Drug screens for VA externs/practicum students

[erg923]

If you're a VA employee and you're aware that your particular position class is subject to drug screening, and you want to keep your job, it's definitely not exactly what I would call the smartest thing in the world to be doing illegal drugs, particularly cannabis, given it's long detection window in urine. Knowingly using drugs in such a situation is basically professionally self-destructive - which probably tells you why random drug testing of VA employees yields so few actual positive results (I've looked it up).

Few people who take the time to receive the training and experience, and go through the application process to to get a job with the VA, would then knowingly throw away all of that just to get high.

Anyways, obviously, aside from the issue of drug screening, I tend to agree about the ethics issue, also would re-iterate that use (or lack thereof) of such a substance in someone's past, particularly cannabis, tells me very little about a persons competence as a professional. Might give me some idea about their predeliction towards obedience to authority, however.

Were in not for the so-called War on Drugs, I can imagine that this really wouldn't be an issue that it is, and the free market would simply find pretty prosaic ways of satisfying consumer preferences as far as what kind of therapist they might want to receive services from (e.g., therapists who are certified teetotallers, or what have you). However, such is not the way things are.

I assume "cardiologyjosh" is not a psychologist. I would like to point out that this is psychology forum, thus, as a psychologist, the part of this thread that interests me the most is the blanket judgments of other humans from one piece of data. This is big no-no in the psychologist's world. That is, valid assessments/predictions of behavior come from multiple pieces of assessment and/or behavioral data. Predictions of traits or behaviors from one piece of data could be correct, but you are on very shaky empirical ground when you do so.

I, many times, willfully ignore the speed limit on the interstate if I am traveling any signficant distance. I often just set the cruise on 80 and watch for cops. What can we reliably infer from this regarding my abilities and competencies with regards to my job and my community? i think most reasonable people would instinctively say "I dont know, tell me more about this (handsome) speed demon..."

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[ClinicalABA]

I, many times, willfully ignore the speed limit on the interstate if I am traveling any signficant distance. I often just set the cruise on 80 and watch for cops.

Where I live, possession of small amounts of marijuana for personal use is a non-criminal offense. It is a civil infraction (same as speeding), punishable by a fine of $100. Hereabouts, speeding is punishable by a base fine of $100, a $50 head injury trust fund surcharge, and potentially increased fines depending on your speed. For those of you who think it is ethically irresponsible for psychologists to marijuana because of it's illegality, does your opinion still apply to Massachusetts? If so, does it also apply to speeding/unsafe driving (which have major financial and public health costs?

As an aside, I once got a speeding ticket on my way to work- 42 in a 35mhp zone. $100 fine, plus $50 dollar head injury trust fund surcharge. Thing is, my job at the time was director of a school for students with Brain Injury. By some of the logic here, I guess I should've resigned.

On a similar vein, they should they have let me teach the social skills groups?
I've also done behavioral marital therapy. I guess the success of this treatment is suspect, because I'm pretty sure one of it's originators (Jacobson) had been divorced at least once!

Back to the OP. I live in a VA town, and associate with a lot of VA clinical employees. They are subject to random drug testing (though none report ever having been randomly chosen for testing). If you want to work at a place that tests for and takes action against pot use, don't use pot. If you want to use pot, don't work at a place that tests for and takes action against pot use.

 

[Psychadelic2012]

Sounds reasonable, I wouldn't want that either. Is this another tangent from the subject of drug testing?

MY post on wanting a sober psychologist is the ONE that is accused of being a tangent from drug testing?!

Edit: You all do know that there are many, many other drugs besides THC on the panels of those drug screens...right?? I mean, really. Leave it to the potheads to defend their weed to the death without considering that any other substances even exist or cause issues in professional settings!

 

[erg923]

As an aside, I once got a speeding ticket on my way to work- 42 in a 35mhp zone. $100 fine, plus $50 dollar head injury trust fund surcharge. Thing is, my job at the time was director of a school for students with Brain Injury. By some of the logic here, I guess I should've resigned.

