Substances to avoid

RN2364 · Jul 11, 2016

I have said it before and will again the so her goes. The thing that scares me the most out of the entire monitoring program is FALSE POSITIVES! N/A or A/A meetings, IOP, aftercare, Nurse support meetings are all somewhat verifiable. The one thing that is not is that dreaded false positives. I have read too many threads on here in regards to them. Once you get that positive notification there is no way to prove its "false". You are now guilty and punishment rains down. I often wonder why they don't look into this phenomenon further. It obviously happens. Even my CM made comments directed at false positives. They even tell you what to do or not do to avoid them. They know they exist yet when they do there is no way to prove its false or not and its a battle I have never seen go the way for the nurse. Why doesn't someone develop better testing. We have essentially used the same testing for decades with limited improvement. It's sad that people lives, careers and reputation can be ruined with a simple cup of urine after using too much hand sanitizer that week.

SororAKS, ADN, RN · Jul 11, 2016

I remember that I was really stressed in the beginning of my monitoring contract when I saw the things that I had to learn to avoid. I was able to adjust, but still on occasion have had some near misses. I sure won't miss the monitoring contract when I finish. Then I won't have to worry about "over hydrating" myself and getting that dread "Dilute Urine" letter.

There needs to be much better oversight of these issues and the BON's that live and breathe by them.

RN2364 · Jul 11, 2016

I got a "dilute" specimen the very FIRST time I tested. I had no idea that was even an issue. What happened was when I went to test I was able to provide a specimen but it wasn't quite enough. It was later in the day and I found out that day that once your there you stay until you provide specimen you can't leave or go outside. Well since it was later in the day the collection site employees really wanted me to go so they started giving glass after glass of water. Needless to say I was able to go within the hour. I thought that was great. Those people are so nice as to help me collect the specimen fairly quickly. I was new. I trusted them and assumed they knew what they were doing. Next thing I know I am getting lit up via phone, email, certified mail about a "dilute" specimen. I was shocked and horrified with it being my first test and all. I immediatly called my case manager at Recovery Trek as well as the BON and explained the situation. They were able to call the collection site and thank god they confirmed that they had me drink all the water. With that I ended up being ok but to this day every time I go to that collection site they are still offering people as much water as they want!

Just st one of the things I learned the hard way. There is so much more to learn however.

Any helpful tips tips would be greatly appreciated. Near misses or problems you have had would be helpful so we all don't make them in the future. I find I get more information and support on this site compared to other so called resources.

allnurses Guide · Jul 12, 2016

God willing, any day or week now I will be granted the gift of TPAPN...I say gift because at the core of the program ( specifically: Eval, treatment, meetings, sponsor, objective and random drug testing) are supportive of a strong recovery program and after successfully completing TPAPN my license will remain intact and unblemished. If the BON chooses to show me justice and NOT mercy, I will be professionally screwed, so yes, I am actually slightly excited about TPAPN, lol
I have spent all of my life never giving any thought to cooking or eating delicious food with white wine or vanilla extract and hydrating myself with 8-10 glasses of water a day. I use hand sanitizer (almost) enough to please any infection control nurse. When I have a cold/flu from hell or allergies, I take NyQuil or Benadryl. I use the hair products that I love, including mouse and hairspray.
......you guys get the point, right?
I feel more anxious over being paranoid about secret ingredients/interactions/false positives than I do staying clean and sober. I have taken pre-employment, routine and for cause drug/etoh tests (urine and blood) and never once had a false positive. Apparently they use some ultra sensitive Ets/etg test that has been documented to be "overly sensitive and nonspecific". What the heck?? That is the science they are using?
I understand that they list these things (and many more) because they don't want someone who did indeed drink and blame it on excessive hairspray and hand sanitizer, so they make broad recommendations.
Have you guys in recovery monitoring been forced to change or second guess what was previously never given a second thought? I am anxious, frustrated and confused. Any insight would be super appreciated , thanks!!!

In the five years that I was in the California program I had two false positives - both were eventually deemed incidental exposure and I had no consequences: That being said here's what I have learned by personal experience and anecdotally:

Avoid

Alcohol based hand sanitizer: It is not getting it on your hands that causes false positive- when you use it and rub it on your hands the fumes are aerosolized and you breath them in t=and they are processed through your body and become + etg molecules. Just wash you hands with soap and water. It takes a few extra seconds and new studies show that hand sanitizer is not as effective as once thought and may be contributing to the development of superbugs.

