Positive pre-employment drug screen! What will happen?

Nurses General Nursing

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Hello, I am a licensed RN for Ohio and California. Have been working travel in California for 6 months. I applied for a new agency to start per diem work in California and just found out I tested positive foramphetamines on my pre-employment drug screen. At first I was confused and told the MRO I have no idea why that would show up and the only meds I take are allergy and sinus meds. Then it dawned on me my teenager takes Adderall and she also takes some of the same allergy meds as me as well. Long story short I am now worried that our meds could have gotten mixed up or a day I asked her to hand me one of our Zyrtec it might have been one of her meds, I don’t know. I keep all of our household meds in the same cabinet and being a single parent of four sometimes I’m handing everyone’s Meds out for the morning or she is. I was told by a friend that this might get me reported to the BON and I may lose my license over this. Can anyone give me advice on what may or may not happen? The MRO states that her job was just to report to the company and it’s at their discretion of what happens next. The recruiter for new agency says she has not heard anything yet and doesn’t know what happens in this situation that she thinks it might be I just reapply in 6 months.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

I think you would know it if you took the adderall. If you are taking your daughter's adderall to stay awake, feel focused, get high, then you have a drug problem. Do you? Rhetorical.

A uds is not a legal test because of the potential for false positives. I'm surprised at how many nurses and docs don't know this. You will get lots of false positives on a UDS. Its not definitive at all. A positive UDS goes to a second level of testing involving chromotography, if it is going to be a legal determination. If that one is positive, you are really positive and you are going to have consequences.

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So do I request that they do the second test? The MRO stated she was sending the results to the company so do I assume she already did the second test? What kind of consequences will this likely occur? I have been in the healthcare field for over 13 years and have had lots of drug screens, pre-employment and random and have NEVER tested positive for anything. I am NOT an addict nor do I like the feeling of being high. I refused norco and anything besides ibuprofen after even giving child birth to my kids bc of how I didn’t like the way it made me feel . I am trying to get more info on this bc all the info I keep seeing online is dealing with nurses who really do have a bad drug habit, like stealing meds, saying they take opioids or meth or other things, who were randomly tested, or nurses who smoke marijuana. I can’t find any info on something similar to my situation, probably because it’s so ridiculous. ?

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If you accidentally took your D's adderall, you can probably say goodbye to this job. Understandable from their perspective-people who purposely abuse adderall are also going to say this is a mistake, or that they accidentally took the med.

If I were you I would have a hair follicle test done-if this is a one off, your hair follicle test should reflect that. That way, you would have a defense in the event that they report you to the BON.

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Agreed...if you have never taken Adderall and "accidentally" took it? Oh trust me...you would know.

Like the other poster said...some OTC preparations will create a false positive (this is known), but second level testing will make the final determination.

Most drug testing companies b/c of HIPAA, have stopped asking about meds before the drug test..they only ask you for evidence if you are positive.

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Did you take a sudafed? Will one of those suckers make you test + for amphetamines? (or do they just make me feel like I could clean my whole house and run a marathon, and I'm alone in this.... lol.... )

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For future reference, if you make any other posts on the topic you'll probably get the most helpful responses to these types of questions on the 'Recovery' forum; the logistics of testing/reporting are really complicated, and those folks are very knowledgeable about the process (including common mistakes by people who are new to the reporting process).

As an aside, in addition to OTC meds causing false positives, supplements can cause false positives, too (especially supplements that advertise 'weight-loss' or 'energy' supplements).

Even though I get the rationale, it makes me sad that nurses aren't given the benefit of the doubt. There is so much evidence in nursing that med errors happen when we're busy/distracted, and I'm not surprised that they can happen on occasion at home. I have a couple of recollections of controlled-substance meds getting mixed up in my family growing up. My dad (a physician) accidentally took an ambien with his AM meds and got into an accident on his way to work but couldn't remember it the next day. My mom accidentally gave me one of my brother's Adderall instead of my nighttime med, and I was bouncing off the walls at 4 am (to be fair, I think you'd probably notice feeling different in retrospect). Just a few days ago I went to take some Benadryl to help me sleep for a night shift, and realized that I'd accidentally taken some Excedrine (which has caffeine :facepalm:). When all of the meds are together (in exactly the same orange RX bottles) and we're busy getting ready for work/school in the morning, switching up meds doesn't really surprise me. We're human, and we make mistakes (both in nursing and at home).

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Specializes in ED, med-surg, peri op.

This sounds like a lame excuse to me.

Instead of just owing up, you trying to tell us, as a nurse you just took the pills in front of you and didn’t notice it was a different pill at all? I’ve giving pills to 80 yr olds that aren’t all with it, but know instantly when there’s a new pill in the mix

Or that you weren’t careful enough with the pills you were giving your self and your family that you took the wrong pills; And didn’t even realise it until the drug test? Even if this was true, I wouldn’t want to hire you. If you can be that careless with your own health, couldn’t imagine what you would be like with others. Being busy isn’t an excuse either for giving the wrong meds.

Stop lying and get some help. Excuses won’t get you far.

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12 hours ago, Pmb said:

Then it dawned on me my teenager takes Adderall and she also takes some of the same allergy meds as me as well. Long story short I am now worried that our meds could have gotten mixed up or a day I asked her to hand me one of our Zyrtec it might have been one of her meds, I don’t know.

Giving the benefit of the doubt:

I'm guessing you seriously don't know how/why you may have screened positive - - just leave it at that. Let them know what meds you take. I would suggest not racking your brain any further (especially out loud) in order to come up with plausible ways this may have happened, although wanting to understand how it did is only natural. But as you can see, when you start trying to come up with something, it can easily begin to sound like story-telling rather than innocent theorizing - especially given the particular topic/situation.

Good luck getting the answers you need.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.
12 hours ago, Pmb said:

So do I request that they do the second test? The MRO stated she was sending the results to the company so do I assume she already did the second test? What kind of consequences will this likely occur? I have been in the healthcare field for over 13 years and have had lots of drug screens, pre-employment and random and have NEVER tested positive for anything. I am NOT an addict nor do I like the feeling of being high. I refused norco and anything besides ibuprofen after even giving child birth to my kids bc of how I didn’t like the way it made me feel . I am trying to get more info on this bc all the info I keep seeing online is dealing with nurses who really do have a bad drug habit, like stealing meds, saying they take opioids or meth or other things, who were randomly tested, or nurses who smoke marijuana. I can’t find any info on something similar to my situation, probably because it’s so ridiculous. ?

You don't need to request anything. If they are going to keep you from a job they need the gas chromotography because a screening is not a definitive test. The screening is just to find out if they need to do more tests.

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If I was you I would get a blood test taken ASAP. You will then either have a recent clean test or know for a fact that you will test positive and therefore should not apply for a job where a drug test is required until you know you will test negative.

If your test is negative I would send it to the employment agency with a letter stating that you believe the previous test was a false positive. If it is positive I would consider that job opportunity gone and hope that they don’t report you to the BON. I would probably also look into lawyers so that if you are reported you are ready to have a lawyer respond for you. Do not speak to the BON without consulting a lawyer!

Obviously you need to have a serious rethink about how you are dealing with medications in your home. Hopefully this was a one time slip that can be a “I will never make that mistake again experience”.

Best of Luck

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Im a cna and you can tell the difference before swallowing any meds or vitimins. I was diagnosed with adhd as a child. Even nurses on the job have asked me,so I caved in and got a prescription. I dont take it often and now been off it for 4 months since I'm job hunting due to possible drug tests....I don't know how anyone can like the stuff,but those with actual adhd know how beneficial it is.

I would just skip the job and apply elsewhere.

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