On a similar vein, they should they have let me teach the social skills groups?
I've also done behavioral marital therapy. I guess the success of this treatment is suspect, because I'm pretty sure one of it's originators (Jacobson) had been divorced at least once.

From his previous posts, cardiologyjosh appears to be into the straight-edge subculture movement. Now, I love me some Henry Rollins, but it is no secret that many of these folks have very dogmatic views and an infexibility of thought regarding this issue. It would interesting to see someone like this reaction the MI movement that is sweeping through PC medicine.

 

[Pragma]

MY post on wanting a sober psychologist is the ONE that is accused of being a tangent from drug testing?!

I was puzzled by that too. Dare I say, perhaps this person was smokin' somethin'?

I kid, I kid...

 

[Pragma]

From his previous posts, cardiologyjosh appears to be into the straight-edge subculture movement. Now, I love me some Henry Rollins, but it is no secret that many of these folks have very dogmatic views and an infexibility of thought regarding this issue. It would interesting to see someone like this reaction the MI movement that is sweeping through PC medicine.

What was that about not making inferences based on a small subset of observations?

 

[ClinicalABA]

From his previous posts, cardiologyjosh appears to be into the straight-edge subculture movement. .

Nah- I think he's just a "square."

Now, I love me some Henry Rollins, but its no secret that many of these folks have very dogmatic views and an infexibility of thought regarding this issue.

Yes, but Ian MacKaye made some great music!

 

[erg923]

What was that about not making inferences based on a small subset of observations?

You can. You know that. We do it everyday as psychologists. I said it was shaky ground to do so. I admit i could be wrong.

I still maintain I would like to see that poster's reaction to MI though...

 

[CardiologyJosh]

.

 

[KillerDiller]

MY post on wanting a sober psychologist is the ONE that is accused of being a tangent from drug testing?!

Edit: You all do know that there are many, many other drugs besides THC on the panels of those drug screens...right?? I mean, really. Leave it to the potheads to defend their weed to the death without considering that any other substances even exist or cause issues in professional settings!

True, but the issue is that other drugs (specifically the more "hardcore" drugs like cocaine and heroin) pass through the system at a much faster rate than fat-soluble cannabis. Unless very recent use of one of these is suspected, drug testing amounts to screening for pot. I'm personally against screenings because of cost. I don't think it's worth it for the government to pay for all this drug testing just to weed out a few employees who occasionally smoke weed and who are otherwise, apparently, performing up to par.

 

[JeyRo]

MY post on wanting a sober psychologist is the ONE that is accused of being a tangent from drug testing?!

Edit: You all do know that there are many, many other drugs besides THC on the panels of those drug screens...right?? I mean, really. Leave it to the potheads to defend their weed to the death without considering that any other substances even exist or cause issues in professional settings!

I'm sorry, I was assuming you were aware that routine urine drug screens (e.g., such as the SAMSHA 5 panel) typically only screen for a few classes of drugs - typically opiates, amphetamines, cocaine, PCP, and cannabinoids.

Of all of those drug classes, the cannabinoid class has the longest detection window and is overwhelmingly the most popular illicit drug. Given those two facts, I think it's fair to understand random drug testing as it's typically practiced in this country as, practically speaking, a test of whether you've smoked pot 2-4 weeks prior to being screened (depending on metabolism, frequency of use, etc). It's a cannabis test.

Also not a particularly good test for sobriety either. Random performance tests (perhaps administered by psychologists!) would make much more sense, I would think.

 

[JeyRo]

True, but the issue is that other drugs (specifically the more "hardcore" drugs like cocaine and heroin) pass through the system at a much faster rate than fat-soluble cannabis. Unless very recent use of one of these is suspected, drug testing amounts to screening for pot. I'm personally against screenings because of cost. I don't think it's worth it for the government to pay for all this drug testing just to weed out a few employees who occasionally smoke weed and who are otherwise, apparently, performing up to par.

