Drug testing- An out of date practice

[FightCRNADiscrimination, BSN, CRNA, CNS]

I may be extremely liberal when it comes to the idea of nurses still being drug tested, but the practice is severely outdated, like other "policies and procedures" in healthcare, and needs to be eradicated. The act of drug testing, specifically for marijuana, is no longer in line with today's workforce. 

With the legalization of many drugs at the state level, most specifically marijuana, medical professionals can still be reprimanded because all recreational drugs are still illegal federally. In good practice, Maine actually prohibits employers from testing for marijuana at the pre-employment stage and from discharging an employee for an initial positive drug test. Ultimately, there is no evidence based practice that supports this continued policy.

Without diving into the deep history of criminalization of marijuana, it's further instructive to revisit how marijuana became illegal in America. Harry Anslinger, the founding Commissioner of the Federal Bureau of Narcotics, declared many racial biases associated with its use, which then led to prohibition of marijuana. These racial biases were then exploited by the Nixon administration, etc. etc. Despite how "far we've come," we are still reprimanding nurses for THC positive drug screens based upon outdated bigotries. Positive drug tests are not acceptable for the majority of healthcare professionals and may result in loss of employment or no employment at all. If marijuana alone is positive on a drug test, is that being held against us?

We just don't know, and they are too many gray areas. Testing has become obsolete for most professions although positive tests for marijuana are at an all time high. There is no published evidence that the act of drug testing (I.e. making sure nurses aren't taking recreational drugs) improves practices, keeps patients or healthcare professionals safer, or yields any kind of better healthcare outcomes. In addition, heavily abused substances such as alcohol and nicotine are not tested for. However, there is evidence many employers don’t see a return on investment when they weigh the costs of pre-employment testing. 

We can collectively agree that THC is mind altering and would in fact maybe affect patient care if a nurse were to come to work high, but out of every single substance that is tested for on a 10-panel urine test, THC sticks around the longest; even if you smoked a joint 30 days ago, you could still test positive. The other heavier substances, such as amphetamines, opiates and barbs are cleared from your system in less than a week and tell us nothing about chronic usage. I can guarantee you that a nurse working 6 12 hour shifts in a row is less able to take care of patients than a nurse that ate an edible to get some sleep two weeks ago. 

But we have to ask ourselves as nurses if our rights are being violated. Are we being given enough time to take a test? Is there a violation of privacy? 

In short, maybe we screen for other substances. But screening for marijuana should go up in smoke. 

#marijuana #nurses #civilrights #fight #resist #drugs 

[JadedCPN, BSN, RN]

I hear what you're saying and agree to an extent. I don't partake in marijuana myself but support those that do and definitely do not think it should be illegal or restricted by employers, much like alcohol isn't. However I do understand that the conflict arises in regards to needing an accurate way to test for an employee being under the influence of marijuana on the job if need be. 

[TheMoonisMyLantern, ADN, LPN, RN]

I agree that marijuana shouldn't barr a nurse from employment anymore. As long as the nurse doesn't use prior to working a shift, then I don't see the problem with its recreational use and equate it to those that drink alcohol on their days off.

As for other substances... I'm an advocate for Harm Reduction and even the legalization of most recreational drugs, however I do think we need to screen for things like opiates, amphetamines, cocaine, benzos etc. because those that are either abusing these types of substances or are addicted could have a conflict of interest due to the drugs they'll have access to on the job. I believe that a nurse in the throws of active opioid addiction is at a higher risk of impairment and diverting than someone who uses marijuana. 

[Guest 1152923]

On 12/24/2020 at 6:07 PM, TheMoonisMyLantern said:

I agree that marijuana shouldn't barr a nurse from employment anymore. As long as the nurse doesn't use prior to working a shift, then I don't see the problem with its recreational use and equate it to those that drink alcohol on their days off.

As for other substances... I'm an advocate for Harm Reduction and even the legalization of most recreational drugs, however I do think we need to screen for things like opiates, amphetamines, cocaine, benzos etc. because those that are either abusing these types of substances or are addicted could have a conflict of interest due to the drugs they'll have access to on the job. I believe that a nurse in the throws of active opioid addiction is at a higher risk of impairment and diverting than someone who uses marijuana. 

Agree with this and would add that THC, being a 'fat bound' molecule, is detectable up to thirty days post-use.  This means that a user (nurse), who indulges on vacation up to almost three weeks prior,  can still test positive and be dismissed summarily.  Many careers have been ruined as well as endless suffering for such minor discretions.