drug testing

[Muser69]

Are you kidding me? please read about cannabis.

[Horseshoe, BSN, RN]

Are you kidding me? please read about cannabis.

From the tone of the OP, I don't think he is concerned about cannabis use in this woman.

We don't know a whole lot about dangers of smoking pot during pregnancy. This article talks about potential effects:

Marijuana and Pregnancy | MotherToBaby

Smoking Weed While Pregnant: Is It Dangerous?

There have been other studies which suggest it may be safe to use (medical) cannabis while pregnant if not smoked.

With something so important as the health of the baby one is carrying at stake, I guess each mother has to determine her willingness to take a chance on something that has not been determined with certainty.

[klone, MSN, RN]

Are you kidding me? please read about cannabis.

Please read WHAT about cannabis? Do you have information about marijuana safety in pregnancy that the rest of us do not?

[FurBabyMom, MSN, RN]

It's totally facility policy how tox screens are collected as well as in what situations. Currently, I work in the OR. We get all kinds of situations, and may or may not suspect illicit drug use. We send tox screens fairly frequently because, especially in our unidentified, unknown patients, who knows what they are on (or not) and many illicit drugs can affect drugs used for anesthesia or affect cardiac rhythms, etc. Some of our providers send them based on patient behavior and whether or not they believe the patient. For what it's worth, urine tox screens are not the only way to determine patients were on drugs. Not all facilities have the capability, but those that do can use a blood sample for tox screens (much harder to "cheat" than urine, and can be drawn at the same time as other labs, most women delivering a baby will get a type and cross drawn to determine blood type/set up blood in case it becomes necessary to transfuse).

[BostonFNP, APRN]

Are you kidding me? please read about cannabis.

Available evidence suggests a significant association between prenatal exposure to cannabis and adverse maternal and fetal outcomes.

Gunn, J. (2015, November). Effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: A systematic review and meta-analysis. In 2015 APHA Annual Meeting & Expo (Oct. 31-Nov. 4, 2015). APHA.

Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates.

Gunn, J. K. L., Rosales, C. B., Center, K. E., Nuñez, A., Gibson, S. J., Christ, C., & Ehiri, J. E. (2016). Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. BMJ open, 6(4), e009986.

Current evidence indicates that cannabis use both during pregnancy and lactation, may adversely affect neurodevelopment, especially during periods of critical brain growth both in the developing fetal brain and during adolescent maturation, with impacts on neuropsychiatric, behavioural and executive functioning.

Jaques, S. C., Kingsbury, A., Henshcke, P., Chomchai, C., Clews, S., Falconer, J., ... & Oei, J. L. (2014). Cannabis, the pregnant woman and her child: weeding out the myths. Journal of Perinatology, 34(6), 417-424.

[t3mama]

Interesting! I've had a baby in Utah, and twins in Rhode Island at a teaching hospital (so delivered in opposites ends of the country) and never peed in a cup before admission. I was never told they would test my babies' meconium either, so I don't know if they did? If they did test the babies, wouldn't they need to inform me first? I'm not worried either way since I don't do drugs, but I'm mostly curious on the policy of informing the patient/mother that they are testing for this. Anyone know?

[Esme12, ASN, BSN, RN]

Interesting! I've had a baby in Utah, and twins in Rhode Island at a teaching hospital (so delivered in opposites ends of the country) and never peed in a cup before admission. I was never told they would test my babies' meconium either, so I don't know if they did? If they did test the babies, wouldn't they need to inform me first? I'm not worried either way since I don't do drugs, but I'm mostly curious on the policy of informing the patient/mother that they are testing for this. Anyone know?

Testing pregnant women for drugs of abuse is a "newer" concept depending on the age of your children. The practice has become more and more common since "drug abuse" has become more mainstream.

The practice varies a little facility to facility. Some facilities waives admission screening if the patient has a physician that is on staff and has tested the mother sometime during the last trimester but testing has become routine in most facilities. You do not have to give expressed permission after you have signed your admission paperwork under the umbrella of permission to treat. Once signed...you have pretty much consented.

[Esme12, ASN, BSN, RN]

Seems like a dumb, expensive solution for something that could be solved through a better policy and better staff education.

The test is essentially "cheap" and permission is included in the admission paperwork. Testing everyone is cheaper than being sued for discrimination.

ADMISSION AND CONSENT FOR TREATMENT: I voluntarily consent to the procedures and services that may be performed for me on an inpatient or outpatient basis under the general and special instructions of my physician, and/or his/her assistant or designee. I understand that these procedures and services may include but are not limited to emergency treatment or services, laboratory procedures, imaging services, medical or surgical treatment or procedures, anesthesia or hospital services. I understand that other conditions may be diagnosed which may require additional treatment

There are certain procedures, like giving blood and invasive procedures, that require expressed consent. Some facilities require a separate consent for transfusions others include it on the surgical consent.

There are many "loop holes" that circumvent "permission" which are under the permission to treat like if there is an emergency. All ER will treat, even a minor, under the umbrella that "life and limb" that cover treatment. Of course if it is for legal purposes, like DUI, that require expressed consent. But even that has a loop hole....mostly ED's have "trauma panel" which include testing for drugs of abuse (yes ALL traumas are included) but need to be subpoenaed to be used in a court of law...but they are still obtainable even without "expressed" consent because that are done on everyone. That way profiling is not in question.

Just like my Dad always told me....read what what you are signing.

[Esme12, ASN, BSN, RN]

Are you kidding me? please read about cannabis.

I have read about cannabis but if you have evidence to the contrary...please share.

[applesxoranges, BSN, RN]

Can they refuse? I personally want to see what a person orders for lab work before I go.

[Esme12, ASN, BSN, RN]

Can they refuse? I personally want to see what a person orders for lab work before I go.

Most people don't ask "what is the test for?" but yes you can refuse....but then that raises red flags as well.

[klone, MSN, RN]

The test is essentially "cheap" and permission is included in the admission paperwork. Testing everyone is cheaper than being sued for discrimination.

Which is where my comment of "better policy and better staff education" is relevant, in order to avoid a discrimination lawsuit.