else with a chronic disease? The continuing ignorance about this disease despite the tons of available research is amazing and is what continues to feed the stigma associated with chemical dependence.

It's OK to randomly test a pilot, truck driver, firefighter or police officer when they don't handle controlled substances? But testing those folks who dispense and/or administer those controlled substances is nonsense? I think not.

I've been in recovery for over 16 years and would gladly give a urine right now if someone was concerned I might be impaired or my employer had a random screening policy. As someone who has experienced the misery and threat to life this disease causes, I see random drug screens as a safety measure for the PRACTITIONER as well as those they care for everyday. Chemical dependence is a disease from which health care professionals are not immune. Part of the disease process is the pathological denial that prevents the afflicted person from recognizing they have the disease or from seeking help. If someone with this disease is seen as a "druggie" (or any other stigmatizing label you can think of), nothing is going to change and the epidemic will continue.

Jack

Specializes in ER, TRAUMA, MED-SURG.
Specializes in Psych,Peds,MedSurg,Tele,OB,Subacute.

Now does anything have any idea as far as nursing school? If one is on a maintainance dose of methadone...including only having to go to their facility on amonthly basis to pick up their meds will that inhibit them from the nursing programs, i know they do a drug screen i am guessing methadone prob is not on their test as it is not an opiod, etc...any clue??

Specializes in Impaired Nurse Advocate, CRNA, ER,.
Now does anything have any idea as far as nursing school? If one is on a maintainance dose of methadone...including only having to go to their facility on amonthly basis to pick up their meds will that inhibit them from the nursing programs, i know they do a drug screen i am guessing methadone prob is not on their test as it is not an opiod, etc...any clue??

Are you tapering off the methadone? Do you plan to taper off?

I am unaware of any state that allows a nurse to practice while on methadone maintenance (although there may be a few). I do know there is a lawsuit underway in Pennsylvania challenging the "hidden" rule by the board of nursing that does not allow a nurse to practice while on methadone maintenance. As far as I can tell there has been no response by the PA BON in that law suit (last update I saw was last June when a judge ruled the BON has to respond to the nurse's lawsuit).

Obviously, the concern is the nurse practicing while on methadone maintenance may have neuro-cognitive alterations creating a risk to those patients the nurse cares for during their shift. There are very few studies looking at this issue, and none I could find specific to nursing. Below is the abstract from one such study. It would be wise to consult with a license defense attorney in your state to obtain their legal opinion regarding how to proceed and whether it would be wise to pay thousands of dollars on obtaining a degree for a profession you may not be able to obtain a license to practice unless you are no longer on the methadone. The cost of a consult is minute compared to your college fees.

Good luck and keep us posted.

Jack

Drug Alcohol Depend. 2002 Jun 1;67(1):41-51.

Cognitive impairment in methadone maintenance patients.

Mintzer MZ, Stitzer ML.

Department of Psychiatry and Behavioral Sciences, Behavioral Biology Research Center, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA. [email protected]

Abstract

Few well-controlled studies have examined psychomotor and cognitive performance in methadone maintenance patients (MMP). In the present study, performance of 18 opioid-dependent MMP was evaluated relative to that of 21 control participants without substance abuse histories. The MMP and control groups were balanced with respect to gender, race, age, years of education, current employment status, current reading level, and estimated IQ score. Recent drug abstinence was verified by urine testing. Participants with a urine screen positive for benzodiazepines or a breathalyzer test positive for alcohol prior to performance testing were excluded. To avoid testing under conditions of acute heroin or cocaine intoxication, but without testing under conditions of acute withdrawal, participants with current use of heroin or cocaine were only required to abstain for 24 h prior to performance testing. MMP exhibited impairment relative to controls in psychomotor speed (digit symbol substitution and trail-making tests), working memory (two-back task), decision making (gambling task), and metamemory (confidence ratings on a recognition memory test); results also suggested possible impairment in inhibitory mechanisms (Stroop color-word paradigm). MMP did not exhibit impairment in time estimation, conceptual flexibility or long-term memory. The wide range of impaired functions is striking, and may have important implications for daily functioning in MMP. Further research is necessary to determine the clinical significance of the impairments in laboratory-based tests for daily performance in the natural environment, as well as to differentiate impairments due to acute methadone dosing, chronic methadone maintenance, chronic poly-drug abuse, and other factors.

Specializes in Med/Surg/Ortho, Oncology, PACU.

With pre-employment drug testing, in my experience, it always depended what lab I went to for testing whether I needed to disclose any meds or not. Some have you list all meds taken in the last 72 hours. Others specifically say not to list any, and if it comes back positive for any, they will then contact you to verify you have a current prescription.

What is a druggie ?

Did I misunderstand you with the word druggie ?

Specializes in NICU, ER, OR.

Agreed-- just because you are not EMPLOYED YET OR WORKING WITH PATIENTS, you absolutely will still be reported to the BON if you test for anything not prescribed while discovered on a pre employment drug test !!!! Many don't know this, I was shocked .

Specializes in NICU, ER, OR.

I've done pre employment drug tests that DO ask you for any medication you are currently taking, and also some that are NOT interested, as in they won't write it down !! I'm not sure why, or what the difference is... maybe someone can shed light? And, btw, on one of them that didn't want to know any meds I was taking ? I absolutely had Vicodin in my system from a dental procedure that very WEEK, yet they never even called to ASK me about it, and I passed the test, never heard a thing ... not sure about how all that works....

Specializes in NICU, ER, OR.

Sorry if this has been answered allready

If you know you are taking a med that WILL show up on a drug screen, then YES, you will have to tell them, otherwise your drug screen will be considered failed...

i have had to do two types of drug screens for pre employment, I have no idea who does what kind or why; one where they made me list any and all meds I was on, or ingested in the last week including otc meds... the other, they did not want to hear anything I was on... ( this one: I thought was weird, because I am on a med that I KNOW shows up, yet I never was called or asked about it!!! Weird)

But how it's supposed to work is, if you give them a list of what you take, and one is a drug they test for,and it shows up.. a medical review officer( NOT your manager) will contact you to provide proof of your prescription for said med, and it's done, your drug screen is considered NEGATIVE

The other one, whatever med comes up , still, a MRO will contact you and tell you, and ask you to provide the same proof.

HOWEVER.,prescription or NOT... there are some drugs that if you want to practice as a RN, you just can't be on, it's not allowed. I don't have a complete list... and I believe it varies from time to time, ... but I know suboxone, methadone, adderall/ Ritalin , and sometimes opiates like Vicodin/ Percocet

move personally done a pre employment screen while on a prescription for Vicodin... I passed the test because I had a script, however at my physical I was given quite the third degree, with them drilling me/ questioning me that if it was a " once in a while" thing that I took it, OR did I take them every day.

Hope this helps!! Oh btw, at the next job , I simply went without Vicodin for 5 days so it wouldn't show up.. the less they know, the better... I'm not recommending you do that or if you are able to, I don't know what your taking, but that's what I did....

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