I'm free!! TPAN is over. Three years in the books

KJE · Jul 21, 2019

6 hours ago, Chan Chan said:
Are these all restricted under this program you finished and if so, why? I can understand the poppy seeds but the other things??
Congrats KJE

Are you in a program ? There's a book called the Talbott manual which people in TPAPN program must follow. It spells out what substances cannot be taken period. And what substances may cause incidental exposure causing a positive. Incidental exposures are not easily excused.

Over the counter medication or any prescription medication is banned unless approved by the program.

Insect sprays are conclusively known to cause false positive EGT testing. Secondary PETH testing will not prove this is incidental exposure as those levels will show exposure. Same with soy sauce, vanilla extract ect.

I have seen two nurses bounced in my group. One got caught taking Benadryl, one claimed whether truthful or not that appositive EGT was from off. Wasn't an excuse since she was been not to use is it.

Three years into the program I had a positive for marijuana. Something I never touched. My case worker and the MRO knew me well enough at that point to realize there was a reasonable explanation, told me not to panick and moved it along to expensive secondary testing. That testing revealed because I had a back injury and was taking Motrin every 4 hours at 600mg a pop, the level of ibuprofen caused a false positive.

Things happen, always best to use caution.

Oldmahubbard · Jul 21, 2019

if such a large number of innocent everyday products can cause a false positive, are the tests reliable at all?

KJE · Jul 21, 2019

2 hours ago, Oldmahubbard said:
if such a large number of innocent everyday products can cause a false positive, are the tests reliable at all?

That's why the program tells you to avoid these products. In other words, don't use. Febreeze has alcohol, so don't use it. Use it and test positive you were warned. So, yes, you have to be careful and give up a whole lot of things that seem stupid to give up, but that's the deal.

Oldmahubbard · Jul 21, 2019

17 minutes ago, KJE said:
That's why the program tells you to avoid these products. In other words, don't use. Febreeze has alcohol, so don't use it. Use it and test positive you were warned. So, yes, you have to be careful and give up a whole lot of things that seem stupid to give up, but that's the deal.

so, outside of a TPAN type program, what is the point of these tests? For my patients in the community, why would I bother ordering these tests for anybody, when they can be thrown off by Motrin and febreze?

It's a rhetorical question, Not looking for an answer.

KJE · Jul 21, 2019

8 minutes ago, Oldmahubbard said:
so, outside of a TPAN type program, what is the point of these tests? For my patients in the community, why would I bother ordering these tests for anybody, when they can be thrown off by Motrin and febreze?
It's a rhetorical question, Not looking for an answer.

I don't think there is a need for the type of testing they do outside of professional monitoring, probationary monitoring or CPS monitoring.

I guess perhaps if you have a patient who is having health effects from alcoholism but is denying having an issue, the ETG or PETH would helped provide a clinical picture.

Basically, the ETG was delevoped soley for monitoring these programs, as the benchmark to prove continued sobriety.

catsmeow1972, BSN, RN · Jul 21, 2019

The problem with ETG being used by these programs as a benchmark for continuing sobriety is that even SAMHSA does not advise using this test as stand alone evidence of intentional alcohol consumption. Their recommendation is ‘a high cutoff level and corroborating evidence.” In my opinion, a person trapped in such a program does not constitute corroborating evidence. Not only do these programs seem to set the cut off levels very low and at who knows what, they do just that. Additionally, they traffic in rumors (neither confirming or denying) such as hand sanitizer causing a positive result. Which I suppose could....if you’re inhaling the vapors and sucking on the dispenser on your way to the testing site. This kind of ludicrousness gives rise to the fear that you can’t use Purell at work or live without hair spray or certain soaps, etc.

It is possible to be doing everything perfectly since the dawn of the contract, bang have a low level +ETG (maybe it’s low, you’re only going to be told + or -, not the cut off nor the actual result) and turn on the $$ faucet and start trying to prove your innocence. Around here (my state) you will likely fail.

To put it simply, in spite of standard substance abuse treatment recommendations, This is yet another means of power and control for these programs.

