Random tests?

[Medsport]

I have been a floor nurse at various nursing homes for over 10 years now. I've never had to take a drug screen except for pre-employment. My current job is probably the best one I've had. The pay is good, I like most of my co-workers and the management is usually pretty laid back. Although call-offs, benefits and time off could be better. I heard one of the nurses got a random drug test recently. The person seems like a good nurse and I think it came from the BON. I know I shouldn't be concerned as I don't use illegal drugs. I do smoke cigs and drink occasionally.

But here's the thing, I am getting older and with all the walking and standing I have inflammation from time to time and may take something for the pain in which I haven't had a script for for a long time. I also have periodic UC flare ups and is why I started smoking (I know it may not be proven, but I do think nicotine helps). So with these issues I'm sure I could get a medical marijuana card as our state is now legal to do so and I've been thinking about it for awhile. I think it would also help with my anxiety and trouble falling to sleep. I'm pretty sure I could get fired if I got a positive test even if I had a card, but it may not be the case at all facilities. What do you guys think? Would a positive test affect my nursing license? It is becoming more and more acceptable so I'm thinking maybe I should just wait it out because sooner or later it may become legal on the federal level and then I would have nothing to worry about.

[canoehead, BSN, RN]

I wonder if the Board would accept CBD oil as opposed to THC? The CBD would be the anti-inflammatory anyway. If you wrote to them inquiring, you could save the response, and share it with your employer.

I've never gotten a random drug test, or heard of one being given to a coworker, so I suspect they are less random than employers let us believe. Even so, I don't even eat poppy seed muffins, just in case.

[Ilargia99, LVN, RN]

I have UC as well and there are a lot of good meds out there to try. Lialda is probably the most recommended as far as oral mesalamines go and has few, if any, side effects. There’s a generic form of it now that is much more affordable.

Just something to think about.

[Medsport, LPN]

Maybe I should try CBD oil first. I know several nurses that use it. I have heard that you do have to be careful with that too and make sure its from a reputable company and doesn't contain THC.

One of the reasons I hadn't gone to a doctor in years until recently is that I didn't have insurance. I finally got a job in which I can afford it, but it sucks. The deductible is outrageous so the only way I can afford to go is save up enough HSA funds for a visit. I really don't want another one of those scope tests either. I know its probably a good idea, but one of the worst experiences I've had except for getting a tooth pulled.

[Jory, MSN, APRN, CNM]

20 hours ago, Medsport said:

I don't work in a hospital, but could stop smoking anytime. I just don't want a flare up to come back. IMO, it seems like we are getting discriminated against for working in the medical field. What business is it of anybody what you do on your own time as long as you don't drive or go to work under the influence?

It's not discrimination. It's about a professional standard. Patient's nor employers should have to worry about their nurses coming into work impaired. This is discussed heavily when we were in nursing school and if any of us had a problem with it, the best option was to quit and find another line of work.

Boards of Nursing don't order random drug testing on nurses "just because". If your friend was randomly tested, it's because her hospital ordered one.

Yes, you can be subject to random drug testing at any time. Yes, if you test positive you can be reported to the BON. Yes, it can impact your nursing license. If you need to take an impairing substance close to your shift, you have to report it to your employer so they can make a decision if you are permitted to work or not.

Let me tell you WHY they have the standards that they do.

The hospitals, nor the Boards of Nursing, are going to get into the "Susan needs her oxycodone and isn't impaired because she has been taking that dose for years, but Beth's prescription is new...so she can't work on the same dose because she will most likely come in impaired".

There is NO WAY you can manage that for thousands of nurses. You disallow all of it. Same with medical marijuana.

While nicotine helps with UC, smoking, is very different. You don't have to smoke to get nicotine and no state BON bans nicotine, but some hospitals do. Nicotine is not an impairing substance and if you have a letter from your physician that it would help with your UC, you may be able to get an exception from your employer if you are using patches. However, if you are drinking alcohol and have UC....seems very counter-productive.

