Drug testing in medicine

[LostinLift]

A recent article on KevinMD by an anonymous medical student,

http://www.kevinmd.com/blog/2014/05/medical-school-drug-testing-moral-scientific-failure.html

discusses concerns, moral and otherwise, regarding drug testing medical students. While I've seen some studies showing that there can be a temporary decrease in brain function for up to a few weeks after marijuana use, I haven't found much data looking into the medium term (1-30 days) effects of alcohol, in minimal, moderate, or heavy users.

While marijuana use by physicians, say on their weekend with no call, is still not allowed (not speaking of legality, rather board, licensure, malpractice), there is not an equivalent rule for alcohol, AFAIK. As long as you are not intoxicated at work, I believe you are in the clear. But what if there are similar medium term effects on the brain from alcohol that can impair or affect thinking just as much, if not more, than marijuana? If that is the case, then it seems to follow that either alcohol use should be monitored in the same sense as marijuana, or they should both be allowable during time off (again, legality aside).

I am more trying to make an argument against alcohol as the "approved drug of society" than, "legalize it, bro". Although I'm not, not making that argument.

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[hpinyak]

I heard one PD at an east coast surgery program say she viewed drug tests as essentially an IQ test for residents.

If you can't figure out how to pass a scheduled drug test with a medical degree and advanced warning then you are either too stupid or too addicted to be in her program.

 

[Hulk Smash]

I don't really get it. Maybe because I never did the marijuana thing, I don't know. I don't see the issue here except maybe the 30 dollar thing.

 

[Ionian]

While marijuana use by physicians, say on their weekend with no call, is still not allowed (not speaking of legality, rather board, licensure, malpractice), there is not an equivalent rule for alcohol, AFAIK. As long as you are not intoxicated at work, I believe you are in the clear.
.

And this is crap. Even if your state legalizes marijuana, why can't physicians smoke it?

Being Drunk lasts for hours, and what's stupid is if you're a drunk and have a problem, you can just not drink for 1 day and be in the clear from any drug test.
Yet, 'just don't come into work drunk' is the common sense principle that makes everything okay.

Being high doesnt last for hours, it's just unfortunate that drugs tests can detect use for several days.
Yet the 'just don't come into work high' idea doesn't fly.

Me smoking a bowl on Saturday and being high for a few hours, hurts no more people than a drunk drinking through the weekend.
We both come into work sober, I just wont be hung over.

If a drug test, which mostly screens for past use and not current use, can get you fired, then drinking any amount of alcohol ever should get your fired.

Reject all drugs, or except them, tired of stupid people deciding what kind of intoxication is acceptable.

 

[Arkangeloid]

Drug testing is retarted, just an excuse to stigmatize marijuana users.

It's because of dat ish that I had to detox myself for a month before those stupid drug tests.

 

[Houmd]

physicians are held to a higher standard than the common public, and rightfully so. If we want to be respected and taken seriously then we should maintain that standard of professionalism and not do stupid things like fail drug tests. Until it's legal federally then you have no excuse to use it as a physician. You can argue all you want about living in Colorado etc but since the federal law still applies then as a physician you should have the common sense to maintain your professional standard and avoid it.

 

[Arkangeloid]

Just curious...do NPs get drug-tested?

Definitely not for nicotine.

 

[LostinLift]

physicians are held to a higher standard than the common public, and rightfully so. If we want to be respected and taken seriously then we should maintain that standard of professionalism and not do stupid things like fail drug tests. Until it's legal federally then you have no excuse to use it as a physician. You can argue all you want about living in Colorado etc but since the federal law still applies then as a physician you should have the common sense to maintain your professional standard and avoid it.

I used the article as a jumping off point. I'm not speaking of legality here.

My point is that alcohol is more addictive and might be more harmful to both the physician's focus in the short-term and health in the long-term, compared to marijuana use. Yet because of the stigma applied to marijuana through slanderous and racist propaganda, it has been both frowned upon and illegal. Whereas alcohol use is not monitored and co-workers are hesitant to report signs of alcoholism.

 

[Ionian]

physicians are held to a higher standard than the common public, and rightfully so. If we want to be respected and taken seriously then we should maintain that standard of professionalism and not do stupid things like fail drug tests. Until it's legal federally then you have no excuse to use it as a physician. You can argue all you want about living in Colorado etc but since the federal law still applies then as a physician you should have the common sense to maintain your professional standard and avoid it.

Do you believe though, if it becomes 100% legal, state AND federally, that hospitals wont still have their own policy regarding testing positive for marijuana?

