preemployment drug testing

Nurses Recovery

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Is anyone familiar with the preemployment drug testing policies of major hospital systems? I know mine is a UDS, but do they typically follow SAMSHA regulations even if they are a private employer?

Specializes in School Nursing.

If you're using the prescription as directed, you really don't have to worry about it. If you're using more than the prescribed amount, only then should you worry about tests coming back showing your outside the parameters.

Have you discussed with your MD non-benzo alternatives? I can't imagine benzos being all that helpful for anxiety if you're too anxious to take a pre-employment drug screening.

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From all of my research, UDSs are not an accurate indication of "therapeutic" levels. Everyone's body metabolizes drugs differently, and short of a blood draw they cannot accurately indicate what my therapeutic level should be. Am I mistaken?

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Even if you have a valid prescription, a facility can determine that they will not employ anyone on a medication that they believe could cause impairment. There is no legal protection against these kinds of hiring policies.

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I have spoken to about 9 different MD's today, and they all say that UDS only shows presence of a drug not level of impairment or recent usage bc everyone metabolizes drugs at their own rate. Blood draws are the only way to determine a therapeutic level as UDSs are very unreliable. If you wouldn't mind could you please share more of your own story so I can understand?

I do not want to share my exact story because it could identify me. What I can say is that I provided a sample for drug testing, it went to MRO review due to positives. I had legal, in date scripts for what I tested positive for, written by the same doc.

BUT:

I was taking higher doses of those meds than the physician prescribed. One was a benzo, the other was tramadol. I submitted my prescriptions to the MRO. I thought I was fine because I had valid prescriptions. I wasn't sweating it.

The MRO called me and told me that while I had valid prescriptions for my positives, my urine metabolite levels demonstrated that I was not taking it as prescribed. He merely said they were "quite high". He was correct; I was abusing my scripts by not taking the prescribed dose. I faced serious consequences.

Listen, I don't know anything other than my experience. It's awfully nice that 9 docs tell you that you will be fine, but that was not my experience. I can't tell you what kind of specific testing they did, and can't tell you what kind of lab my pee got shipped to. I don't know how they processed it. I just know I peed in a cup and then a poo storm ensued.

I'm not here to argue my experience. I'm not lying, it really did happen. I have no incentive to scare struggling nurses. I'm in monitoring and I'm merely trying to help keep other nurses out of monitoring if I can.

But you do you. You know these 9 docs...you don't know me. Do with it what you will.

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From all of my research, UDSs are not an accurate indication of "therapeutic" levels. Everyone's body metabolizes drugs differently, and short of a blood draw they cannot accurately indicate what my therapeutic level should be. Am I mistaken?

Accurate or not, they are used.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
I'm confused as to what I have done wrong, as I have followed the legal and prescription instructions.

Really? Are you really confused? You don't understand the issue?

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Sorry to put you on the spot, but you were using a totally legal, prescribed drug, just abusing it, and they flagged you for "overuse"?

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But you were placed on monitoring bc of high levels of prescribed meds?

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yes, I am confused. I have legally acquired these prescriptions and followed each prescription as prescribed. So yes, please inform me of what my issue is by abiding by my prescribed prescriptions and getting them legally prescribed.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

That is " double dipping"

I would not test till I was consuming the therapeutic amount of only one of the prescriptions...

Best wishes

Sorry, please, I'm just really freaking out. I have two separate prescriptions for 1 mg of a benzo and for the past two days I have taken both prescriptions, and they are both legally prescribed to me, so I do not see how I could get into trouble for this. So for the past 4 days I have taken 2 mg (1 mg from each prescription), i don't know if this makes sense or not, but I cannot risk my license.
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Specializes in critical care, ER,ICU, CVSURG, CCU.
Respectfully, I have GAD, PTSD, and panic disorder so I "panic" about anything. I am just trying to ensure that I have done nothing wrong. I was not told to d/c anything, and he prescribed another 3 month script of benzos.

Maybe you should not be applying for a nursing job... Hate on me, but trust me you will Hate BAon actions worst... You are double dipplin

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Specializes in critical care, ER,ICU, CVSURG, CCU.
Respectfully, I have GAD, PTSD, and panic disorder so I "panic" about anything. I am just trying to ensure that I have done nothing wrong. I was not told to d/c anything, and he prescribed another 3 month script of benzos.

You have done something wrong....but don't trust me , just wait. And see what your BON does

Best wishes

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