Drug use and drug testing and Klonopin

[amesly15]

I work in a County Correctional Facility. My question is...what do other facilities do with inmates booked in who say they are on Klonopin? We had an inmate who had been taking Klonopin through his MD. We varified that was the medication. We have started to taper him off this medication and give him Tegretol to prevent seizures. If someone states they are abusing Klonopin (no prescription in their name) we put them on Tegretol 200mg Bid x one month. We have run urine tests on one inmate who is on Klonopin and he tested negative for benzos twice???? We have read that benzos do not always show up in the urine???

What does your facility do?

[Multicollinearity, BSN, RN]

Your facility should be sending out for gas chromatography confirmation testing. Urine tox screening is never considered definitive, only an initial screening. Benzo metabolites should show up on gas chromatogaphy testing if within half-life window periods. Klonopin does have a short half-life. When did he state he last used v. the urine tox test? The other thing to consider is the inmate may be lying, trying to get benzos, possibly to smooth the withdrawal from something else. Or he could be telling the truth.

[Penelope_Pitstop, BSN, RN]

Klonopin does have a short half-life.

Actually, it doesn't. On average, it's about 30 hours vs. 12ish for Xanax. Valium has a longer half life than both of those, and I think Ativan is a little more than Xanax.

[Multicollinearity, BSN, RN]

Good clarification. I was thinking in comparison to diazepam.

[morte, LPN, LVN]

yup, had to look it up because I thought lorazepam was markedly shorter, it isn't! 11.2 for Xanax,12 for lorazepam, 35 for klonopin, and 100 for diazepam.

Actually, it doesn't. On average, it's about 30 hours vs. 12ish for Xanax. Valium has a longer half life than both of those, and I think Ativan is a little more than Xanax.

[Orca, ADN, ASN, RN]

We had a psychiatrist who was in love with Klonopin. He was using it for behavioral and psychiatric issues. At our facility it was a controlled medication, meaning that we had to manually sign out each pill. We would randomly perform blood levels of clonazepam to ensure that the inmates were in fact taking the medication and not diverting it. We chose blood levels because the urine drug screens were notoriously inaccurate. They are fine for spot checking if you don't need to be too fine with it, but blood levels are the way to go if you want to be sure.