Hair Follicle Testing in Monitoring Programs

PaddedCellLPN, LPN · Mar 29

My script isn't a benzo or opiate, maybe that's the difference? Or the fact I turned in a letter from my genetic MD saying I am stable on this med, and I need it to live. In the same letter, it tells the BON and my case manager what my emergency treatment is at the ER, my local ER knows the letter very well. She spills out what medicine/dosage, fluids, labs, and when to admit me and when to call her. Now, I haven't needed an ER trip, but it will happen while I'm in monitoring. My case manager just said to have hubby contact her (if I'm in the ER, I'm about dead) and let her know what's happening so she can discuss relapse prevention.

Maybe I just got a decent case manager 🤷‍♀️. Who knows.

brandy1017, ASN, RN · Mar 29

Healer555 said:

In my atate, They usually approve controlled substances for ADHD NOT anxiety in my state despite a valid diagnosis ie no benzodiazepines no Ambien, etc, no Neurontin. Short term opiates for pain once approved are OK. I

That's what I mean. They don't let you have hardly anything. Neurontin isn't even a controlled substance, though some people want to make it one! It is used off label now for chronic pain, especially back pain, in lieu of pain meds. Even for protracted itching they will try it.

I retired end of 2020 due to stress of unsafe working conditions. I don't have a drug problem myself, nor do I drink alcohol. Once I quit the toxic job, my physical and mental health has improved a lot. I just feel bad for people tossed into these programs as I don't think everyone in it really needs to be. Many who haven't diverted drugs find themselves being pushed into a monitoring program for other situations that it shouldn't apply in my opinion, but it's a one size fits all option and there is a big financial incentive to keep someone in it for years!

I was just offering my opinion to look at all your options before you agree to this. Consider early retirement if you can and do a job outside of nursing. At least then it is your choice. The stress and bad working conditions in nursing now are rampant such that nurses need to have an exit strategy from a toxic job. Save as much as possible in the meantime to give you options. Start with an FU savings account that gives you the freedom to walk away if you need to! Then a Roth IRA can be used as an emergency account as contributions are tax free if you need to take them out early, also can use them to keep your taxable income low to get affordable insurance thru Obamacare.

TIMFY · Mar 30

brandy1017 said:

Plus, it is very draconian from what I've read. You aren't allowed anything that would be considered a controlled substance even if you have a prescription for it. Doesn't matter if you have pain or anxiety. So even if you had a valid script, they probably wouldn't let you use it.

Lets not spread misinformation 😉 The reason I didn't self report was because of comments like these-I am in pain management and I thought there was no way they'd let me continue my meds throughout the program. But they didn't bat an eye or require anything extra (just the quarterly report from my prescribers, and a picture of the script if I started a new prescription). They didn't say no to anything, including benzos/opiates/ketamine/ADHD meds. I will forever be grateful that I was able to complete the program while still taking care of my health.

brandy1017, ASN, RN · Mar 30

TIMFY said:

Lets not spread misinformation 😉 The reason I didn't self report was because of comments like these-I am in pain management and I thought there was no way they'd let me continue my meds throughout the program. But they didn't bat an eye or require anything extra (just the quarterly report from my prescribers, and a picture of the script if I started a new prescription). They didn't say no to anything, including benzos/opiates/ketamine/ADHD meds. I will forever be grateful that I was able to complete the program while still taking care of my health.

I'm only going by what others on here have stated over the years. And the IN lawsuit over not being allowed to take her prescribed med, but instead told to go cold turkey. I'm guessing you are the exception from what others on here have said in the past. Unless times are changing or you live in a more enlightened state.

I'm glad you feel the program has helped you, but I have heard a lot of complaints of others who find it burdensome and not that helpful, emotionally and financially. But I look forward to others feedback about their experiences, especially if it mirrors yours. I'm glad you found it worthwhile but wouldn't an alternative have been better such as just getting individual therapy or group therapy on your own without being placed into a monitoring program where you are drug tested for the experience at your own expense! Once entered the program is no longer voluntary and may last 3-5 years, whereas if people had chosen to get therapy themselves outside of this they could quit when they felt it was no longer necessary instead of being ordered to comply for years! The alternative your health insurance will pay for your treatment vs you out of pocket as well in my opinion.

Obviously if someone was diverting meds than they do need the monitoring program. I would assume that was the reason for it in the first place so in that sense it would make sense to forbid taking such meds as narcotics. I can understand the dilemma when you have chronic pain and/or anxiety and are using prescribed meds to help. Nurses are human and the job itself can cause anxiety and chronic pain from back and body injuries from moving people as well as many other medical conditions that can do the same.

But others have spoken out about a mental health crisis, suicide attempt or DUI or past history of psych problems before they become an RN that they ended up in the program in order to work as a nurse. There is even a post here "I hate being in a monitoring program" where people speak up about their real feelings about the whole thing. The most apt comment by Healer 555 is "Perhaps someone will read your post and find a private therapist instead of self-reporting like you did. It's really great that you posted."