[Jory, MSN, APRN, CNM]

3 hours ago, Medsport said:

Maybe I should try CBD oil first. I know several nurses that use it. I have heard that you do have to be careful with that too and make sure its from a reputable company and doesn't contain THC.

One of the reasons I hadn't gone to a doctor in years until recently is that I didn't have insurance. I finally got a job in which I can afford it, but it sucks. The deductible is outrageous so the only way I can afford to go is save up enough HSA funds for a visit. I really don't want another one of those scope tests either. I know its probably a good idea, but one of the worst experiences I've had except for getting a tooth pulled.

There are no FDA standards on CBD oil and anyone who uses it risks testing positive for THC. CBD oil companies will ALL advertise they don't contain THC. Otherwise, you can't sell your product.

I have a colleague who works in addiction medicine (they have many patients that are under court-ordered treatment) and they had a receptionist that they knew was not a marijuana user, but her PT had recommended CBD oil for her knee that was having frequent flare ups even after she had knee replacement surgery.

CBD oil had only recently became legal in my state. She purchased a very high quality CBD oil that was very reputable. She used it for a month.

My colleague, as an experiment, asked her to take a drug test because they were curious if she would test positive for THC...and she did. They did this experiment with a couple other employees on a purely voluntary basis and over 50% of those they tested, came up positive.

They added to their contract that their patients cannot use CBD oil (we don't live in a state with legalized marijuana), because some of them are under court order testing and any "fails" have to be reported. They wanted to take it out of the equation.

[adventure_rn, MSN, NP]

Another issue with non-random drug tests: even if you aren't the one diverting, you could still be targeted. I've worked on units where a single person was diverting but it was unclear who, and the entire unit was tested as a result. Even if you don't give management a cause for suspicion, you could still get 'non-randomly' tested and risk losing your job, license, and livelihood.

8 hours ago, canoehead said:

I wonder if the Board would accept CBD oil as opposed to THC? The CBD would be the anti-inflammatory anyway. If you wrote to them inquiring, you could save the response, and share it with your employer.

3 hours ago, Medsport said:

Maybe I should try CBD oil first. I know several nurses that use it. I have heard that you do have to be careful with that too and make sure its from a reputable company and doesn't contain THC.

I would use extreme caution with CBD products. There are nurses on this site who were using CBD oil they thought was perfectly safe, then ended up testing positive for THC on drug tests, like this poster:

Last year Lori Brown (the 'AN Nurse Attorney') wrote an article on the legality issues that arise with CBD oil and THC. Her take is that the only way to CBD oil and be 100% safe from the BON is to use CBD products containing 0% THC.

The problem is, since the suppliers aren't regulated by the FDA (or any other oversight body) you have no way to know with 100% certainty that your product is actually free of THC. You have to take the suppliers' word for it, and if it turns out they weren't being truthful, the BON won't care. To me, that wouldn't be worth the risk of losing your job, license, and livelihood, and being saddled with thousands of dollars of legal fees to go through an intrusive drug monitoring program.

It sounds like you need to get together with your doctor and work on a collaborative game plan. I get the sense that you have some mistrust for the medical system (and I understand that medical care in the US is expensive), but it's also been several years since you've worked with a doctor to manage your condition. Surely there are medical options that you haven't explored yet. I get that it's cheaper and easier to buy CBD oil online or apply for a medical marijuana card, but it sounds like a very risky, unwise decision to me.

[Horseshoe, BSN, RN]

21 hours ago, Lurkndmurk said:

Unless it becomes federally legal.. it won't matter that the state legalizes it. The BON is federal law; therefore, even if your job says its okay... your license can end up in trouble ? It's really dumb & i dont agree with it, but hopefully they'll just legalize it within a few years and then viola, problem solved ?

"The BON" is NOT "federal law". BONs are not any kind of law. They are regulating entities that are in the business of protecting the public by making sure nurses are following their Nurse Practice Acts-which are state laws, not federal. Every state NPA is slightly different.

However, as long as marijuana remains illegal per federal law, you are correct that many (if not most) BONs will not accept a positive test even if the state has made it legal for medical or recreational use.

