Just got hired and heard that Zoloft can come up as a Benzo on drug test?

[sweetnlow4]

Hello,

I just got hired and have heard that Zoloft can sometimes cause a false positive for Benzo's? I find it hard to believe since their properties are different...however I have read several articles regarding this...Now I am concerned...any input would be helpful. Also I took an Ambien 4 days prior to my test...would that show up as well. Yes I understand the Half-Life concept but it is different for everyone and metabolism plays a big role and my metabolism is ZERO....LOL....kidding...(have gained a lot of weight since nursing school)...Thank you...:redbeathe

[That Guy, BSN, RN, EMT-B]

why is everyone jumping down this person's throat- of course he/she is anxious about even getting a job in this climate of hire/fire for no good reason at all.

anyhow, sounds like some good advice was given re: being honest what you take/have prescribed.

i must say- if being on some sort of psych med is wrong , the no one would be getting hired anywhere.

To be a nurse- you must be psychotic lol. i just keeed.....

good luck- i hope you get the job

Because its a ******* prescription written for this person. It would be different if they said I scored some oxy from the creeper on the corner and snorted it. But this person went through legal means and obtained a legit script. No one cares if it is legal!

[xtxrn, ASN, RN]

I didn't read it in a tone of "jumping down anyone's throat".... a lot of people have been very supportive about not worrying - just not hiding anything that has a legit rx. :)

I had a drug screen show up w/Darvocet (back when that was ok)- I brought in all prescriptions, OTCs, and would have brought air and soil samples if they wanted them- LOL. It was scary to have a positive test even though I knew I had legit prescriptions.

Just letting folks know that the legit stuff turns out ok :)

[morte, LPN, LVN]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728940/

good luck

[SuesquatchRN, BSN, RN]

I just disclose everything I'm on. Including benzos and SSRIs.

[martymoose, BSN, RN]

Yes - there's a prescription written- but also a stigma attached to those who are on those meds. Tell me that an employer thinks otherwise?

[SuesquatchRN, BSN, RN]

Yes - there's a prescription written- but also a stigma attached to those who are on those meds. Tell me that an employer thinks otherwise?

It's never stood in my way.

[42pines]

I do not blame you for not listing the meds.

Technically you have a responsibility to, at a post-hire physical to answer such questions, and the medical person has a responsibility to not share those with the company. The problem intensifies within a medical facility. Of course there will be times when it'll turn into "well..she's on xxxx and xxxx, do we really want her working here?" And of course, in such cases you may be left high and dry with a "prove it."

But remember, this information can only be used AFTER being hired, never before. Even then what you are taking is only of importance to the person/s deciding if you need accommodations. At a small entity (let's say a 5 person clinic) they may not be able to accommodate certain needs and you are out of luck. But at a hospital, if a med you take leads to a decision that you cannot do the job--the hospital is obligated (because they are a big entity) to find you alternative work. They cannot reverse the hiring decision under ADA.

Frankly, when I do a post-hire physical I make it clear that I will not divulge information to Human Resources, but only needed accommodations. And I have had management furious with me for not telling them the reason that an employee need accommodations. I hold my ground--period, and also advise them if they find out in some way by bypassing me, that they are opening the company up to huge liability under ADA or EEOC. This occurs at each job I have had, but management understands the risk and accepts it.

In a hospital there is naturally more access routes to medical records and I can understand why a person would omit telling about meds or medical issues. (Note: If a person lists meds and then gets un-hired, under HIPAA one can request and must receive a list of who and when her medical record was accessed. If Personnel accessed it, most hospital systems will log this--if I was a lawyer I'd drool over such a case!)

Now consider this:

When a drug test is taken, be it hair, urine, fingernail filings or blood the sample must go to a proper testing lab. The lab analyzes the results. The results are then transmitted to a MRO (Medical Review Officer). This is generally (see following note) the only person who ever sees the results.

What most do not know is that every drug test and every company (though some do not understand this) has certain limits, above which triggers a positive (fail). What this means is that if you were out in a car, and two people were smoking pot, and you were breathing second hand smoke, many tests would give a positive result for cannabinoids. However, the nanograms/milliliter would likely be below the threshold. Thus you tested positive for cannabinoids but at a low limit, and that in most cases would result in a negative result (a pass, not a fail). Therefore in many cases occasional use or distant (several days prior) of some substances might show a result but still result in a "pass."

I remember the poor fellow that came in one day, totally shaved, head, armpits, legs (we did not do urinalysis only hair)--he turned a bit white when I said: "no problem I'll take some fingernail scrapings." The poor fellow never returned probably expecting a "fail," but in fact--he passed.

Now let's consider prescription meds: Let's use Xanax (nobody looks for antidepressants). The MRO sees a positive for benzodiazapines. So she calls you and says: I see a positive for benzodiazapines, do you have a prescription for them? And if you say: "Uh, no, I borrowed one from a friend..." Oops..."fail" and job is lost. But if you say: "yes," the MRO takes your doctor info, calls them and the fail becomes a "pass."

Note: State law in many cases decides what can or can not be tested for and in some cases chain of custody. State law can be rather odd too. For instance Imipramine is a "drug of abuse" in the State of Vermont. Yet Imipramine is on NO way a drug of abuse--that's just crazy, but it's there. Also there is the "in house urine dipstick method" that picks up gross + on several drugs of abuse. In this case there is no MRO. When there is an MRO involved there usually is only a pass or fail, not an identification of the drug/s. At bigger organizations often the in-house testing is not done specifically so that the MRO is making decisions as the litigatory risk is too high.

But this may not hold true for testing which involves police, FBI, Secret Service, Military, or in jobs where for instance military clearance may be an issue.

I hope this helps.

