drug screens on admission???

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Hey everyone - I was wondering if any of you are dealing with routine drug screens on admission for labor? As with most places we are seeing an increase in drug abuse - especially Meth - and our OB committee is kicking around the idea of drug screens on admission. Want to know what people think about this. They (our OB's) plan to do one with the patient's routine first labs & then tell them to expect one when they present in labor. That way there is time for counselling/treatment prior to delivery. I do know that if a mother tests positive for Meth in WV it is an automatic removal of Newborn until mother completes treatment. Your input is appreciated. Thanks & have a GREAT day!!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

we don't do routine drug screens. I am really beginning to think we SHOULD.

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Specializes in NICU.
we don't do routine drug screens. I am really beginning to think we SHOULD.

I think it's a good idea. It seems so judgemental how they do it at my hospital - if someone "seems nice" they won't even think to run a screen. But every young, unmarried woman that comes in - "Oh, make sure to run a tox screen." Same thing with the babies in our NICU. We'll have kids that are obviously withdrawing, and they won't run a tox screen because the mom "seems nice" and is married.

Because married people never do drugs. :confused:

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Just curious, would insurance cover that?

I sure would be mad if I didn't look "nice" and got stuck paying for a drug screen. Especially since those most likely to get screened (young, unmarried) are those who can least afford it. But then again maybe their babies are the ones who need it most?

Seems like cost would be an important consideration. Maybe I am biased because it seems like no one has insurance at my current clinical site.

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We have a policy that if they meet critieria such as late entry to care..after 20 wks, past history of use, any + screens, precip labors. Mom's have to give consent, but we don't have to have consent to screen the kiddo.

If they have any of the above the kiddo gets tested also.

Here in Oregon they've put all the pseudophedrine behind the counter. We have had a lull on the meth babes. "knock on wood".

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I think we might be really surprised at WHO does drugs if we did routines....and then again, this is not fool-proof either. Some know well how to fly "under the radar" well enough. That much I KNOW.

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Specializes in LTC, assisted living, med-surg, psych.
I think it's a good idea. It seems so judgemental how they do it at my hospital - if someone "seems nice" they won't even think to run a screen. But every young, unmarried woman that comes in - "Oh, make sure to run a tox screen." Same thing with the babies in our NICU. We'll have kids that are obviously withdrawing, and they won't run a tox screen because the mom "seems nice" and is married.

Because married people never do drugs. :confused:

I think if drug screens are going to be done, they should be uniformly administered---not just to young, unmarried moms, or those without insurance, or those who are low-income. Years ago when I had my last child, they did one on both of us, even though I was in my 30s and married; I learned some years later that it was routine for Medicaid patients at the time.:confused:

I have yet to understand why being poor automatically makes one suspicious for drug use........but that's a whole 'nother thread that I don't want to start.:stone

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I agree; uniformity is needed. That way no one can say we are being prejudicial or stereotyping anyone else. And like I said, you might be very surprised to see "who" is doing "what". It's not just your unmarried, young and poor people---- some "soccer moms" do these things, too. It is a huge problem that needs to be addressed other than in a punitive way.

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Specializes in NICU.
I agree; uniformity is needed. That way no one can say we are being prejudicial or stereotyping anyone else. And like I said, you might be very surprised to see "who" is doing "what". It's not just your unmarried, young and poor people---- some "soccer moms" do these things, too. It is a huge problem that needs to be addressed other than in a punitive way.

Exactly. That's why I agree that it should be a part of the routine labs for laboring moms.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

agree!!!

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Specializes in LTC, assisted living, med-surg, psych.
agree!!!

So do I, again, as long as it's done as a routine part of prenatal and admission care. After all, we have to go through these things just to get jobs a lot of the time; seems to me that having a baby is at least as important. And I also agree that the entire focus of drug screening should be on treatment, not punishment, for those who are found to be using substances during pregnancy......otherwise, we risk alienating the very people we should be trying hardest to help.

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