My understanding is that the trend for a while in the US has been for private industry to move away from random drug screening of their employees for this very reason. The cost-benefit analysis really doesn't justify it - it seems to be a waste of money.

 

[JeyRo]

Wrong. In college I was the king of my fraternity; you are free to make any and all inferences from that. Point is, as I enter the healthcare field, I make a personal sacrifice, so as to lead by an example.

You make it sound like you've joined the Army.

 

[ClinicalABA]

Wrong.

As most of usually are when trying to make big judgements based on limited data (even if we were only joking, as evidenced by the winky face).

In college I was the king of my fraternity; you are free to make any and all inferences from that.

You got me beat- my highest rank in my fraternity was Song Master (you are free to make any and all inferences from that!)

Point is, as I enter the healthcare field, I make a personal sacrifice, so as to lead by an example.

Leading by example is admirable, if for no other reason than hypocrisy is disgusting. However, believing that every decision you make in your private life is important to your patients might be little narcissistic. Believing that your patients are not able to distinguish the decisions you make for yourself from the decisions they make for themselves may be selling them a little short. All that said, smoking pot if you're going to be drug tested is stupid, and showing up to work impaired is irresponsible (regardless of the job or field).

 

[Psychadelic2012]

Unless very recent use of one of these is suspected, drug testing amounts to screening for pot. I'm personally against screenings because of cost. I don't think it's worth it for the government to pay for all this drug testing just to weed out a few employees who occasionally smoke weed and who are otherwise, apparently, performing up to par.

It's a cannabis test. Also not a particularly good test for sobriety either. Random performance tests (perhaps administered by psychologists!) would make much more sense, I would think.

Right, unless tests are given randomly at which point the employer would have some evidence that the employee has a problem with even pills or something (they don't have to be shooting heroin), if something other than THC shows up. Otherwise, I find this casual flippant attitude about weed to be very immature. It's more than just doing something every once in a while that has no long-term addiction potential. I feel the same way about alcohol, smoking, junk food, and sleep habits. People should take care of themselves and employers, if they are watching for such things, might then have an obligation to educate their workers on the importance of a healthy lifestyle so that they can perform. There are healthier ways (both personally and globally) to relax than smoking weed, if that's the argument, which is what we ought to be teaching our clients as well. Sorry if that sounds like a soapbox, but I practice what I preach and I mean it. You don't have to, but other professionals might, so it's a matter of finding where you belong and who fits with your worldview professionally.

 

[roubs]

In a profession that is often called on to be the arbiter of when a habit becomes a problem I find it disturbing that some see the only way to remain in a "healthy lifestyle" is to totally abstain from tobacco, alcohol, THC, junk food, staying up late(!?!).

 

[CardiologyJosh]

.

 

[JeyRo]

Right, unless tests are given randomly at which point the employer would have some evidence that the employee has a problem with even pills or something (they don't have to be shooting heroin), if something other than THC shows up.

Certainly if a person was actually drug-dependent then they would potentially get nabbed by a random test. Again, happens very rarely and doesn't seem to justify the cost of such programs, but that's just my understanding.

However, my point still stands, regardless of whether the tests are random or not, the issue of base rates of use in the population, and detection windows, simply dictate that standard urine drug screens are, for all practical purposes, a test of whether someone has used cannabis in the previous few weeks.

Otherwise, I find this casual flippant attitude about weed to be very immature.

Excuse me? Since when is trying to discuss this issue in a rational fashion "casual" or "flippant"? I've pointed out more than a few times that peoples jobs, livelihoods, and even personal safety are being threatened if they use cannabis, particularly if they work in a job that does random drug testing. This is absolutely a deadly serious issue. What I take objection to is the flippant attitude many others seem to be taking here towards thinking critically about the subject of substance use.

The vast majority of cannabis users (again, cannabis being what these drug screens overwhelming detect), much like alcohol users, appear to use these substances responsibly, and their health doesn't appear to be negatively affected by such use, and may in some cases be enhanced by it. This is a fact. If you find that "casual" or "flippant" that I simply state such a fact and don't clip the proverbial red ribbon on my chest and join in with the soapbox crowd, so be it.