I believe they can write there own policies, employees are subject to their rules, and positive drug test will always result in termination, regardless of state and federal law.

So why would I care about state and federal law now?

The problem will always be the hospitals, and the drug tests.

 

[Anastomoses]

I used the article as a jumping off point. I'm not speaking of legality here.

My point is that alcohol is more addictive and might be more harmful to both the physician's focus in the short-term and health in the long-term, compared to marijuana use. Yet because of the stigma applied to marijuana through slanderous and racist propaganda, it has been both frowned upon and illegal. Whereas alcohol use is not monitored and co-workers are hesitant to report signs of alcoholism.

Coworkers would be hesitant to report anything other than actual medical misconduct (if that). Alcohol abuse may also be harder to prove. Society has legalized it making it socially acceptable. Maybe once marajuana receives the same, restrictions will ease up?

I'm oblivious to the racist element. Austin and SF have massive educated white populations which indulge in the drug so I might be clueless to a class-correlation. Though I do confess to seeing more grace in those eating it in truffle or brownie form. I think of only crack and cocaine as being class-distinctive.

@Arkangeloid NP = nurse practitioner

 

[Arkangeloid]

Coworkers would be hesitant to report anything other than actual medical misconduct (if that). Alcohol abuse may also be harder to prove. Society has legalized it making it socially acceptable. Maybe once marajuana receives the same, restrictions will ease up?

I'm oblivious to the racist element. Austin and SF have massive educated white populations which indulge in the drug so I might be clueless to a class-correlation. Though I do confess to seeing more grace in those eating it in truffle or brownie form. I think of only crack and cocaine as being class-distinctive.

@Arkangeloid NP = nurse practitioner

I think that at this point, the floodgates have opened. By the time I'm 45 or 50, marijuana will probably be legalized in most states.

And by that time, the people who make the rules will be the people who were getting blazed every week back in undergrad. I don't think they'll care as much about weed as people do today.

 

[Ionian]

I think that at this point, the floodgates have opened. By the time I'm 45 or 50, marijuana will probably be legalized in most states.

And by that time, the people who make the rules will be the people who were getting blazed every week back in undergrad. I don't think they'll care as much about weed as people do today.

Guess ill have to wait till I'm 50 to be happy.

Same old story.

 

[Arkangeloid]

physicians are held to a higher standard than the common public, and rightfully so. If we want to be respected and taken seriously then we should maintain that standard of professionalism and not do stupid things like fail drug tests. Until it's legal federally then you have no excuse to use it as a physician. You can argue all you want about living in Colorado etc but since the federal law still applies then as a physician you should have the common sense to maintain your professional standard and avoid it.

Don't y'all be hatin on a player pimp for trying to get his smoke on. I mean, let's be honest here, we've all hit that Mary Jane before, and it's fun lol. All your worries go away, and everything is so cray cray when you're up in the clouds, namsayin'?

 

[DermViser]

Drug testing is retarted, just an excuse to stigmatize marijuana users.

It's because of dat ish that I had to detox myself for a month before those stupid drug tests.

Uh, no.

 

[DrCharlemagne]

Coworkers would be hesitant to report anything other than actual medical misconduct (if that). Alcohol abuse may also be harder to prove. Society has legalized it making it socially acceptable. Maybe once marajuana receives the same, restrictions will ease up?

I'm oblivious to the racist element. Austin and SF have massive educated white populations which indulge in the drug so I might be clueless to a class-correlation. Though I do confess to seeing more grace in those eating it in truffle or brownie form. I think of only crack and cocaine as being class-distinctive.

@Arkangeloid NP = nurse practitioner

There is an account of marijuana legislation that argues the only reason weed was made illegal was an attempt to ban things associated with Mexican/hispanic culture (think Zoot Suit Riots) to discourage immigrants. There is another account that says weed is illegal because of paper barons not wanting hemp to cut into their profits off of timber acquisitions. There is a current hypothesis that the war on drugs specifically targets people of color, and there is some evidence that people of color get much harsher sentences for minor marijuana infractions when compared to whiteies.

 

[DermViser]

Just curious...do NPs get drug-tested?

Nearly all health care professionals do. This isn't just limited to doctors.

 

[DermViser]

There is a current hypothesis that the war on drugs specifically targets people of color, and there is some evidence that people of color get much harsher sentences for minor marijuana infractions when compared to whiteies.

Simple solution: Don't use drugs.