Healer555 · Mar 30

TIMFY said:

Lets not spread misinformation 😉 The reason I didn't self report was because of comments like these-I am in pain management and I thought there was no way they'd let me continue my meds throughout the program. But they didn't bat an eye or require anything extra (just the quarterly report from my prescribers, and a picture of the script if I started a new prescription). They didn't say no to anything, including benzos/opiates/ketamine/ADHD meds. I will forever be grateful that I was able to complete the program while still taking care of my health.

It's not that way everywhere. Definitely not.

Vanessa L · Apr 8

I am also in TN and on TNPAP. No they do not test hair right away. It's like 6 months or more down the line. I hope that helps ❤️ it's rough just do it to keep your license and get thru the struggles you have or may of had

Purplenurse123 · Apr 8

This is a general hair follicle question, not super important but just something that's been bugging me a bit :)

I met another RN when I was in rehab who had been thru her state's monitoring program; she didn't 'graduate' and said she got caught when her follicle test was positive for magic mushrooms/psilocybin. This has always sounded a little funny to me... I know there ARE follicle tests for psilocybin but they aren't the standard ones offered by LabCorp. I kind of assume she failed for a different reason and didn't want to disclose that? Again, not super important, just curious if anyone has insight into what exactly is tested for. Thanks!

Healer555 · Apr 8

Purplenurse123 said:

This is a general hair follicle question, not super important but just something that's been bugging me a bit 🙂

I met another RN when I was in rehab who had been thru her state's monitoring program; she didn't 'graduate' and said she got caught when her follicle test was positive for magic mushrooms/psilocybin. This has always sounded a little funny to me... I know there ARE follicle tests for psilocybin but they aren't the standard ones offered by LabCorp. I kind of assume she failed for a different reason and didn't want to disclose that? Again, not super important, just curious if anyone has insight into what exactly is tested for. Thanks!

They test for everything. We never see the results unless it's positive.

PsychRNXXX, BSN · Apr 8

Purplenurse123 said:

This is a general hair follicle question, not super important but just something that's been bugging me a bit 🙂

I met another RN when I was in rehab who had been thru her state's monitoring program; she didn't 'graduate' and said she got caught when her follicle test was positive for magic mushrooms/psilocybin. This has always sounded a little funny to me... I know there ARE follicle tests for psilocybin but they aren't the standard ones offered by LabCorp. I kind of assume she failed for a different reason and didn't want to disclose that? Again, not super important, just curious if anyone has insight into what exactly is tested for. Thanks!

I always try to look up the requested lab and see what all it is for but can never figure it out. My case analyst said even Benadryl shows up. But I'm not sure they test for it all the time. I also take Suboxone and haven't seen the testing "code" for it.

Purplenurse123 · Apr 9

PsychRNXXX said:

I always try to look up the requested lab and see what all it is for but can never figure it out. My case analyst said even Benadryl shows up. But I'm not sure they test for it all the time. I also take Suboxone and haven't seen the testing "code" for it.

I think things like Benadryl CAN show up, but only if it's ordered; as we all know from being in these programs, nothing is free! LOL. They aren't ordering 100 panel drug tests each time, but I agree, it's so hard to figure out what they're testing for! I keep getting A-763829 and I'm in the program for alcohol, but according to my Google research, that one doesn't even test for ETG... so who knows

Purplenurse123 · Apr 9

Healer555 said:

They test for everything. We never see the results unless it's positive.

They certainly don't test for everything every test; they COULD test for anything they'd like, but the tests would be way more expensive if they were adding on special tests each time. At least for my tests, I get one code each time; it could be a standard panel but it couldn't be a more unusual combo (not sure if other people get multiple test codes each time). A lot of the more specific/individualized tests also take longer to return. I could see more extensive testing taking place at the end of the process, but I've gotten the exact same test each time (A-763829) and I've been in for almost 9 months. They certainly do a good job of keeping us in the dark 😂

Healer555 · Apr 9

Purplenurse123 said:

They certainly don't test for everything every test; they COULD test for anything they'd like, but the tests would be way more expensive if they were adding on special tests each time. At least for my tests, I get one code each time; it could be a standard panel but it couldn't be a more unusual combo (not sure if other people get multiple test codes each time). A lot of the more specific/individualized tests also take longer to return. I could see more extensive testing taking place at the end of the process, but I've gotten the exact same test each time (A-763829) and I've been in for almost 9 months. They certainly do a good job of keeping us in the dark 😂

Where I live they add whatever they want to the codes supposedly. I know people who have tested positive for the metabolites of benadry and pseudoephedrine,, We get hair blood urine and sometimes nail tests. We even get observed urine tests. But I guess you're right it's probably that they could test for anything and everything.