Really need someone..

SpankedInPittsburgh, DNP, RN · Nov 5, 2019

Well let start with the good news. I really very much doubt criminal charges will be filed against you without any direct evidence of stealing drugs. It doesn’t seem they have any. You didn’t waste meds correctly. That’s not a crime. As far as just a failed pee test I doubt any DA would have much interest for a variety of reasons

Now to the horrible news. I don’t doubt that you are gonna wind up in monitoring and probably with some level of inpatient or outpatient treatment. After that support groups and drug tests for years. You gotta pay for all this and if you cannot then monitoring is not for you. I agreed to all the above to save my license. I had a bunch of vacation and sick time saved up at work and a union job so I never missed a paycheck (albeit small ones). I also had insurance to pay for treatment. I’m sure I would have lost my license without all the above. I have no idea how many make it through these programs as the costs alone are crushing not to mention the time and stress. I wish you luck and advise that you weigh if the costs of keeping your license is worth it and if you are able to comply with all the terms and conditions before agreeing to anything

good luck

Cgritz77, RN · Nov 5, 2019

5 hours ago, Glb12287 said:
Hey all. I am struggling. HARD. I have some questions.. and will give the shortest back story of my situation. 14 months ago, my job at a hospital that I worked at for 10 years questioned me about why I waste so many narcotics compared to other nurses. I have MS and drop things frequently. But they still drug tested me, and it came up positive for some things I had gotten from my dad.. sadly. I don’t have an addiction per say. I was in the lowest point in my life then. Had a miscarriage, got the ms diagnosis, my father is very ill, I think I had PPD not treated too. So clearly I wasn’t making the best choices in asking family for things I didn’t need. Anyway— fast forward to a month ago, I get the dreaded letter from the BON. I got a lawyer and have been waiting a month for her to get all of my records. Well she calls me today and says they have 17 boxes of info on me, a dirty drug test and paper work claiming I admitted to having an issue. Which I NEVER did. I am beside myself with this whole situation. Moral of my story is the lawyer thinks my only way around this is to enter PAP or some other program. I am willing to do what I need to do to cooperate, clearly but I have sO many questions. I haven’t taken anything in over a year (I also just had a baby)... am I even a candidate for this? Everything is out of pocket for me to pay? And does everyone test 2x a week for 2 years??? I pray they tailor the program to us independtly. I am soooo upset over not being able to just have a glass of wine on a holiday bc of an issue I don’t have. Obviously, the latter of my situation is much worse. Can anyone please just give me some insight on what to expect? And has anyone ever heard of anyone having criminal charges with these things? I am so terrified they won’t believe me and something way worse will happen. Help ?

Hello,

I am very sorry to read your situation. Unfortunately, these programs seem for most to be a lot of crap that finances them and the boards. I had a DUI two years and a half years ago and my program just got started 2 months ago. I think it depends on what state you live in as to how the monitoring will go. I attempted to fight the process with my lawyer, but due to my medical records and things I said in therapy years ago, they were able to force me into a monitoring program and now I have a mark on my license. I think it is best to listen to your lawyer and enter into a program, because it may save you from getting a mark on your license, which makes it hard to find a job. It is hard financially, but thankfully I have my family for support. The program involves signing a bunch of release forms to allow your case manager to speak to all of your providers and a few additional people like a significant other, sponsor, etc. Once you do that then you will need to sign up with a monitoring service that your case manager refers to you such as RecoveryTrek. You download an app that allows you to check in every day (mine is M-F) to see if you have a random urine test. Depending on the test and the approved provider you go to, you will pay a fee. So far each one for me has been $25. I have only had 5 tests so far. The program itself is $300/year for me. Your case manager will refer you to an approved provider that may be covered by your insurance to get an evaluation. You go to the evaluation and answer their questions as positively as you can. That's what I did, and after a month they will give your case manager the results of your evaluation. They will not let you work in a nursing position until they give you stipulations for return to work as a nurse and also tell you what your plan of treatment is. They determined that I was in remission so I just have to go to three AA meetings a week. It is honestly not that terrible once you get into it. I still have not gotten my stipulations for return to work yet, so that's frustrating. I recommend being proactive about the process and calling your case manager to make sure they are on top of things. The programs operate under the PHMP, which will also assign you a case manager. The PNAP case manager's job is to "advocate" for you to the PHMP case manager, however I have taken it upon myself to call the PHMP case manager when I need answers. You should keep all records of your testing and receipts. They also need to know all your prescriptions and when you get a new one you must notify them and send them the prescription and a release form for them to be able to communicate with your physician. Not being able to drink is annoying when you really don't have a problem, but it's not the end of the world. I was very disgusted and disheartened when I knew I had to begin this process, but I just look at it as a stepping stone on the path to success. Recovery isn't even a factor to me in this process, because it doesn't feel like I need to recover from anything. Unfortunately, it feels like a way for power hungry people to exert control over others. It does suck, but you just gotta look at it like something that needs to be done to continue in the nursing profession. You can do it. It's just a bump in the road. When you feel lost or need support, come back to this forum and talk to people who understand. Best of luck to you ?

KyBeagle, ASN · Nov 5, 2019

First- congrats on NOT taking anything for a year. Very smart move.

I second what everyone has said so far.

8 hours ago, Glb12287 said:
am I even a candidate for this?

Yes- positive drug screen & multiple wasted meds...your attorney probably can not get you out of this.

8 hours ago, Glb12287 said:
I pray they tailor the program to us independtly.

I’m sorry to say- not usually. If it was wasted meds & a clean UDS- you MAY have gotten by with a tailored disciplinary action such as a civil fine or a year of monitoring- but you had a positive UDS & no valid prescription. Unfortunately, they most likely will require the full time for their compliance program.

