I have a bizarre case...

Nurses Recovery

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I am going to try to keep this as short and sweet as possible. I tested positive for drug use at work and I’m sure the plan is for me to enter an IPN.

Okay but heres the thing.

I have a diagnosis of MDD. About two months ago i started taking 300 mg Wellbutrin daily. About one month ago..... my brain broke. I went from ‘normal’ to ‘not normal’. I was having massive constant panic and anxiety, suicidality, i would sit at home and cry all day every day when i didn’t work, and then at work i was like a frantic madman. I went and bought drugs from homeless people in the park, don’t even know what i bought. I would IV it.

I called and told my Psych NP something was really wrong. He told me to discontinue the Wellbutrin immediately. Prescribed Ativan. I THEN found out i was staying up hours later than i thought i was, running around the house speaking gibberish. (My sister and i live together). I got tested 3 days later.

I have now been off the Wellbutrin for 10 days and all of these symptoms have completely resolved. I disclosed to my Psych NP and stopped the Wellbutrin JUST prior to this going down and i can supply the medical records to prove it.

. I’m sure I’ll get fired I’m just waiting on the call.... but.... how the heck do i proceed from here? I don’t do drugs. I mean i did, for two weeks i was a fiend. I dunno. I’m pretty bummed about this.

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Specializes in Med/Surg, Women's Health, LTC.

Get an attorney and a doc or NP who can attest to your dilemma. The attorney needs to be one who can defend your license.

Congratulations on getting the help you need! Stay strong and visit this forum for support!

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Thanks. I’m kind of intimidated and freaked out, because i honestly don’t need help with substance abuse. I have a heck of a problem with Wellbutrin though, and it looks like research backs it up. I have never behaved that erratically in my life. I have contacted a lawyer and have a psych NP who can vouch for this.

I already set up a Peer Assistance appt should i wait to see if i will need to enter it?

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Specializes in Med/Surg, Women's Health, LTC.

If you tested positive at work, assume they will report you to the BON. If you have already entered/self-reported and start a confidential program, that may be better in terms of the BON not forcing you into a "public" discipline. I am not sure what state you are in or how your BON works.

Since you have an attorney, I would consult them and see how they want you to proceed.

Good luck to you and keep visiting here, for support! We cannot give legal advise but we sure can offer the support you seek!

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I’m in Colorado. I haven’t entered yet. Given what i have now fervently researched all night, i have learned that dose increases on Wellbutrin can cause a switch into manic behavior. Which of course subside with dc of the medication, so now i get to fight THIS battle. Kool.

I have the meeting w Peer Assistance scheduled but from what I’ve read here it appears they don’t care too much about the details surrounding the case.

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Specializes in Med/Surg, Women's Health, LTC.
38 minutes ago, GladiatorBill said:

I have the meeting w Peer Assistance scheduled but from what I’ve read here it appears they don’t care too much about the details surrounding the case.

That is probably true. Remember they have likely heard every single possible story to "justify" (and I am not saying you are wrong for doing so) any type of positive drug screen/scenario.

However, I am not positive, but I would guess getting into a self-reported program before the board comes knocking will be better for your outcome. You probably won't get out of monitoring, but, at hopefully, once done, you will have an unencumbered license.

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God. That’s just insane. I even told my hospital investigator i was taken off an antidepressant 3 days prior that made me manic (and I’m not bipolar). And that my psych could corroborate.

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Specializes in OR.

We’re I in your place, I would not speak to any hospital investigator any further. Channel EVERYTHING through your lawyer. Sadly, you are correct in that the people that IPN sends you to for the evaluations don’t care much about the details. No matter why you are there, this will get twisted to cram into a box that justifies substance abuse treatment of some sort. If money is sniffed out (cash, generally...in my experience the ‘approved’ programs don’t take insurance) you can bet there will be inpatient followed by outpatient. Additionally, contrary to published evidence, IPN (and the evaluators they use) seem to adhere to the notion that 12 step methodology is the end-all-be-all fix for all things. That is how my documented mental health issue merited me 5 years of sitting in meetings getting that stuff shoved down my throat.

That was pretty much my experience...I had an exacerbation of a mental health issue and because I didn’t know better and thought these scam artists were there to help....Well, I just finished nearly 6 years of hell whereupon I was pushed through a scummy drug rehab (where my psych needs were blithely ignored) and a 5 year contract of being treated like a person with SUD.

I needed (and asked for) help and got a complete screw job that in many ways did more damage than good. The fact that I made it to the other side and seemingly have rescued my career is a testament to my family, my own stubbornness, and a good therapist. Definitely not due to anything remotely IPN related.

