preemployment drug testing

klone, MSN, RN · Mar 5, 2018

I have no idea what SAMSHA regulations are.

I pee in a cup in a very controlled environment (blue stuff in the toilet, not allowed to wash your hands until you leave the bathroom, urine temp is monitored. Then, it gets sent out to a lab. That's all I can tell you, and I've never really thought too much about it because I don't have any illicit substances in my system.

Why, are you concerned about what the drug testing might find?

ruby_jane, BSN, RN · Mar 5, 2018

Is anyone familiar with the preemployment drug testing policies of major hospital systems? I know mine is a UDS, but do they typically follow SAMSHA regulations even if they are a private employer?

I think we'd be more helpful if you could be more specific on your question. Rest assured, if an employer is going to decline your services because a drug screen showed a substance, there would be a lot of policy and chain-of-evidence protection to back that up.

babynurse98 · Mar 5, 2018

I have a legal prescription for a benzo, and I am very worried that while I know I will test positive for it, the medical review officer might say the level is "too high" or something of the sort. Like outside of therapeutic range, even though he/she is not familiar with my past legal usage, frequency, body weight, etc.

Eris Discordia BSN, RN · Mar 5, 2018

Don't pee if you won't pee clean under the tightest of scrutiny in drug testing. Every employer tests differently and they certainly won't tell you their testing protocol prior to an offer. It's not worth the risk if you have something you shouldn't in your system.

If you have a valid script that is in date, that's one thing. If you don't have an in-date, valid script for something that could test hot, put off your job hunt, stop using, and get clean before you do a pre-employment screening. Trust me on this.

Just hop on over to the nursing recovery board here and read about the many nurses who were reported to the Board and disciplined and/or placed in 3 to 5 year monitoring contracts for popping hot, for something like THC that they used on vacation in Colorodo, one month later on a pre employment screen.

I'm not trying to be pedantic, but rather honestly warn you about the risk. Failing a pre-employment screen will cost you more than a job in most states.

Edit: just read your response. I'm sorry. I know from experience that the MRO that reviews any positives, excused or not, can detect the level in the urine. How do I know? It happened to me. They said my level was too high and inconsistent with taking at prescribed doses/intervals...and they were right.

babynurse98 · Mar 5, 2018

but did you get in trouble for that? because everyone's therapeautic levels are different...

Eris Discordia BSN, RN · Mar 5, 2018

but did you get in trouble for that? because everyone's therapeautic levels are different...

Yes I did get in trouble...quite a bit of it.

If you take it as prescribed, your levels really should be fine.

babynurse98 · Mar 5, 2018

if you dont mind me asking is that what got you placed on BON monitoring?

babynurse98 · Mar 5, 2018

Sorry, please, I'm just really freaking out. I have two separate prescriptions for 1 mg of a benzo and for the past two days I have taken both prescriptions, and they are both legally prescribed to me, so I do not see how I could get into trouble for this. So for the past 4 days I have taken 2 mg (1 mg from each prescription), i don't know if this makes sense or not, but I cannot risk my license.

allnurses Guide · Mar 5, 2018

Does each of the physicians who prescribed those know that another physician also prescribed them? It sounds to me like you are meant to be taking one of those prescriptions but are rationalizing taking both, thus your internal "freaking out". Get honest and admit you are taking them outside of prescribed parameters. If the physicians aren't coordinating your care, then you aren't taking as prescribed and yes, you will come up as being outside of therapeutic range. Again, it sounds like you are well aware of this but hoping for a "gimme". There are none when it comes to narcs and benzos as a nurse.

You have two prescriptions. If they are identical but from different doctors, you are taking drugs meant to only be taken as a stand-alone prescription, thus doubling the dose. Rationalizing "But I have two prescriptions for the exact same thing so that makes it okay if I am getting twice as much as I am supposed to" isn't going to fly if those docs weren't each aware of the other prescription. It is pretty frowned upon to get more than one doc to write you multiple prescriptions for the same drug and is a generally well known hallmark for abusing medication. Did you fill them at the same pharmacy? Why are you taking so much? Why do you have two prescriptions? Why did two doctors write for the exact same thing? Why are you so worried about it? All are likely answers you need to think hard about.

Yes, this could get you in trouble with the BON.

Eris Discordia BSN, RN · Mar 5, 2018

It's a big problem if they are not from the same physician. If they are from different physicians, it's an even bigger problem if they don't know that the other doctor is concurrently prescribing a benzo.

From experience, while that may not or may not be considered an addiction per se, I'm pretty sure that the Board would consider what you are describing as substance abuse (doctor shopping, if you are in fact seeing two different doctors). Now, if it's the same doc that has you on one script for a scheduled dose, and a seperate script as a prn dose, you will be fine. If it not the same doc prescribing both scripts, I'm afraid that is asking for trouble.

I'm not a lawyer, I'm not a doctor, but knowing what I know, I personally wouldn't risk it.

babynurse98 · Mar 5, 2018

they are from the same doctor, and they are both PRN prescriptions