[Horseshoe, BSN, RN]

20 hours ago, Lurkndmurk said:

Actually, it definitely does. I asked the BON about this subject and they said they would have no grounds against it.

That is not correct. This has been challenged in various states (not by nurses that I'm aware of), with results being mixed. One employee of a cable company in a state where MJ is legal challenged his firing all the way to the state supreme court - and LOST his case.

There have been examples in other states where the opposite was true. So no, one cannot ASSUME that if MJ is legal in their state that they can use without repercussions.

[Jory, MSN, APRN, CNM]

20 hours ago, Lurkndmurk said:

Actually, it definitely does. I asked the BON about this subject and they said they would have no grounds against it.

Going to work high or drunk is a different story. The BON can't take action against your license because you're drinking at home. They can if you break the law such as DUI. Being an addict or an alcoholic is completely different as well. Prescription drugs are allowed & I definitely see leeway with federal legalization of THC in the near future.

I definitely see stipulations and problems concerning this though, considering how long it takes THC to get out of your system. How will they possibly know if a Nurse is high or not? Its going to get interesting one day...

I wouldn't go by what someone at the BON tells you over the phone. If they are telling you that they have no issue with it, ask them to point you in the direction of where it says you can consume a mind-altering substance and still work as a nurse.

Oh, I'll save you the phone call, because their guidelines will say just the opposite. So why is that an issue in a state with legalized MJ? Because they will use that same clause to sanction you if you get reported by your employer for showing up positive.

Hospitals and BONs have the right to say which drugs you can and cannot take and still work as nurse. OSHA has been doing it for years. They do the same with CBL drivers. Nursing is no different.

But if you want to bet your career on it, go right ahead. I love the ability to take care of my family and pay my bills. I don't wish to engage in a social experiment and ruin my career.

[JadedCPN, BSN, RN]

22 hours ago, Lurkndmurk said:

Unless it becomes federally legal.. it won't matter that the state legalizes it. The BON is federal law; therefore, even if your job says its okay... your license can end up in trouble ? It's really dumb & i dont agree with it, but hopefully they'll just legalize it within a few years and then viola, problem solved ?

This isn't accurate. More than likely, even if it is legalized federally, no hospital will allow it - just as many hospitals will not hire you if you us any form of nicotine.

OP you've received some good replies. I want to emphasize that you should be as equally concerned about testing positive for one of those medications you are taking without a prescription. Depending on the med, a positive without a script will get you in just as much trouble.

[Horseshoe, BSN, RN]

21 hours ago, Lurkndmurk said:

Actually, it definitely does. I asked the BON about this subject and they said they would have no grounds against it.

Going to work high or drunk is a different story. The BON can't take action against your license because you're drinking at home. They can if you break the law such as DUI. Being an addict or an alcoholic is completely different as well. Prescription drugs are allowed & I definitely see leeway with federal legalization of THC in the near future.

I definitely see stipulations and problems concerning this though, considering how long it takes THC to get out of your system. How will they possibly know if a Nurse is high or not? Its going to get interesting one day...

Yes they can. In my state, it specifically asks if you have any history of alcohol abuse. If you answer yes, you will be forced to go through TPAPN if you haven't already addressed it. The question is not have you ever used alcohol while working, it asks if you have ever had an abuse problem.

Of course most people are not going to answer that question honestly. But if it comes to the BON's attention that you have an alcohol problem, your license can and will be affected, even if you only ever drink at home.

I worked with a nurse who answered "yes" to the question. What a total mess she found herself in.

[rn1965, ADN]

On 12/17/2019 at 12:38 AM, Medsport said:

What do you guys think? Would a positive test affect my nursing license? It is becoming more and more acceptable so I'm thinking maybe I should just wait it out because sooner or later it may become legal on the federal level and then I would have nothing to worry about.

Head on over to the Recovery forum on AllNurses. You will see the destruction a positive drug screen can have on your license.

Please do not take any chances. MJ is not okay with any BON in the US. Positive drug screens without Rx's are going to, at the very least, land you in some type of monitoring, and at the worst, leave a permanent mark on your license.