The best excuses for positive drug screens

[rnaturcervix]

I have recently had a lot of positive UDS pts, and the excuses I hear as to why they are positive simply blow my mind! Anyone have any good stories? I'll start with my favorites.....

+ marijuana: I was trapped in a car with 10 other people smoking and the windows were broken

+methamphetamine: I don't use it, I just cook it, and usually not at my own house

+cocaine: I was asleep, and my boyfriend blew it up my nose. The 2 gay men that live next to me put cocaine in their air vents, and it must have got into my apartment.

**my all-time favorite: well, of course my wife is positive for cocaine, you have no idea how many cokes she drinks everyday**

Anyone else??? :)

[rnaturcervix]

This brings up an interesting question. Is it considered illegal if Child Protective Services uses the report that I am required to file to take custody away from a mother? Never once, in my 15 yrs of L&D, has the issue of obtaining consent for a uds come up. Thoughts?

[rnaturcervix]

Let me clarify....I don't think they will use the report as the sole determining factor, but I am the one alerting them of the positive screen.

[brillohead, ADN, RN]

My interpretation would be that consent (or a warrant) is only needed for criminal charges to be filed, which is different than CPS taking custody of the child.

CPS takes lots of kids without pressing charges against the parent(s).

[LakeEmerald]

In my ER we can do a UDS in my state without specific consent. I think it is inferred when the patient gives consent for treatment. It is a great help in identifying possible causes of altered mental status, chest pain, mania, etc. However, I have seen 2 cases within 3 years in which two separate patients insisted vehemently that there was no way the drug screen was correct and insisted on rerunning it. Both positives were for amphetamines and both reruns were negative within 2 hours of the initial tests. The urine did not appear to be tampered with.

I have found that most people will just fess up when confronted with positives. These two cases were illuminating and thought-provoking.

[KRVRN, BSN, RN]

Baby soap linked to newborns' positive pot test - Health - Health care | NBC News

I'm surprised this has never come up at my work.

[chiandre]

How about...

"It is normal for people from my country to test positive for heroin. We eat a lot of sesame seeds"

[FLAlleycat]

In the early 90s when I was in charge of the pregnancy program in a my county, we started UDS on ALL ladies coming to our clinic. The research was getting out on the cocaine babies as well as importance of identifying drug users during pregnancy. Crack and cocaine was all over in the county. Most of the local OBs and pediatricians were against this initially. I worked with two local treatment facilities and one several counties away and found beds for both long-term and short-term treatment before we even started testing. We also had outstanding home-health nurses for our pregnant women as well as a full-time social worker. We did not announce we were starting drug screens nor obtain consents. If anyone tested positive, the social worker and one of the home nurses met with the patient and discussed their desire, if any, for treatment and treatment options. Even those ladies who did not want treatment but continued to use still came to our health department. Perhaps it was due to the RN's stressing the importance of prenatal care, but I think it was because we also cared a lot about our women, users or not. If one missed an appointment, a home-health RN visited her to make sure she was OK, to see if she needed transportation to the appointment, etc. The hospital was alerted to any positive tests and CFS was notified. If the baby tested positive, our RN would do the home assessment for CFS. If the pt was one our ours, her assessment was very thorough as she had been following the lady throughout her pregnancy. I think the local OBs were surprised at the number of their private patients who were doing cocaine! I can't remember the percentage our PTL and low-birth weights dropped in two years, but we did receive a state award for the significant decrease.

Now, back to the excuses given for positive tests . . . I thought I had heard it all until one woman very seriously told me she was at someone's house making cookies and must've gotten into their stash instead of the sugar. Um, yeah, and turnip truck and all that. Of course, everyone was in pot-smoke-filled-car-with-windows-up if it was for pot . . . even though it's like 90-100 in day and 80-90 at night.

[FLAlleycat]

Oh, and one of my patients was in her 14th pregnancy with all her other children removed due to her drug use. She refused treatment. She refused birth control. She said she was going to keep having babies until "the let me keep one".

[Calinurse4]

"My boyfriend put some of his meth in the sugar bowl without my knowledge and I sprinkled it in my iced tea".

[OB-nurse2013, BSN, RN]

We don't need consent for a uds. On another note here are some good ones I've heard.

1. I needed to smoke marijuana to prevent morning sickness

2. I was running with my bf from the cops and I loved him so much I swallowed his crack rock so he wouldn't go to jail. That's why I'm positive for crack cocaine

3. This isn't a drug or illegal but I loved thisexcuse for smoking. I need to smoke because otherwise my bp is too low. Lol

[morte, LPN, LVN]

what you do if someone expressly forbid you doing testing for drug use?

We don't need consent for a uds. On another note here are some good ones I've heard.

1. I needed to smoke marijuana to prevent morning sickness

2. I was running with my bf from the cops and I loved him so much I swallowed his crack rock so he wouldn't go to jail. That's why I'm positive for crack cocaine

3. This isn't a drug or illegal but I loved thisexcuse for smoking. I need to smoke because otherwise my bp is too low. Lol

[OB-nurse2013, BSN, RN]

what you do if someone expressly forbid you doing testing for drug use?

Then I don't know I've never heard of that ever happening. Although my guess would be it would be covered under something since their is an infant involved. Or there's the possibility of just doing all the steps that would be followed after a positive uds which would just include a social work consult. They would take it from there too.