It's more than just doing something every once in a while that has no long-term addiction potential. I feel the same way about alcohol, smoking, junk food, and sleep habits. People should take care of themselves and employers, if they are watching for such things, might then have an obligation to educate their workers on the importance of a healthy lifestyle so that they can perform.

Random drug testing isn't "educating... workers on the importance of a healthy lifestyle" and moreover, I think as an employer you can certainly feel free to offer whatever services you want to your employees for their benefit, or require random drug testing, or loyalty oaths, or whatever. However, it seems a little silly to me to be offering education to highly trained, highly educated, adult professionals like psychologists or physicians as to what constitutes a "healthy lifestyle" - they pretty much all already know what that looks like to them, and either they practice it or they don't.

There are healthier ways (both personally and globally) to relax than smoking weed, if that's the argument, which is what we ought to be teaching our clients as well. Sorry if that sounds like a soapbox, but I practice what I preach and I mean it.

Good for you. Really. Do what makes you feel good about yourself or makes sense in your practice. Really not for me to say otherwise about you.

You don't have to, but other professionals might, so it's a matter of finding where you belong and who fits with your worldview professionally.

 

[JeyRo]

In a profession that is often called on to be the arbiter of when a habit becomes a problem I find it disturbing that some see the only way to remain in a "healthy lifestyle" is to totally abstain from tobacco, alcohol, THC, junk food, staying up late(!?!).

Apparently the standard being argued for here in terms of being a properly competent, ethical healthcare professional is to look upon being licensed as somewhat of a cross between enlisting in the Army and becoming a monk.

 

[JeyRo]

All that said, smoking pot if you're going to be drug tested is stupid, and showing up to work impaired is irresponsible (regardless of the job or field).

Really that's the only sensible moral of the story.

 

[ClinicalABA]

Random drug testing isn't "educating... workers on the importance of a healthy lifestyle"

...particularly when a diabetic, Dorito taco eating employee with a BP of 160 over 100 would "pass" the random test. Seems to me (and I have no research to back this up) that if you really want to pick out the people with drug problems (or at least piss-poor decision making capabilities) do announced testing. Tell them that they are going to be tested in one month. If they then don't pass, perhaps you know a little more about them (though what you know may not be a valid indicator/predictor of work performance).

 

[erg923]

.Dorito taco eating.

Ha! My wife's sister swears by these things. Its genius from profit margin perspective. Add 10 cents worth or Doritos, charge 1 dollar more than normal taco!

 

[JeyRo]

Ha! My wife's sister swears by these things. Its genius from profit margin perspective. Add 10 cents worth or Doritos, charge 1 dollar more than normal taco!

Doritos were to no small degree a reason why I gained so much weight during my out-of-state internship and postdoc.

 

[erg923]

Point is, as I enter the healthcare field, I make a personal sacrifice, so as to lead by an example.

Noble, obviously. But have to agree that there is more than a touch of narcissism there to 1.) believe that all your actions are the business of your patients 2.) that they can't distinguish your actions from their own. 3. That they would even care (the last one might be more of political thing, but I could generally give less than a **** if my dentist fires-up doobies at his Saturday night swingers parties).

Moreover, the idea of the doctor/psychologist/healer (or whatever) as superhuman and that they need to/should conquer all temptations that those we treat are subject to is a slippery slope that has implications for your own emotional health and for the profession in general.

I also have to agree that the "leading by example thing" has it place, but also has a strange "appeal to authority" feel to it (similar to how the military runs things) that flows against the tide in which modern medicine is currently headed. That is, a more patient centered approach that seeks to meet the patient at the stage of change where they currently are (transtheoretical model) and to decrease the "I know what's best for you, do as I say and as I do" model of treatment.

 

[Pragma]

In a profession that is often called on to be the arbiter of when a habit becomes a problem I find it disturbing that some see the only way to remain in a "healthy lifestyle" is to totally abstain from tobacco, alcohol, THC, junk food, staying up late(!?!).

