Tramadol Prescription & Nursing School Entrance Drug Testing

[ADNcandidate]

Hello, I was recently accepted into a clinical nursing program and need to have a drug screen. I have been taking Tramadol, Soma, and Tizanidine for an L4-L5 spinal injury that occurred while helping to lift a patient when I was working in the OR 4 years ago. I have been on these medications for 2 years now and I take them 3 times a day. I am really concerned about how my medications may be received by my school, nursing facilities that I will be completing my clinicals and by future employers. Obviously I have a strong tolerance to these medicines after having taken them for so long. I am concerned if they will appear in a urine drug screen and if so if I should disclose my medications or not. Obviously I prefer to disclose them and hope they are accepted but I don't want to risk them not being accepted. Can anyone please let me know how these medications are treated among the nursing community, and any advice any of you have about how I should go about dealing with this is greatly appreciated! Thank you!

[ADNcandidate]

I am concerned about clinical facility sites and future employers that find out about my condition feeling as if I may be some sort of danger because of my medicines. I know that nurses work while taking medicines for a variety of conditions but there is such a stigma with pain medications. I don't want to be grouped into this category when I'm competent and able to be trusted. That's why I would prefer not to disclose my condition or medication if I have a choice in the matter. I will start keeping all of my prescription bottles and not throwing them out for the next few months when I get them refilled so I have additional hard evidence if I need it.

[JustBeachyNurse, LPN]

Your pharmacy can print out a record of any or all of your prescription medications if needed. Especially if you have used the same pharmacy for years. No need to save bottles as the printout signed by the pharmacist including fill dates would likely have more merit than a bunch of old prescription bottles.

Most don't screen for ultram just common drugs of abuse. Just be aware that there are a couple of state BoNs that have restrictions on nurses working while taking any (even prescribed) narcotics. This info would be on the BoN website if it applies in your state

As far as chronic pain, if you can meet all of the job requirements without accommodation there should be no real reason to disclose. Lately most employers have asked if you have any condition that may limit your ability to fully perform job duties or require ADA accommodations.

[ADNcandidate]

Thank you, I know that I can go to Walgreens for a print out as well. I'm in Maryland which I've heard is strict but not as strict as some other states. I'm not sure what their policy is on this issue though.

[JustBeachyNurse, LPN]

Look at the BoN website. Look at the application for a nursing license. In my state drugs of abuse are asked and if you have any condition requiring accommodation or any unstable medical or psychiatric condition such as bipolar not compliant with medication, had surgery recently and on lift restriction...,

[thimble]

Here is what happened to me. I knew I would come up positive. They do not screen for Soma and Tizadine but may for Tramadol since it is a control now. I took my drug test, the company called me 6 days later. The longest 6 days of my life!! They then instructed me to take pics of my prescription bottle. Make sure it is the bottle from the date you took the test. I saved mine because my script ran out and I started a new one by the time tegu called. I took 3 pics of the bottle and emailed it to where I was told. I was then given a negative drug screen within an hour. It's very easy.

Soma is a controlled substance too. At the place I work, we do oral fluid panels that DO test for Soma. I would bring a list of all your medications, just in case. Better safe than sorry.

[BiotoBSNtoFNP]

I work in urgent care and we have occupational health contracts with many many companies in the area. I perform pre employment and post accident drug testing frequently for the companies.

Usually I ask the pt if they take any medications. If they say they take a narcotic (or other substance where they will test positive), I tell them that their results may take a little longer to process. I do not record what they are taking anywhere on the form. I perform a rapid UDS at the urgent care. If its negative for whatever the company is testing for, I fill out the negative slip and and fax it to the employer. If it is positive, i fax the employer a "non negative" slip that states we are sending it out to the lab. If the rapid UDS is positive/non negative, i send the urine to the lab for further processing. The lab will then call the patient and ask what medications they are taking and will have the patient send a picture or other confirmation of the script to the lab. Once the script is verified, the lab will send a negative result to the employee. The employer never finds out what medication they are taking or why.

[ADNcandidate]

Thank you for that information! That's very helpful. I'm aware that Soma is also a controlled substance now since I spoke with my doctor's office yesterday about this. They are writing a letter for me to give to the lab to let them know the medications they have prescribed for my conditions. They said I will have a positive result for opioids but their lab technician wasn't entirely sure the process of how it may be documented despite my legitimate prescription. BiotoBSN, your information seems the most likely scenario though and I will prepare myself for that process. Thank you.