[spore2008]

I, too, can fully understand the desire to protect one's privacy and limit what is divulged about my health background to a future employer...or anyone. When I volunteered at a major NYC area hospital, I had to go through the same introductory package as any newly-hired employee. That included a drug screen. I found the process very stressful and humiliating. Is this what I have to look forward to in my new career? I am about to begin an Accelerated BSN program!

As long as mental illness and the use of psychotropic drugs is stigmatized, these questions will continue to pop up and be debated. I wish drug screens would be better at avoiding false positives. I wish there would not be a need to screen employees for legal drug use without just cause.

[nurseprnRN, BSN, RN]

here's the abstract. the full study can be viewed at:

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2728940/

false-positive urine screening for benzodiazepines: an association with sertraline?

a two-year retrospective chart analysis

kevin m. nasky, do, george l. cowan, md, ms, and douglas r. knittel, md

kevin m. nasky, dr. nasky is staff psychiatrist, department of psychiatry, naval medical center, portsmouth;

contributor information.

corresponding author.

address correspondence to:kevin m. nasky, do, 6716 glasgow street, suffolk, va, 23435; phone: [phone]; e-mail: [email protected]

abstract

objective: to determine the frequency of false-positive benzodiazepine screens associated with sertraline use at the authors' institution.

method: urine drug screen results spanning a two-year period were data mined to identify those positive for benzodiazepines. when confirmatory gas chromatography-mass spectrometry determined false positives, they were subsequently cross-referenced against pharmacy records to identify patients with active prescriptions for sertraline at the time of the initial urinary drug screen.

results: of the 522 records reviewed, 160 were later determined to be false positives by confirmatory gas chromatography-mass spectrometry. sixty-two of those were associated with a concomitant benzodiazepine prescription. of the 98 remaining, 26 were associated with a concomitant sertraline prescription.

conclusion: our findings suggest that sertraline may be an unreported cause of false-positive benzodiazepine results in a widely used screening assay.

keywords: false positive, screening assay, urine drug screening, benzodiazepines, sertraline

[42pines]

So the trick is, if you use sertraline and want it to remain private (as it should) simply ask your doctor for a script for a benzo. It could be for amount: 1, refill zero; prn.

Naturally nobody would ever fill it as you'd pay a minimum $20 for a single pill, but when the MRO calls you and asks if you have a prescription for a benzo you can say "yes" and the MRO will confirm.

The one MRO that I have talked was so amazingly on top of things that I do not doubt that if you said no, I don't use an benzodizapines, he would then say: do you take any other meds, and if you said sertroline, you'd become a "pass."

[42pines]

I, too, can fully understand the desire to protect one's privacy and limit what is divulged about my health background to a future employer...or anyone. When I volunteered at a major NYC area hospital, I had to go through the same introductory package as any newly-hired employee. That included a drug screen. I found the process very stressful and humiliating. Is this what I have to look forward to in my new career? I am about to begin an accelerated BSN program!

As long as mental illness and the use of psychotropic drugs is stigmatized, these questions will continue to pop up and be debated. I wish drug screens would be better at avoiding false positives. I wish there would not be a need to screen employees for legal drug use without just cause.

I too find it stressful if I have to urinate. Why? Because I can't without good privacy. According to:

http://www.paruresis.org/

About 7% of Americans suffer paruresis called by various names: shy bladder, pee-shy, etc.

Years ago at Laidlaw Environmental I had to produce a sample inside a flimsy cloth covered cubicle with a group of noisy people waiting. I tried and failed. There was a nurse there and I told her why, and offered blood but no go, and no job.

If you suffer from this same common syndrome have your medical practitioner document it as I have done. If I ever get a "fail" for inability to pass urine on a drug test, I will offer alternatives, hair, blood, etc. If not accepted the next stop will be an ADA lawyer. And I have no doubt that it will be settled quickly.

If you do not document it properly (you can't call your doc on Wednesday and get it documented if you go for a drug test on Thursday--mine has been documented for over a decade, and I periodically remind my doc) you will have zero recourse.

Talk about humiliating, the DOT has a protocol for those who can't produce urine. You must sit there for hours, and drink so much.... But I have no interest in doing that, my bladder will become fuller and fuller until it is painful, and I will still be unable to unless afforded privacy. I will offer alternatives, then attempt to comply, then if I fail due to pain, it'll be off to an ADA lawyer....

It is difficult as people who do not have paruresis will try to use this as a means to escape the drug test. The critical part, I think, is to be very clear about the problem and offer alternatives.

The sad part is that at the job that I lost, I even offered to pay for the blood sample cost.

As a nurse that administers urine based drug tests, I often realize I'm dealing with a person with paruresesis as their anxiety is overtly evident, and I go to great lengths to make them comfortable. But even when doing this I get an occasional person that literally freaks out, gets up and runs away, never to return.

And for those who think "oh, just wait, and you'll fill up and pee." This is not the case. Simple pressure does not overcome the tricanter muscles of the bladder. The urine will build up, back up through the ureters, fill the calyx of the kidneys and damage the kidneys. It Med/Surge I remember getting a fellow who looked like he had a conehead in is abdomen from a over-full bladder. He had impaired brain function (multiple brain abscesses) and had no sensation or clue that his bladder was over-full. I was amazed at the quantity of urine I drained via catheter. He had no sense of fullness, and in his case, no sense of pain either. If the tricanter muscles could be bypassed (they must be relaxed to urinate) by pressure his certainly would have!

[carolmaccas66, BSN, RN]

If you had not lied on your application re taking this medication, you wouldn't be worrying endlessly about it. And no-one can give u an answer as to what the company will test for.

Fess up & tell them re the new medication, or if it doesn't come up as an issue, let it go. You've created a whole world of worry & stress for yourself, that is probably unnecessary.

Next time, don't lie on your application - be a responsible adult and list the medication.