8 hours ago, Glb12287 said:
And does everyone test 2x a week for 2 years??

Well...The good and bad news. The bad news: Every state is different with their program length. I’ve seen very few that received 2 years. Most programs are either 3 or 5 years. I don’t know what state you’re in. I’m in Kentucky & the KARE Program is 5 years for everyone with a positive urine. Or for those with a second DUI, etc. But you had a positive urine so I would brace yourself for the full length of your state’s program.

The kinda good news: When I was in the program, they told me at the first meeting that tests were completely random & they did not have a set amount each year. I could be tested weekly. However, the first year, I had 2 UDS per month (24/year). After the first year, it varied. Most months I had 2/month, but occasionally one per month. One year I only had 18 tests. Some tests were 20 days apart...sometimes 5 days apart. Only once did I have 3 tests in one month.

But- like I said, each state is different. Kentucky doesn’t usually do routine hair testing (expensive) unless they have a high suspicion of drug usage - urine tampering, failed daily check-ins to your drug monitoring provider, etc. However, other states, do routinely order hair testing every 3-4 months in addition to the UDS. Many states will also order routine PEth testing (blood work that checks for alcohol use in the past 3 weeks). I only had one but I wasn’t in the program for alcohol. But, again, each state is different.

Kentucky doesn’t have a fee for their program, like the $300/year mentioned by Cgritz77. It’s covered in the licensure fees paid by all KY nurses. However...

8 hours ago, Glb12287 said:
Everything is out of pocket for me to pay?

Pretty much- yes. You will start with a chemical dependency eval- the evaluator must be approved by the board. I was lucky enough to still have insurance at this point. I managed to get it in before my insurance termed. If you’re not insured- you WILL pay. You may just be referred to IOP (outpatient). I was. Much cheaper than inpatient. Once my insurance ran out (after 2 visits) it was about $50 2X week for 7 weeks. I did have to pay most out of pocket. After that, I attended a Healthcare Professionals meeting weekly for 10 months. That was $45 per visit. Now— ALL the UDS, or possibly hair & blood tests orders by Recovery Trek or Affinity... yes, ALL out of pocket. Most of my UDS were $41.50 (paid online to Affinity) then I had to pay $15 or $20 (depending on the lab) for the actual urine collection. Every few months, I had a $65 UDS plus collection costs. Once I had the blood PEth at $130 plus a $20 collection fee.

Also- in KY, we check in 7 days per week. I was never selected on a Sat/Sun but I heard from a KY Nurse on this site that was chosen for several weekends right before she finished the program. Still- if we didn’t check-in on the weekend, it counted as noncompliance.

8 hours ago, Glb12287 said:
I am soooo upset over not being able to just have a glass of wine on a holiday bc of an issue I don’t have.

This is the LEAST of your worries. You will also have to refrain from ANY foods cooked with alcohol, soy sauce, vanilla extract, avoid most aerosols (hairspray, perfumes, etc.), almost all bug spray, etc. Anything with ethyl alcohol or fermented foods can potentially cause a positive etg urine test. Etg is a waste byproduct of ethyl alcohol. It can remain in your urine for 48-80 hours. Positive etg...means failed test, as they can’t prove if it was a glass of wine or an accidental inhalation of hairspray. That was my biggest worry over the 5 years I was in the program.

In addition to the above, it was just as the others have said. 3 AA OR NA meetings per week, some work restrictions, especially with controlled meds, early in the program. No HH, no travel nursing. Employer gets a copy of your contract (and has to do a work evaluation for the program every 3-4 months). All prescriptions must be reported to the program. Must avoid all mood-altering OTC meds (Benadryl, any pseudoephedrine such as Sudafed, etc.). That said, with a MD statement, I was allowed to take Benadryl for my allergies. I also took a very short term narcotic for a fracture. The KARE program was reasonable, if the need was medically necessary.

Glb12287— I only told you this because you asked. It’s fair that you know what your facing, up front. That said... it may also sound overwhelming or impossible. IT’s NOT! I was determined NOT to lose my license. The first few months, my whole family was eating ramen noodles & beans & cornbread! I felt terrible at the time but they all look back now & laugh— and talk about the bonding we did as a family when money was so tight. I was able to get a Case management job about 3 months later. Whenever we would get a tax refund... I would put $500-$600 in my Affinity account to start off strong for the year then add $50 here & there. That made it SO much easier. When I got my CM job, I was eligible for a medical flex spending account... that accepted the Affinity UDS testing costs! I would wait until November... submit ALL my receipts for the year... and get a huge check right before Christmas. It was those little things that I figured out over the years to make this more bearable.

I finished about 2 weeks ago.

5 years ago, I felt like you, panicked & hopeless. As the years went on, it was frustrating at time, but also a routine part of life, once I settled into it...Check-in with Affinity before getting out of bed. (Usually at 5am...most days it was back to sleep for a couple of hours unless I was selected to test). Reading EVERY ingredient on the menu & questioning the waiter if unsure if alcohol was in an entree. Holding my breath when using hairspray or body spray,etc. (Holding my breath... I’m STILL doing it, LOL). But it becomes routine most days. And when you finish... it’s exhilarating... probably a bigger achievement and more exhilarating experience than getting your nursing diploma! At least, that’s how I felt. Whew! Five years OVER!

Once you sign your contract- only look at ONE day at a time. Before you know it, one year will be behind you- then 2 years, etc. Save “counting down” until your last 3 months! Otherwise, it will feel too overwhelming.

You CAN do this. And we’ll be here for you each tiny step of the way!