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Random drug testing


Hello all. I have just started a new job and of course you get drug tested which is fine with me. I do not take take any medications or drugs.  I have had life long anxiety and depression which is treatment resistant it seems. I have tried numerous SSRIs, SNRis, Buspar, etc. and a lot of therapy. Needless to say this has always been an issue for me personally as well as professionally my whole life. I have up and quit jobs for no reasom other than anxiety. I have had 14 jobs in 6 years and I have only managed to hold on to one per diem job for the last three years. How I am not homeless is beyond me but I have always managed to pay the rent somehow,

I have been offered Ativan along with the SSRis and the SNRis and I have always refused it as I know it can be addicting. As a last resort I am going to see a psych NP to get prescribed a very low does of PRN ativan just for the days I have to work which will be 3 days a week. I am at my wits end and I can not lose another job. 

The place I work does random drug tests. The benzo will show up in the drug screen. Will I lose my job or will having a condition needing the Ativan exempt me? It is not something I want to take but I have to keep this job. I have always had bad anxiety but the last 8 years have been the worst.

Thank You


It is not illegal to take Ativan if it is prescribed for you from a licensing stand point but many hospitals will not let you take any "mood altering" drugs while on duty regardless of your diagnosis. They do not want absorb the liability if something happens. Also, you  may have difficulty with your malpractice insurance company.

iluvivt, BSN, RN

Specializes in Infusion Nursing, Home Health Infusion. Has 32 years experience.

Where are you practicing? You need to find out exactly what the law is in you state or wherever you are.Many allow you to take any drug that you have a valid and current prescription for You also need to find out what their definition of "current" is so you  can can always be in compliance. You must make certain that the drug does not effect you in such a manner as to impair your judgment and ability to function.This is where it can be a bit tricky. I would make sure to get adjusted on the drug and see how my mind and body is effected.Many people who do take narcotics and other psychoactive medications find they actually function much better as your focus is off your pain and/or anxiety or whatever the problem is.I must admit it can be a bit of a gray area but if you are drug tested you must have proof you have a valid and current RX if the law allows it. 

Edited by iluvivt

Been there,done that, ASN, RN

Has 33 years experience.

IF you are tested and IF  you are positive for benzos, your company policy will decide what to do with those results. 

"prescribed a very low does of PRN ativan just for the days I have to work". What I hear you saying is, you are most anxious at work.  Have you ever worked with ativan on board?   Consider a less stressful job. Have you considered something like private duty? 

I have anxiety regardless of where I work. 14 jobs in 6 years. Various roles. I have anxiety to the point I have not been able to have even 2 date in 24 years. I also have agoraphobia and can only go certain  places. I am a good candidate for disability but do not want to go that route at all.  I will talk to the NP about other options as well. It is absolutely miserable to feel like you are in a heightened state of anxiety all the time. 

CharleeFoxtrot, BSN, RN

Has 10 years experience.

OP if your screen name is anything like your for-real name please ask an admin to change it for you. Employers go Google searches and the internet is forever. I haven't anything else to add except my sincere hope things work out for you.

Undercat, BSN, MSN, CRNA

Specializes in Retired. Has 41 years experience.

I am sorry that your anxiety is so high that you would need a drug that could compromise your job.  Are you seeing a psychopharmacologist?  You may require more expertise than a non-specialist can provide since you obviously aren't getting relief.  I assume that you are supplementing meds with cognitive therapy.

Nunya, BSN

Specializes in NICU/Mother-Baby/Peds/Mgmt. Has 39 years experience.

I understand if you need this drug but the problem I see is if you make any sort of error at work there might be more problems if they know you're on it.  And in some places a bad enough error will get you drug tested.  

Edit: not saying you're going to make an error but we all know it happens....

Edited by Nunya


Specializes in oncology. Has 44 years experience.

13 hours ago, Heather Winer said:

I have had 14 jobs in 6 years

I admit I am confused because what you are saying here is a direct opposite to previous posts. You worked one job for 5 years. I asked about being a traveler for a Covid assignment. Who is the real HW?

I have had one part time to per diem job for three years. I am sorry if I confused you all. The 14 jobs were full time jobs I could not handle in the last 6 years as the anxiety went more haywire.  I did work a med surge job for 5 years from 2009-2014. Both are me. 


Specializes in oncology. Has 44 years experience.

4 minutes ago, Heather Winer said:

last 6 years as the anxiety went more haywire

Thank you for explaining things. You have had the loss of both your parents and it is so stressful when we lose them. No wonder you are anxious, plus you are looking to get back into acute care. I am glad you are looking at possible health care providers (psych NP) for solutions. I really don't know anything about antianxiety drugs but is propanolol something to ask NP about? Or Vistaril? 

Best wishes and success to you. I hope for the best for you!


Specializes in oncology. Has 44 years experience.

I have sent messages to Admin. by clicking on the triangle at the lower left corner. You can add a free text question. Hope this helps.

Some people have found propranolol, prescribed off label for PTSD or severe anxiety, to be very effective. Added benefit is its antihypertensive effects. No worries, as it is not a scheduled drug.  Recommend you speak to your provider about this. Whatever you do, advise you to, as much as possible, keep your medical conditions and meds to yourself. I have read here where people have had personal info like this used against them by coworkers. You don’t need the added stress worrying about this. 

BeenThere2012, ASN, RN

Specializes in PICU, Pediatrics, Trauma.

Off topic for your drug testing question...but have you tried TMS treatments? No drugs involved and can be highly effective for depression and anxiety.

I wish you the best.  As another said, have you considered a less stressful setting to work in?

Thank you. I want to try TMS treatments as so many other things have not helped or even made it worse with side effects. I just have not been able to hold on to full time jobs for the insurance for the treatments. I have worked in many settings as a nurse. It is me. Not the settings. I have had this all of my life but did not realize what it was. It has got really bad the last 6-8 years.