Don't add alcohol to anything you cook - contrary to popular belief, unless you are cooking at very high temperatures all the alcohol does not cook off and can leave traces. Also don't consume any food cooked in a restaurant that has alcohol. I always simply told my waiter's that I was allergic to alcohol and to hold the sauce. A couple of restaurants I frequented in those years would have the cooks/chef whip up something simple for me and it was always delicious.

I never worried about vanilla extract as such a small amount 1/2 teaspoon is used in most recipe's

Stay away from alcohol based beauty products.

Nyquil and Benadryl are definite no no's both are tested for and frequently abused substances.

Bottom line don't take anything even prescribed medications without talking to your case manager.

good luck to you

Hppy.

dirtyhippiegirl, BSN, RN · Jul 12, 2016

Ibuprofen can cause false positives for THC and is one of the few false positive medications that cannot be differentiated with higher level testing like GC/MS. I have had two false positives that were "cleared" after they were run through a GC/MS. Prilosec popped THC and lamictal popped for PCP. :/

SororAKS, ADN, RN · Jul 12, 2016

Wow. Prilosec and Ibuprofen are new ones on me. Thank you for posting. I take Naprosyn and so far haven't had any issues.

dagobah, ASN, BSN, MSN, RN · Jul 13, 2016

I got a "dilute" specimen....

Man, false positives scare the bejesus out of me. There was one time I had to test on July 5, 2011. Day after the 4th and our ICU had a potluck. NO ONE brought any meat dish, and so it was all pasta and desserts.

And, for anyone that has been in for a few years you know how essential it is to have some protein (please newcomers don't get hung up on the protein and not worry too much). But, I went extreme binge on the sugars and carbs.

Yup, had a dilute when I tested on July 5, 2011. I didn't find out until a week later. I got grilled like I was a criminal. In the end, nothing happened. However, I ended up testing 3 times in a 6 day period. Ouch on the lab and collection fees. What I did on that 4th of July was extreme though. 12 hour shift with great desserts and my kryptonite: Mac and cheese!!!

Soy sauce, ate tons of that never had problems. I was told not to eat that, but I did. No issue. Everyone is different on the metabolism I suppose.

There was a time pre-2011 where DM (dextromethorphan) was not on the ban list. Well, I took that after 2011 and got a positive. Got a big slap on wrist! I got delayed by one month. Yes, it could've been worst. Got ordered to meeting Qday for 1 month even with work. That was my punishment.

Good luck everyone. I agree with RN2364, I could deal with everything but that whole being treated like I did something bad when I didn't. I had to remember they're looking out for the public and not for us. At least that was told by me at the time by the old timer nurses who were there before me.

reneern623 · Jul 13, 2016

Ibuprofen can cause false positives for THC and is one of the few false positive medications that cannot be differentiated with higher level testing like GC/MS. I have had two false positives that were "cleared" after they were run through a GC/MS. Prilosec popped THC and lamictal popped for PCP. :/

Funny cuz we are only able to take Tylenol, ibuprofen, naproxen and aspirin without a doctor's note/prescription. I take 800mg Motrin every night before bed and haven't any false positives (knock on wood)! [emoji15]

gabby3 · Jul 13, 2016

I am one of the unlucky one that test frequently positive for etg. I now get 189$ PEthtests instead. When etg first came out in 2005 when I started monitoring in California any level was considered positive. Most states have increased the level and most people do not test positive for etg.

I think mine is related to yeast infection in my colon that I take meds for now. I am a rare case.

I wouldn't worry about it. Just make sure there is no alcohol in your food and products. Just the ethyl alcohol and SD alcohol. Rubbing alcohol and acetyl alcohol in most products are different,they don't cause positive.

Gabby

TXRNC · Jul 13, 2016

I took Advil and Prilosec daily without any problems for my entire contract

dirtyhippiegirl, BSN, RN · Jul 13, 2016

I took Advil and Prilosec daily without any problems for my entire contract

It's weird how false positives work. I continued to take the lamictal and Prilosec for several months and never had another false positive and had been taking them for a while before I got the false positive.

The ibuprofen also depends on what test they are using.