Well that is one perspective. I just think that, in a profession that is so often called to assess the use/abuse of illegal drugs in individuals, it is probably a good idea if the people in that profession are not engaged in illegal drug use. I also think that most licensing boards and professional organizations would agree with me here.

 

[Pragma]

Noble, obviously. But have to agree that there is more than a touch of narcissism there to 1.) believe that all your actions are the business of your patients 2.) that they can't distinguish your actions from their own. 3. That they would even care (the last one might be more of political thing, but I could generally give less than a **** if my dentist fires-up doobies at his Saturday night swingers parties).

Moreover, the idea of the doctor/psychologist/healer (or whatever) as superhuman and that they need to/should conquer all temptations that those we treat are subject to is a slippery slope that has implications for your own emotional health and for the profession in general.

I also have to agree that the "leading by example thing" has it place, but also has a strange "appeal to authority" feel to it (similar to how the military runs things) that flows against the tide in which modern medicine is currently headed. That is, a more patient centered approach that seeks to meet the patient at the stage of change where they currently are (transtheoretical model) and to decrease the "I know what's best for you, do as I say and as I do" model of treatment.

I don't really think it is narcissism. I just don't think that a psychologist should engage in illegal behavior as a licensed professional.

You can beat me to death wtih slippery slope "speeding ticket" arguments all that you want, but I think if you engage in illegal drug use for recreation, your clinical judgment of people who engage in illegal drug use is hypocritical. If I binge drink all the time and then go in to assess a patient for alcohol dependence treatment, same issue. But when the behavior is legal, it is much more of a grey area to me than when it is illegal. If pot were legal and regulated, I'd feel the same way I do about it with alcohol.

We are talking about substance use and abuse here, one of the most prevalent and costly problems in our society. Not to mention that impaired physicians/psychologists present a major threat to the health of patients and healthcare in general, given the status we are afforded within the system. That people argue so vehemently that psychologists should be able to toke up and no one should care is beyond me. I guess I am dogmatic and inflexible. I'd rather be labeled that and be on this side of that argument.

 

[paramour]

Funny that you bring up binge drinking. I know some folks who deride their clients for smoking pot "rarely" to "occasionally." These clients must have a substance abuse/dependence issue, but the clinicians go out binge drinking multiple times on a weekly basis and do . . . questionable things while under the influence.

Then they wonder why their clients won't open up to them.

 

[Qwerk]

If I binge drink all the time and then go in to assess a patient for alcohol dependency treatment, same issue. But when the behavior is legal, it is much more of a grey area to me than when it is illegal.

Substance abuse programs typically assist those who suffer from chronic use of hard drugs like heroin and cocaine, not pot. Apples to oranges. As someone stated earlier in this forum, it would be like saying that someone who works with recovering alcoholics (and is not a a recovering alcoholic themselves) shouldn't drink wine with dinner. We're not talking about binge drinking or smoking pot at work. We're talking about responsible, occasional use.

I'm curious why you think the illegality of the substance contributes to the harm. Do you think it would be okay for a clinician in Amsterdam to smoke legally-obtained weed on the weekend?

Not to mention that impaired physicians/psychologists present a major threat to the health of patients and healthcare in general, given the status we are afforded within the system.

Did anyone in the thread say that clinicians should be able to smoke at work, or come to work high? No. Just as no responsible clinician would down a few cocktails before going to work, no responsible clinician should get high in a way that affects his/her job performance.

You've mentioned the supposed harm that pot causes many times in this thread, but vaguely, and you've lumped it in with other (more harmful) drugs. Can you expand on this harm in specific language? If a clinician smoked weed on Friday evening and then came into work on time and not high on Monday, what concrete, specific harm would he/she be doing to his/her patients? What actual harm do you believe that pot -- distinct from other drugs -- causes?

(edited for misapplied quote tag)

 

[erg923]

That people argue so vehemently that psychologists should be able to toke up and no one should care is beyond me. I guess I am dogmatic and inflexible.