KJE · Jul 21, 2019

3 hours ago, catsmeow1972 said:
The problem with ETG being used by these programs as a benchmark for continuing sobriety is that even SAMHSA does not advise using this test as stand alone evidence of intentional alcohol consumption. Their recommendation is ‘a high cutoff level and corroborating evidence.” In my opinion, a person trapped in such a program does not constitute corroborating evidence. Not only do these programs seem to set the cut off levels very low and at who knows what, they do just that. Additionally, they traffic in rumors (neither confirming or denying) such as hand sanitizer causing a positive result. Which I suppose could....if you’re inhaling the vapors and sucking on the dispenser on your way to the testing site. This kind of ludicrousness gives rise to the fear that you can’t use Purell at work or live without hair spray or certain soaps, etc.
It is possible to be doing everything perfectly since the dawn of the contract, bang have a low level +ETG (maybe it’s low, you’re only going to be told + or -, not the cut off nor the actual result) and turn on the $$ faucet and start trying to prove your innocence. Around here (my state) you will likely fail.
To put it simply, in spite of standard substance abuse treatment recommendations, This is yet another means of power and control for these programs.

Yep!! Truth. EGT is an instrument terror and control despite its inaccuracies.

Chan Chan · Jul 21, 2019

12 hours ago, KJE said:
Are you in a program ? There's a book called the Talbott manual which people in TPAPN program must follow. It spells out what substances cannot be taken period. And what substances may cause incidental exposure causing a positive. Incidental exposures are not easily excused.
Over the counter medication or any prescription medication is banned unless approved by the program.
Insect sprays are conclusively known to cause false positive EGT testing. Secondary PETH testing will not prove this is incidental exposure as those levels will show exposure. Same with soy sauce, vanilla extract ect.
I have seen two nurses bounced in my group. One got caught taking Benadryl, one claimed whether truthful or not that appositive EGT was from off. Wasn't an excuse since she was been not to use is it.
Three years into the program I had a positive for marijuana. Something I never touched. My case worker and the MRO knew me well enough at that point to realize there was a reasonable explanation, told me not to panick and moved it along to expensive secondary testing. That testing revealed because I had a back injury and was taking Motrin every 4 hours at 600mg a pop, the level of ibuprofen caused a false positive.
Things happen, always best to use caution.

No ma'am. I am not. Just being nosey. Was curious.

catsmeow1972, BSN, RN · Jul 21, 2019

3 minutes ago, Chan Chan said:
No ma'am. I am not. Just being nosey. Was curious.

I don’t think there’s a thing wrong with being nosy/curious in this question. I see this question an an opportunity to explain some of the absurdities of these programs to someone who is not in the midst of it. This is how we can educate the ‘outside’ so to speak. That’s perhaps how change can start...

Wizard 1 · Jul 22, 2019

13 hours ago, catsmeow1972 said:
The problem with ETG being used by these programs as a benchmark for continuing sobriety is that even SAMHSA does not advise using this test as stand alone evidence of intentional alcohol consumption. Their recommendation is ‘a high cutoff level and corroborating evidence.” In my opinion, a person trapped in such a program does not constitute corroborating evidence. Not only do these programs seem to set the cut off levels very low and at who knows what, they do just that. Additionally, they traffic in rumors (neither confirming or denying) such as hand sanitizer causing a positive result. Which I suppose could....if you’re inhaling the vapors and sucking on the dispenser on your way to the testing site. This kind of ludicrousness gives rise to the fear that you can’t use Purell at work or live without hair spray or certain soaps, etc.
It is possible to be doing everything perfectly since the dawn of the contract, bang have a low level +ETG (maybe it’s low, you’re only going to be told + or -, not the cut off nor the actual result) and turn on the $$ faucet and start trying to prove your innocence. Around here (my state) you will likely fail.
To put it simply, in spite of standard substance abuse treatment recommendations, This is yet another means of power and control for these programs.

It is also iffy when caseworkers don't know how to read test results, in addition to these obvious issues with Etg. One can even have a specimen that pops positive for urine alcohol due to contamination. No alcohol use and no prohibited substance consumption. The burden of proof is on the one being monitored to prove innocence and caseworkers will do what they can to suck more money out of them.

KJE · Jul 22, 2019

10 hours ago, Chan Chan said:
No ma'am. I am not. Just being nosey. Was curious.

Nothing wrong with curiosity.?

Missvicrn · Aug 5, 2019

Congratulation for all your accomplishments. Please keep recovery first and remember anything you place in front of your recovery is subject to be lost. You will be tempted to work as much overtime as you can to offset the loss of income during your restrictions. Please, take it from someone who knows this too well that we sometimes have a built in forgetter and we think that maybe I wasn't really an addict. Stay Grateful. Remember how good you feel now, but please remember how defeated and low you felt during your worst times. I pray for your continued sobriety and clean time and your life long recovery. One more thing, remember One is too many and a thousand is very enough. Peace and Blessing.