 

[DrCharlemagne]

Simple solution: Don't use drugs.

If it were that simple, drug abuse would not be as much of a problem as it is.

 

[Hulk Smash]

So then drug abusers, as previously stated, should get weeded out... No pun intended

 

[DermViser]

If it were that simple, drug abuse would not be as much of a problem as it is.

What I'm saying is that if you think the intention of drugs laws are to throw minorities in jail, then simple solution: stop doing drugs.

 

[Anastomoses]

What I'm saying is that if you think the intention of drugs laws are to throw minorities in jail, then simple solution: stop doing drugs.

Well, the psychology of those trapped in some of those underprivileged communities can be...something many of us don't entirely comprehend. It's disturbing the disproportionate class bias for criminality and imprisonment. Being born into certain ghettos/barrios is practically a sentence to be involved in criminal or drug activity.

I'm in favor of tougher punishments for those who commit an illegal act while on a substance. Like the way legislation is applied to drunk-driving, or felony-murder (though this isn't substance related but I mean the way the law is written).

 

[LostinLift]

What I'm saying is that if you think the intention of drugs laws are to throw minorities in jail, then simple solution: stop doing drugs.

You'll have to speak a bit louder, you're rather high in your ivory tower.

 

[DermViser]

You'll have to speak a bit louder, you're rather high in your ivory tower.

Has nothing to do with being in an "ivory tower". It's common sense, re: drug laws. You making this about race is ridiculous.

 

[touchpause13]

The war on drugs does throw way more black people in jail than it does white folks. Why does crack come with heavier sentences than cocaine? Why do black people tend to get longer sentences for the same drug related crime? I know it's easy to just say they were on drugs so fuk 'em, but dealing with addiction is a much more complicated beast than just say no.

 

[Anastomoses]

The war on drugs does throw way more black people in jail than it does white folks. Why does crack come with heavier sentences than cocaine? Why do black people tend to get longer sentences for the same drug related crime? I know it's easy to just say they were on drugs so fuk 'em, but dealing with addiction is a much more complicated beast than just say no.

Ugh this stuff makes me tired. They should just give lighter sentences for drug laws that have no victim + make them across the board - no wiggle room for judges. I don't wanna hear about how the sweet preggo blonde at Yale got a lighter sentence than the big hulky black guy from a bad neighborhood. Just across the board sentences depending on what's on them, number of times caught,etc.

 

[DermViser]

The war on drugs does throw way more black people in jail than it does white folks.
Why does crack come with heavier sentences than cocaine? Why do black people tend to get longer sentences for the same drug related crime? I know it's easy to just say they were on drugs so fuk 'em, but dealing with addiction is a much more complicated beast than just say no.

1) The war on drugs does throw way more black people in jail than it does white folks.

And point is? So based on the race of the defendant, one's sentences should be lighter?

2) Why does crack come with heavier sentences than cocaine?

Crack is also more addictive than cocaine. Oh but bc more blacks are caught with crack vs. cocaine, so all of a sudden it's a racial injustice? Give me a break.

 

[gregoryhouse]

What I'm saying is that if you think the intention of drugs laws are to throw minorities in jail, then simple solution: stop doing drugs.

You're simplifying the issue. Although I don't agree that drug laws are only for the minorities. It does seem that minorities get stricter punishment for similar drug offenses than whites.

So while its simple to say 'stop doing drugs'. The heart of the issue is deeper than that.

 

[DermViser]

You're simplifying the issue. Although I don't agree that drug laws are only for the minorities. It does seem that minorities get stricter punishment for similar drug offenses than whites.

So while its simple to say 'stop doing drugs'. The heart of the issue is deeper than that.

That can be said for crime of ANY nature, that race plays a part.

 

[Wordead]

And this is crap. Even if your state legalizes marijuana, why can't physicians smoke it?

Being Drunk lasts for hours, and what's stupid is if you're a drunk and have a problem, you can just not drink for 1 day and be in the clear from any drug test.
Yet, 'just don't come into work drunk' is the common sense principle that makes everything okay.

Being high doesnt last for hours, it's just unfortunate that drugs tests can detect use for several days.
Yet the 'just don't come into work high' idea doesn't fly.

Me smoking a bowl on Saturday and being high for a few hours, hurts no more people than a drunk drinking through the weekend.
We both come into work sober, I just wont be hung over.

If a drug test, which mostly screens for past use and not current use, can get you fired, then drinking any amount of alcohol ever should get your fired.

Reject all drugs, or except them, tired of stupid people deciding what kind of intoxication is acceptable.

