Positive pre-employment drug screen! What will happen?

[Pmb]

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.

[choksantos, BSN, RN]

To answer your question bluntly, you won't get the job. If you "mistook" your allergy meds for Adderall , then it seems you're careless. If you did take Adderall for whatever reason and it's not prescribed to you, then it would be classified as abuse and your integrity will be in question not to mention your license.

[dream'n, BSN, RN]

On 7/14/2019 at 10:19 AM, FolksBtrippin said:

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.

True, I just read that Sudafed can cause a positive for amphetamine. But the further testing can differentiate between the two. So take a deep breath right now

[DannyBoy8, RN]

On 7/14/2019 at 8:17 PM, Newgradnurse17 said:

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.

lol, new grad nurse coming in to drop kindergarten knowledge bombs on us.

[MSUOUgirl]

All the drug tests I have taken with agencies usually say will send out for chromatography with positive on the paper they send you. Once those results come in which will differentiate between Sudafed or Adderall. Anything requiring a prescription, the drug testing company will contact you to explain any positive results. If it is Adderall and you do not have a prescription; your agency will find out the results and are required by law to report the results to the BON of that state. That BON will contact the other BON. They will suspend your licenses and you will be required to enter a diversion program.

[myoglobin, ASN, BSN, MSN]

I probably missed this somewhere above, but by all means at least consult an attorney experienced in nursing license law. It may be "unnecessary" and involve a few hundred dollars of money spent at a time when you cannot afford it, but when the potential stakes are your license it is money well spent (plus many attorneys will give you an initial consultation for free). I know that I probably take 25-30 OTC supplement pills per day so God only knows what I would pop positive for on a drug screen.

[BSN-to-MSN, ADN, BSN, RN]

Sorry, but you would notice a difference if you took aderall, even accidentally. That's why I don't think you are being truthful. Either way, consult a lawyer, big trouble is headed your way. Sorry.

[myoglobin, ASN, BSN, MSN]

12 minutes ago, no.intervention.required said:

Sorry, but you would notice a difference if you took aderall, even accidentally. That's why I don't think you are being truthful. Either way, consult a lawyer, big trouble is headed your way. Sorry.

There is a good deal of speculation in your reply including:

a. Perhaps he would notice and perhaps not. Working in mental health I can't tell you how many clients tell me "I don't notice any difference at all" when they are started on low dose stimulants.

b. He was speculating as to why he tested positive. It may be a different drug or supplement (or simple lab error) caused the possibly false positive. It is a statistical certainly that a certain percentage of people will experience false positives with front line drug screenings.

I always start with the proposition that people are sincere and telling the truth until definitively proven otherwise. This is all the more true when they come of their own free will to a site to seek opinions and are largely anonymous.

[Meriwhen, ASN, BSN, MSN, RN]

If you tested positive, it's up to the potential employer as to whether they choose to hire you. You could explain that you took your child's medication by mistake...but IMO, it sounds like a pretty flimsy excuse that, short of you having a video recording of your entire medication-taking experience, is almost impossible for you to prove. I've heard similar excuses more than once from my patients.

I'm not saying you're not telling the truth...but step back, detach from the situation, and consider how it comes across. Seems sketchy, doesn't it?

I think you can write this job opportunity off as a loss, consider it a painful lesson learned, and hope that they decide not to report this positive to your state BON. The odds are they won't--they're usually more concerned about reporting results if it's an actual practicing employee than a potential one.

And in the future, if this indeed was a bona fide mistake on your part, pay more attention when you're in the medication cabinet. Your credibility would really go south if this were to happen to you a second time--employers would start to think that if you can't keep your own medications straight, could you really keep your patients' meds straight? Seriously, it's something to think about.

Best of luck.

[DCNP, BSN, MSN, APRN]

Let's just talk about facts, since it seems everyone wants to jump to conclusions without knowing all the information about how you tested for amphetamines...

So to answer your question, you can get a false positive from supplements, medications, herbs, etc.. However, the 10 or 12 panel drug test, tests for both substance containing amphetamines/methamphetamine and also its metabolites. If you test positive for the first portion of the test (immunoassay), amphetamines/methamphetamine are within the cutoff level, it will then be retested for metabolites (Gas chromatography/mass spectrometry). The metabolites is how they confirm the positive reading. If the metabolites are are positive cut off level on confirmation study, these specific metabolites can be identified, quantified and reported for a positive test result.

