Drug Test

[concernedlpn]

I have been an LPN for 3 years, never been in trouble. I recently had a drug test and the test came back positive for opiates which i have a prescription for but it also came back positive for propoxyphene which i have never taken. I don't know how to prove this and what is going to happen my supervisor said it could be turned over to state board but she said she thought the only way it could is for illicit drugs or diversion. I haven't done either of those. Every medicine was accounted for and everything was charted. I just don't understand why it came up positive and what im going to have to go through if they do turn it over. Am i going to lose my license? Im trying to get into RN school and that would look awful. I read that diphenhydramine can cause a false positive for propoxyphene and i work nights so i take 3 benadryl every morning before bed. Any ideas on any of this would help! I find out tomorrow what they are going to do but I will fight it if it gets turned over.

[TopazLover, BSN, RN]

Did you list all medications you take? If so, you can show your documentation of false pos. If not, I don't know.

In most states you would not lose your lic. but that is a BON decision.

[concernedlpn]

They didn't ask me for a list of ALL drugs. Just the prescribed ones and i gave them my prescription for ultram and vicodin.

[mondkmondk]

I was recently hired for LTC and my urine came back positive for like 2 or 3 different things but I take 6 scheduled meds and a ton of OTC's. To be on the safe side, I brought in all my bottles so they could see my name on them and they wrote all of them down, even prn's.

Blessings, Michelle

[medsurgrnco, BSN, RN]

Wondering why you were asked to take a drug test. Suggest you check for what OTC meds you might be taking that could cause a false pos. (Maybe a web search could help with this.) Ask for a second drug test, as it could just be an error of a false pos.

[TexasNurseEducator]

I agree with a second test if possible and write down everything including herbals or OTCs. Worse case scenario it would go to the BON who would investigate, probably require pysch eval and lie detector test and then depending on results worse case scenario a year of random drug screens. Quite a lot depends on your particular state rules. Read them! It usually takes quite some time for all of this to get resolved and you are not required to notify the school until after investigation is complete and you receive final order. This may even take a year or so. You could still get in school and then deal with it if it comes to that point. Remember you are innocent until proven guilty. You may wnat to consider consulting with a Nurse JD that is practicing in your state and famailiar with the rules there. Call your nursing association or legal nurse consultants group in your state.

[country mom]

Actually, if they are following the accepted protocol for drug testing, the donor should never be asked to bring in their meds, prescription or OTC, to the drug testing site. If it is positive, the donor should be contacted by a Medical Review Officer, a physician who is specially trained to review drug test results. An MRO is aware of every conceivable scenario for a false positive and is legally considered the ONLY person who is capable of deciphering a true positive from a false positive. When federal testing protocols are followed, the donor is contacted for an interview before the employer is notified of the result. If you had an MRO that contacted you, you will want to talk to that person, their number is usually listed on the upper right corner of the chain of custody form- that is, if indeed your employer used proper chain of custody in handling the specimen. If they did not document chain of custody, then they don't have a leg to stand on.

[southernbeegirl, BSN, RN]

many drugs cause a false positive on the first part of the test but when the second part is done to determine exactly what meds were used it wont show positive. my albuterol inhaler caused a false positive on barbituates on most of my drug screens with TNPAP while i was on contract but when the 2nd part was done, nothing would show.

the above poster is right about the MRO.

[sissiesmama, ASN, RN]

Actually, if they are following the accepted protocol for drug testing, the donor should never be asked to bring in their meds, prescription or OTC, to the drug testing site. If it is positive, the donor should be contacted by a Medical Review Officer, a physician who is specially trained to review drug test results. An MRO is aware of every conceivable scenario for a false positive and is legally considered the ONLY person who is capable of deciphering a true positive from a false positive. When federal testing protocols are followed, the donor is contacted for an interview before the employer is notified of the result. If you had an MRO that contacted you, you will want to talk to that person, their number is usually listed on the upper right corner of the chain of custody form- that is, if indeed your employer used proper chain of custody in handling the specimen. If they did not document chain of custody, then they don't have a leg to stand on.

Hello country mom - Thank you for that post. I had wondered about that, about the MRO!

Anne, RNC

[country mom]

many drugs cause a false positive on the first part of the test but when the second part is done to determine exactly what meds were used it wont show positive. my albuterol inhaler caused a false positive on barbituates on most of my drug screens with TNPAP while i was on contract but when the 2nd part was done, nothing would show.

the above poster is right about the MRO.

The "second part" you talked about is called the split specimen. When a drug screen is collected, it is supposed to be poured into 2 separate bottles, "A" and "B". Both are sent to the testing laboratory. Bottle "A" is tested intially. Bottle "B" is kept in storage. The donor has a right to request that Bottle "B" be tested when he/she is notified by the MRO of a positive result. In order to further analyze a specimen, the MRO can request further testing of the specimen, such as when the donor is on a prescription medicine, as different medications have different metabolites. For instance, methamphetamine will have a different metabolite upon analysis from other types of substances in the same family. That is why a certified MRO is absolutely critical to the integrity of the process.

[chevyv, BSN, RN]

If all else fails, can you do a hair sample? It seems that I'd pay out of pocket to prove that rather than lose my license. Please keep us posted.