Just because alcohol is too entrenched to make illegal doesn't mean that making another substance legal is the answer.

 

[Ionian]

Just because alcohol is too entrenched to make illegal doesn't mean that making another substance legal is the answer.

False.

It's also about freeing up time and resources.

Do you know how many non-violent 'criminals' are behind bars for charges of possession?
Like, really? Who where they really hurting?

You know how many people would be in jail if there was an alcohol prohibition?

Do all those people you know that would still drink or make alcohol seem like the kind of people that deserve to be in jail? Hm.

 

[Wordead]

False.

It's also about freeing up time and resources.

Do you know how many non-violent 'criminals' are behind bars for charges of possession?
Like, really? Who where they really hurting?

You know how many people would be in jail if there was an alcohol prohibition?

Do all those people you know that would still drink or make alcohol seem like the kind of people that deserve to be in jail? Hm.

You're bringing up isolated points that don't affect the overall point - legalizing it would not make things better.

I've smoked plenty of times in the past. This isn't a moral objection. It would just not be good for society to have widespread marijuana legalization. Regardless if theres more tax money or whatever.

 

[Ionian]

You're bringing up isolated points that don't affect the overall point - legalizing it would not make things better.

I've smoked plenty of times in the past. This isn't a moral objection. It would just not be good for society to have widespread marijuana legalization. Regardless if theres more tax money or whatever.

Seemed lifting the alcohol prohibition was good for society, unless you want to argue that.

You can expect the exact same outcome from legalization of marijuana.

 

[Wordead]

Seemed lifting the alcohol prohibition was good for society, unless you want to argue that.

You can expect the exact same outcome from legalization of marijuana.

You think alcohol is a net positive for society?

 

[Ionian]

You think alcohol is a net positive for society?

Oh yeah, my bad, I guess organized crime goes in the positives column.

And that was the least of the problems.

 

[Wordead]

Oh yeah, my bad, I guess organized crime goes in the positives column.

And that was the least of the problems.

It was a pretty simple yes or no question. Way to focus on one small part of the history of alcohol in the US only, though. Totally logical.

 

[ChrisGriffen]

Alcohol is bad, so we should legalize marijuana.
With arguments that air tight it's hard to believe we havent legalized yet.

Seriously, if you honestly just cant stop smoking weed you have a real problem. Not addiction, just stupidity. If you want to make the argument that thc is a mild high at most, which we all can agree on, then why is it such a big ordeal to give it up? You are an adult. If you cant make it through the day without getting stoned, you have deep issues.

 

[ChrisGriffen]

Society has rules. Get a haircut, iron your shirt and trim your beard. Sure, you can rebel if you want, and go to work like a bum. You aren't hurting anyone. You would be acting like a ***** though and probably not last long.
Its the same thing with weed. You are expected by society to be mature enough to not make dumb decisions.
..... That and you are also expected by the DEA to not possess or use. We can ignore that for now though.

 

[Ionian]

It was a pretty simple yes or no question. Way to focus on one small part of the history of alcohol in the US only, though. Totally logical.

You're right, it's completely illogical to use a similar situation to explain rises in criminal activity, increased imprisonment of minorities, and the morbidity/moralities that result from the production of products not subject health regulations and standards.

None of that will decrease with legalization, just like none of it decreased with the repeal of alcohol prohibition right?

It doesn't really matter what your perception of drugs in society is, because smarter and more powerful people than yourself clearly found it unwise to uphold the prohibition, and since we are quickly heading down the road of complete marijuana legalization, there must be many people that disagree with you too.

Not that there is really anything to disagree with you about, since you've yet to make any valid arguments, other then just to say 'drugs are bad mkay'.

 

[Prodromo]

Alcohol is bad, so we should legalize marijuana.
With arguments that air tight it's hard to believe we havent legalized yet.

Seriously, if you honestly just cant stop smoking weed you have a real problem. Not addiction, just stupidity. If you want to make the argument that thc is a mild high at most, which we all can agree on, then why is it such a big ordeal to give it up? You are an adult. If you cant make it through the day without getting stoned, you have deep issues.

Who here has stated that they can't stop smoking weed or make it through the day without smoking? The argument isn't whether individuals are so addicted that they have to smoke or will withdraw like a fiend. If the high is only mild as you stated, the question shouldn't be why is it such a big ordeal to give up, but why is it such a big ordeal to place people in jail for over using.

