Chronic pain condition and pre-employment drug testing

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Hello!

I am a new nurse who happens to suffer from several chronic pain conditions. I am able to work to my full capacity but I do get help from prescribed medications. I recently was offered a position at a clinic but the offer is pending a drug test. I have never been drug tested before (despite working several direct patient roles over the decade) so Im a little nervous to what this entails. Currently my meds that I am concerned about are: nortriptyline 25-50mg QHS, Baclofen 10mg BID, oxycodone 5mg Q12H/PRN (I don't take nearly that amount, I split them), Imodium 1-2mg QID/PRN, Valium 5mg QHS/PRN (this is taken by alternate route and I only take half the dose and haven't taken it in a long time).

So anyways, I know that since I legitimate scripts my medications shouldn't be too much of an issue, or would they? Anyone have any expierence with taking long term meds that may show up on a drug screen.

My other concern is that I have seen varying info on weather Imodium shows up as a opioid on a drug screen. I take a large amount of this almost daily to help with a chronic GI issues, stopping it before a drug test is not an option. Has anyone here had an issue with it triggering a false positive?

Also, I read that TCA's can trigger a false positive for amphetamines. I take this med for pain and GI issues so stopping it not an option either. Anyone know about this?

If I trigger positives on my test does anyone know if they can test if further to rule out false positives?

I know I have scripts for all of these meds and even the Imodium use is well documented so getting doctors notes won't be an issue, but I am worried about my new employer being notified about all of my medications (little TMI, and kinda embarrassing) and really would like to keep my medical history to myself.

Sorry if this post seems a little silly, I am a little nervous about my first job an a RN and the drug test so I would appreciate a little advice (please no judgment).

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Specializes in Maternity.

In most hospitals you cannot take opiates or benzos even with a legal prescription. I suspect you are going to have some difficulty. A positive drug screen may also get reported to the BON. I would tell the HR of your employer that you are taking these drugs and see what they say. You don't want to get reported to the board. All they see is a nurse with positive drug screen that wants to work. They don't care if it's prescribed or not. Good Luck.

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Specializes in ICU.

Did you not have to take one in nursing school? The reason I ask is because I am taking one for school and that is what the hospitals look at. I have never heard the immodium thing. I was told all the drug company asks when you come up positive is for your script number and that I would be fine. I would simply ask ahead of time. It shouldn't be an issue. I also have chronic pain that is controlled by pain meds. I explained to my school that I have been on the same med for over 3 years and have never had an increase in the amount nor have I ever missed a pain mgmt appt. In my state I am required to go to doc appts. every three months for pain management. I have my doctors full support in this and he didn't think it would an issue either. I understand how hard it is to talk with a potential employer about it because of the stigma attached with pain meds but be upfront and talk to them. I was prepared to have my doc write a letter for me but it turns out I was worrying about nothing. All the do is ask for the script number.

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II'm pretty sure rnibclc is incorrect. I have seen numerous post were people with legit script s were fine. It seems it depends on the employer, besides I the oxy is prn as is the valium neither of which I take everyday(I haven't taken the valium in weeks bc it makes me drowsy). My question was I guess more about what I should disclose and if Imodium and tca's w/o cause a false positive.

Heather, my school didn't require a drug test. Even if they had, I wasn't taking anything but the Imodium when I started. I am also under the care of pain management and several other specialists so I know I can certainly get notes and can produce labels for anything that might come up. Though the Imodium is otc, so I might ask my Dr for a letter.

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Specializes in Emergency.

All the drug screens I have seen have the physician oversights check the levels against the script. If it's within acceptable, the results are reported as negative to the employer. Full disclosure: the only nursing related screen I have ever been involved with was my nursing school screen, so I don't know any variables on that.

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Specializes in Maternity.

Please keep us posted so I can correct my information.

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Specializes in Complex pedi to LTC/SA & now a manager.
II'm pretty sure rnibclc is incorrect. I have seen numerous post were people with legit script s were fine. It seems it depends on the employer, besides I the oxy is prn as is the valium neither of which I take everyday(I haven't taken the valium in weeks bc it makes me drowsy). My question was I guess more about what I should disclose and if Imodium and tca's w/o cause a false positive.

Heather, my school didn't require a drug test. Even if they had, I wasn't taking anything but the Imodium when I started. I am also under the care of pain management and several other specialists so I know I can certainly get notes and can produce labels for anything that might come up. Though the Imodium is otc, so I might ask my Dr for a letter.

While there may be a false positive on an initial screen ( never heard that for Imodium but I have for lomotil but that is opiate based) the "Truth" would be revealed upon GC/MS confirmation testing.

Using PRN class 2/4 narcotics can be an issue. But not always. There are many nurses that take amphetamines for legitimate reasons (Narcolepsy, ADHD) or anti-anxiety meds for legitimate reasons and have no issue as long as the staff member is willing to produce the prescription or permit the medical officer to confirm with their treating prescription.

Some BoN prohibit nurses from working while on any narcotic even with a legitimate script. You would need to check your BoN for that information.

Sometimes you need medical clearance and regular follow up with your treating physician as a condition of employment.

The biggest issues I've seen posted in recent months were positive drug screen from taking a non-prescribed narcotic (Valium for insomnia, oxy for back pain, Ritalin to pass a test) from family/friends and thus no legitimate or legal reason for the drug to be in their system.

So, don't worry about false positives as that's what GC/MS confirmation is for if a test is positive. Check with your BoN if you are permitted to work with occasional prescribed narcotic use. Congratulations on the job.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I take tramadol and klonopin and have had multiple drug tests for CNA school, nursing school (ADN), nursing school (BSN), prn job, reg job #1 and reg job #2. I have legitimate scripts and have never had a problem

Full disclosure before test all times.

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i also have had multiply rx's throughout the years and never has that disqualified me. Just tell them before the test you have a rx and show them the body if requested and thats that. The only law to nurses with pain management is not coming to work impaired or "under the influence". Other than that rule, you should be fine.

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