Your second question: The second test is to confirm, it is performed prior to getting back results of the first test. You only get results from the first test if you are negative. If you test positive, automatically the second is performed, then you are notified.

Also, this "possible" adderall intake would have to be ingested within 72 hours to get a positive read, unless it had been taken multiple times or at high doses, then it could last in your system for 5-7 days.

[steven007, BSN, MSN]

On 7/14/2019 at 3:48 PM, 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. ?

On 7/14/2019 at 3:48 PM, 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. ?

It is a pretty surreal situation and I am sure that others have used this excuse in the past (whether legit or not, its not for me or anyone else to say).

But my advice to you, to put your mind at ease, would be to talk to whichever person reported to you that this came back positive. I suspect it would be the HR department for whichever agency. Ask them what the next steps are and what action they will be taking? Don't assume the worse.

In terms of reporting to the BON, I wouldn't worry too much about it.

*DISCLAIMER IN ADVANCE, I AM NOT PROVIDING YOU WITH LEGAL ADVICE AND I WOULD HIGHLY RECOMMEND SPEAKING TO AN ATTORNEY*

I'm a nurse and a law student in Canada and not too sure about the American statutes, but the BON would be hard press to do anything against you for this positive, for 2 reasons:

1. This was positive PRIOR TO and NOT DURING employment with the organization. You were not tested positive while you were physically at your place of work. Thus, the BON cannot prove that you endangered the life or safety of any patient. Under the California nursing act, the following is stipulated:

"In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following:

(b) Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license"

2. I am ASSUMING that you have an otherwise untarnished track record of practice. No previous positive drug tests, no impaired while at work reports, etc. If your track record working as a nurse is clean and untarnished, then the BON would be hard press to prove that this 1 off occurrence reflects on your ability to nurse.

Again, follow up with this girl, find out what is going to happen. Assume you won't get the job (best case scenario) and that it will end. Worst-case scenario, they report it to the BON. But you must ask them what they are going to do. If they say they must report this to the BON, then contact an attorney ASAP. Based on the California nursing statute though, I don't think they would report it as there is no provision for a positive drug test, only a provision for using drugs while you are actively practicing and on site as a nurse. But, again, I am not 100% sure as my experience is predominately Canadian.

Best of luck to you!

[EDNURSE20, BSN]

14 hours ago, DannyBoy8 said:

lol, new grad nurse coming in to drop kindergarten knowledge bombs on us.

Not a new grad, I was in 2017 when I made the username, and can’t seem to change my username now.

Still think it’s a lame excuse. They suddenly remember after a drug test that they took the wrong medicine. Really???

[brandy1017, ASN, RN]

I don't know what really happened but would find it strange that the OP wouldn't realize it was the wrong med. I take several meds and know what each looks like, although the pharmacy does switch them up from time to time with different brand manufacturers so yes I guess they can look different.

I know of a nurse who was taking his stepchild's adderal for his own use, don't know if he got caught on the job or with the BON, but heard his wife divorced him and that was at least one of the reasons why.

I've heard of false positives and also that some OTC diet supplements have been found to have actual prescription drugs in them so I'm assuming that would come across as a stimulant on a drug test. I'm leary of taking OTC alternative herbs, pills for exactly this reason because you are relying on the integrity of that manufacturer that it is what they claim it is.

To the OP I suggest you keep your child's med separate from yours and don't share your allergy meds. Make sure you are taking your meds yourself, keep them in your bedroom for instance.

I hope this turns out to simply be a false positive and you don't get reported to BON. From what I heard if you are reported you will find yourself in hell for several years being forced into a drug treatment program at your own cost. It is a nightmare for those who get caught up in their web.

Also be aware some facilities use hair samples that can show if you've been taking controlled meds going months back if not longer. I feel like nursing is becoming a police state and we give up all our rights to privacy just to have a job.

When I first started working as a nurse it wasn't like that, they didn't even do drug testing unless they had reason to believe you were impaired. Now it is routine, can be random, and expected if you file a workers comp claim. So to everybody out there never take a chance by "borrowing" a friend or family's med. Always get a valid prescription if you ever need a med!

PS It must be a current valid prescription if you take some med from years ago and get caught that won't be considered a valid med.