Why can't individuals in the land of the free choose which substance they prefer to induce a, "mild high". Especially one proven to be as benign as cannabis.

 

[ChrisGriffen]

Anyone in the healthcare profession who is trying to rationalize their current or future personal use of marijuana.

If you cant just be an adult and stop smoking, you are a clown. You can piss in the wind all you want about how fair the world is, but in the end the rules are the rules.

 

[Ionian]

Anyone in the healthcare profession who is trying to rationalize their current or future personal use of marijuana.

If you cant just be an adult and stop smoking, you are a clown. You can piss in the wind all you want about how fair the world is, but in the end the rules are the rules.

Yeah, go tell that to any physician, but instead refer to drinking.

Many physicians don't have a problem with drinking, but do drink, tell them to grow up and see what that gets you.

Okay, now, do you see how stupid it is to tell those physicians that smoke to grow up?
F you for judging me on my drug of choice while you sit their intoxicated like a child off some byproduct from a goddamn yeast.

A drug is a drug, smoking is childish, but drinking is okay? You're an idiot.

 

[gregoryhouse]

Anyone in the healthcare profession who is trying to rationalize their current or future personal use of marijuana.

If you cant just be an adult and stop smoking, you are a clown. You can piss in the wind all you want about how fair the world is, but in the end the rules are the rules.

So being an adult means we should blindly follow rules?

You don't even have to be a drug user to realize that the war on drugs, especially marijuana is a waste of government resources.

 

[touchpause13]

If you can't figure out how to pass a drug test and you smoke weed you are a clown. Seriously it's not that difficult.

 

[ChrisGriffen]

Yeah, go tell that to any physician, but instead refer to drinking.

Many physicians don't have a problem with drinking, but do drink, tell them to grow up and see what that gets you.

Okay, now, do you see how stupid it is to tell those physicians that smoke to grow up?
F you for judging me on my drug of choice while you sit their intoxicated like a child off some byproduct from a goddamn yeast.

...... Yea drinking in moderation is not illegal. Marijuana is illegal. See the difference there?

 

[ChrisGriffen]

So being an adult means we should blindly follow rules?

You don't even have to be a drug user to realize that the war on drugs, especially marijuana is a waste of government resources.

being an adult does actually mean there are rules you need to follow regardless of if you disagree or don't understand them.

Or not. Go ahead and get a neck tat and wear sweats to an interview. Just tell the interviewer that you dont think it makes sense that you should have to wear a suit.

 

[Ionian]

...... Yea drinking in moderation is not illegal. Marijuana is illegal. See the difference there?

I can name probably 5 things you do in life that is illegal.

You watch porn, I'm sure you don't pay money for it.

By visiting sites that violate copyright laws and redistribute video products for free which you subsequently (and quite frequently) use, you are committing a crime.

So grow up.

 

[gregoryhouse]

being an adult does actually mean there are rules you need to follow regardless of if you disagree or don't understand them.

Or not. Go ahead and get a neck tat and wear sweats to an interview. Just tell the interviewer that you dont think it makes sense that you should have to wear a suit.

Wow, how did you become such a moral beacon of justice. It must be nice living up on that pedestal. I'm sure you've never done anything illegal. You've never gone over the speed limit?

There is a difference between following rules and following rules blindly just because that's what you were told to do. If no one ever questioned rules then slavery would still be the norm.

You're main argument is that weed is bad because its illegal. So during prohibition drinking alcohol meant you didn't know how to be an adult, but now that its legal drinking alcohol is perfectly compatible with being a respectable adult. Quite an arbitrary line you are drawing.

 

[ChrisGriffen]

And if it came down to potentially losing your license for one of your hospitals required urine porn screening, i would tell you the same thing.

If you are willing to risk your career over something that stupid, you are a clown

 

[ChrisGriffen]

Wow, how did you become such a moral beacon of justice. It must be nice living up on that pedestal. I'm sure you've never done anything illegal. You've never gone over the speed limit?

There is a difference between following rules and following rules blindly just because that's what you were told to do. If no one ever questioned rules then slavery would still be the norm.

You're main argument is that weed is bad because its illegal. So during prohibition drinking alcohol meant you didn't know how to be an adult, but now that its legal drinking alcohol is perfectly compatible with being a respectable adult. Quite an arbitrary
line you are drawing.

I actually am not arguing that weed is bad at all.
I am arguing that you are in a position where using it could end your career.

You could fight it all you want. Tell the judge an your boss that "you don't blidly follow laws". That usually works.

 

[ChrisGriffen]

.