Step lightly with these people, my friend. Having the lawyer now is one of the best things you can do. You may still get forced into monitoring (they have so-called mental health contracts but the stipulations are essentially the same) but hopefully the lawyer can steer them into not treating you the same as someone who cleaned out the Omnicell or came to work under the influence.

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Yeah, i hate the idea of getting a lawyer but.... this was literally ‘a medication reaction’. And once i was off of it I am fine. I don’t really know if i should go the IPN route at this time because of that. These things did indeed happen, but we are health care professionals - we know that these things can genuinely happen. One would think my history would support me.

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Specializes in OR.

As I said before...facts and evidence that is contrary to a generic substance use issue (diversion, + toxicology testing, and the like) is rarely taken into account. I have seen all sorts of bizarre things that if they occurred out in the ‘real world’ (outside of the murky, carte blanche to do what we want world of IPN) would be grounds for malpractice. These people essentially hold a person’s license and livelihood hostage. There is no oversight and any grievance you might follow goes no further than themselves. It is a guilty until proven innocent world and proving that innocence is a very expensive road.

There is a population that does benefit from these kind of programs. I have and will continue to acknowledge that. One of IPNs problems (and there are many) is that, in spite of what they claim, everyone is treated like a substance user on the verge of relapse. I can personally attest to them utilizing evaluators that stand to make serious money off of what is said in these evaluations and whatever dreck is written is taken as truth, even if it is unprovable lies. In the over 5 years I was subject to this abuse, I never knew of anyone that walked into an evaluation and didn’t come out without a contract.

IPN is registered as a for-profit entity in the state of Florida. Considering the ring of commonly used evaluators (nearly everyone I am acquainted with was given Gainesville as one of very few options for evaluation) and the potential for ungodly amounts of money to be exchanging hands, you know darn well that there is some major corruption afoot. I can’t prove it but I personally think it’s pretty obvious.

Once IPN is aware of your existence, either via self reporting (and trust me when I say that DOES NOT guarantee confidentiality) or Employer reporting or BON sentencing, refusing their “help” (and I use that term very loosely) most likely results in public discipline and license suspension. This is where your lawyer earns his money.

In short, when it comes to this stuff, the almighty dollar screams louder than any sense of ethics or professionalism. It’s a very sad state of affairs.

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Specializes in Med/Surg, Women's Health, LTC.
On 9/16/2019 at 4:50 PM, GladiatorBill said:

Yeah, i hate the idea of getting a lawyer but.... this was literally ‘a medication reaction’. And once i was off of it I am fine. I don’t really know if i should go the IPN route at this time because of that. These things did indeed happen, but we are health care professionals - we know that these things can genuinely happen. One would think my history would support me.

Given the fact you can prove these behaviors were a direct result of prescribed medication -- and I believe you, having been the "victim" of some weird side effects to a very old tricyclic many moons ago -- I would strongly suggest you get an attorney who is willing to fight the fight for you. There is a remote chance you will prevail, and that alone may be worth the cost!

I wish you good luck and good vibes, and I am so glad you are doing better. Stay strong my friend!

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Specializes in Home care.
On 9/16/2019 at 11:28 AM, catsmeow1972 said:

We’re I in your place, I would not speak to any hospital investigator any further. Channel EVERYTHING through your lawyer. Sadly, you are correct in that the people that IPN sends you to for the evaluations don’t care much about the details. No matter why you are there, this will get twisted to cram into a box that justifies substance abuse treatment of some sort. If money is sniffed out (cash, generally...in my experience the ‘approved’ programs don’t take insurance) you can bet there will be inpatient followed by outpatient. Additionally, contrary to published evidence, IPN (and the evaluators they use) seem to adhere to the notion that 12 step methodology is the end-all-be-all fix for all things. That is how my documented mental health issue merited me 5 years of sitting in meetings getting that stuff shoved down my throat.

That was pretty much my experience...I had an exacerbation of a mental health issue and because I didn’t know better and thought these scam artists were there to help....Well, I just finished nearly 6 years of hell whereupon I was pushed through a scummy drug rehab (where my psych needs were blithely ignored) and a 5 year contract of being treated like a person with SUD.

I needed (and asked for) help and got a complete screw job that in many ways did more damage than good. The fact that I made it to the other side and seemingly have rescued my career is a testament to my family, my own stubbornness, and a good therapist. Definitely not due to anything remotely IPN related.

Step lightly with these people, my friend. Having the lawyer now is one of the best things you can do. You may still get forced into monitoring (they have so-called mental health contracts but the stipulations are essentially the same) but hopefully the lawyer can steer them into not treating you the same as someone who cleaned out the Omnicell or came to work under the influence.

Blows my mind that health Professionals put you thru that... shameful!!

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