positive drug screen at the MD's office

[needananswer]

I'm an RN in Florida and I need to make an appointment with an MD that I stopped going to 5 years ago as soon as possible. I'm expecting to go through all the new patient motions, including a urine sample which I'm assuming may include a drug test. I have an anxiety disorder and unfortunately use marijuana occasionally to help out when I'm feeling particularly panicked and all other cerebral attempts aren't proving effective. I'm not proud of it and I understand how risky it is, but I do not want to manage my anxiety with addictive prescription medication and don't want to practice under the influence of anything whether it is prescribed to me or not. Anyway to get to my point, I want to know if I am tested, and its positive (my smoking is sporadic and the amount I smoke is minimal), will the doctor have to report it to my employer and/or the BON, or does this fall under the umbrella of HIPAA? If I were to have to be admitted at some point to the hospital I work for by this doctor, would it be part of my record and can action be taken by my employer based on this record? Is it possible to refuse a drug test and still be seen/treated by the MD? Thank you for your help.

[Esme12, ASN, BSN, RN]

What makes you assume your PCP will drug test you? Is this the MD's policy? Personally I would be more concerned about my place of employment will call me for a drug screen...many places do them.

Why would you be concerned about prescription med to appropriately treat your anxiety...when in fact you are at greater risk at getting arrested for an illegal substance? Even if you "know" the person you buy your illegal substance they are still a dealer and can get busted at any time and so can you.

You will be in far greater trouble for being arrested for marijuana than taking a prescription med. Finally...yes some states do have mandated reporting when a care giver is positive for a criminal substance or other substances of abuse especially if they do not have a prescription. If your usage is so casual...just stop smoking for a while it should be easy to "clear" your system.

[klone, MSN, RN]

Agree with Esme on all counts. SSRI based anxiety medications are not addictive, and from a legality standpoint, far preferable to illegal drugs. Further, if you're just using it "once in a while" when nothing else is effective, how really would that be different from using Ativan or Xanax "once in a while" when nothing else is effective? I think that a daily SSRI with PRN benzo anxiolytics is a reasonable option that stays within the confines of your state's (and BON's) laws.

I have never heard of a PCP doing a UDS as part of a new patient workup. They may ASK if you take any illegal drugs, and of course that's up to you how you respond. It might be a good seque into discussing your anxiety issues with your physician and discussing with him what can be done to treat/manage it.

[classicdame, MSN, EdD]

It is inevitable that you will feel stressed while at work. You do not have as much control over this drug as you think - you know it is illegal but you do it anyway. You know there are other options but you choose not to use them. You know you will be caught one day, and are risking your license and maybe your freedom. I hope you get help for your anxiety as it may ruin your life.God bless

[BostonFNP, APRN]

From a PCP perspective: I ask all my patients about THC use, tobacco use, alcohol use, and IVDU. I do this so I can best care for them and I do it in a way that encourages them to be open and honest with me.

I have never reported a patient for use of any of those substances, unless they were an active danger to themselves.

I only drug test patients if we have a signed CS contract.

I have opinions, like others here, on how you should handle your anxiety but that is a discussion for you and your provider.

[Guest219794]

I would not expect to be drug tested at a PCP visit, but maybe some PCP type nurses can chime in.

And, you can't post on here with a question about how to avoid detection of your illegal drug use and not expect to get feedback in that regard. I don't really see much difference between benzos and weed, other than one is illegal and could jeopardize your profession. Both get you high, both relieve anxiety.

But, if you are prone to anxiety- Doesn't the risk of getting caught make you anxious?

[TU RN, DNP, CRNA]

As long as you're not doing it at or before work within reasonable time, morally and ethically you should be allowed - by the laws of God and man - to partake in this form of anxiolysis. However, since some years ago the tobacco industry felt threatened by the snowballing popularity of an herb other than their product, laws have been bought-- er-- enacted by big business-- er-- Congress since then and you must adhere to them to practice your trade as an honest working American

[HouTx, BSN, MSN, EdD]

^^^^ srsly???^^^^

Marijuana is illegal in Florida. If you are using any illegal substance, you are putting your license at risk. Suggest you make a visit to the 'Recovery' forum to see what our colleagues are going through as a result of similar behavioral choices.

[T-Bird78]

I doubt the PCP will do drug screening, but your employer will as a pre-employment screening and random screenings throughout your employment.

[TiffyRN, BSN, PhD]

I've never been drug tested by my primary care doctor, in fact, I don't think I've ever been drug tested by any doctor. Only employers or insurance (maybe?). Maybe ask the office what kind of testing they are going to do.

You could use this occasion to discuss your anxiety issues with your MD and pursue a legally safer treatment option.

[nurseprnRN, BSN, RN]

I don't see any reason why they would do a drug screen for a routine new-ish patient intake visit, and I totally agree that you should take this opportunity to get a referral for an appropriate episodic legal prescription for your episodic anxiety.

[toomuchbaloney]

The PCP will not randomly test you for cannabis.

The PCP has no professional reason to report your use of cannabis to either the BON or your employer.

SSRI's may not be addictive but they are associated with a withdrawal syndrome that is significant and shouldn't be ignored.

It sounds like your use of cannabis to combat anxiety is causing you more anxiety, which defeats the purpose. I would recommend switching therapies or moving to a state which allows such medicinal use. Your upcoming PCP visit is a good opportunity to explore other options.