Sure people can care. But I guess I don't view myself as a superhuman who needs to stand as an example or as a absoloute model of health/mental health outside my working hours. I'm just a man, same as you ya know. Don't delude yourself into thinking that your degree or license makes you into to something fancy. You have a special and important job, no doubt, but let's tone down the histrionics and narcissism. I think we are putting ourselves on a bit of off-putting pedestal here, something physicians and clinical psychs are notorious for anyway.

Also, I'm not sure I get the focus you have on the license part here. What's up with that? It's a license to practice a profession, man. Not life. Like the WAIS question, "why do some professions require a license to practice." The 2 point response is to protect the person who seeks the professional services from being harmed- - to ensure competence of the professional service provider. Its about the service delivery. There's nothing in there about making sure that those practicing serve as role models of perfect health behavior for the patient- -To ensure that your provider always makes sounds choices otuside the office. No. Thats not the purpose of being a licesned provider.

 

[Pragma]

Funny that you bring up binge drinking. I know some folks who deride their clients for smoking pot "rarely" to "occasionally." They must have a substance abuse/dependence issue, but they go out binge drinking multiple times on a weekly basis and do . . . questionable things while under the influence.

Then they wonder why their clients won't open up to them.

Well this is a big problem! Now, I am sure that some people would say - "see - people drink so why can't they smoke? Just cuz' it's illegal?" The hypocrisy of the pot/alcohol debate isn't even a debate to me. They both can cause problems. One just happens to be legal.

There are guild ethics here people! To me, it goes like this: 1) Don't do anything illegal. 2) Then, out of the things that are legal, don't do things that are going to impair your clinical judgement. I think that active monitoring of the use of alcohol among trainees and psychologists is also quite important. I have known people have gotten into trouble for coming in to a healthcare job hungover. Alcohol is socially accepted when done in moderation, but it carries a huge stigma when you are perceived as someone who has trouble with it.

 

[Pragma]

Sure people can care. But I guess I don't view myself as a superhuman who needs to stand as an example or as a absoloute model of health/mental health outside my working hours. I'm just a man, same as you ya know. Don't delude yourself into thinking that your degree or license makes you into to something fancy. You have a special and important job, no doubt, but let's tone down the histrionics and narcissism. I think we are putting ourselves on a bit of off-putting pedestal here, something physicians and clinical psychs are notorious for anyway.

Also, I'm not sure I get the focus you have on the license part here. What's up with that? It's a license to practice a profession, man. Not life. Like the WAIS question, "why do some professions require a license to practice." The 2 point response is to protect the person who seeks the professional services from being harmed- - to ensure competence of the professional service provider. Its about the service delivery. There's nothing in there about making sure that those practicing serve as role models of perfect health behavior for the patient- -To ensure that your provider always makes sounds choices otuside the office. No. Thats not the purpose of being a licesned provider.

You lost me here, Erg

I never argued for serving as role models. I argued against illegal activity, particularly with something like substance abuse, which we are supposed to asses.

 

[AnnoyedByFreud]

I'm surprised so many people care about what their healthcare provider does in their own free time. I do not care if my GP occasionally smokes pot, drinks wine, eats doritos, even stays up late! They have their own life. As long as they're not impaired when they're at work, what does it even matter? How is that any of my business?

I agree that an addictions counselor who is currently addicted to a drug is a bad situation, and I could see advocating for drug testing in that circumstance. But others seem to argue that an addictions counselor can't work with a heroin addict because they themselves smoke pot on rare occasions, which strikes me as utterly ridiculous. I feel like the legality of the drug gets conflated with the actual harm caused by occasional use.

 

[Pragma]

I'm curious why you think the illegality of the substance contributes to the harm. Do you think it would be okay for a clinician in Amsterdam to smoke legally-obtained weed on the weekend?

I think that a professional who will willingly engage in an illegal activity, knowing the consequences, probably has a lot more problems with narcissim/histrionics than what I have heard thrown around this thread recently.

If you take on a role where you indicate that you won't engage in such activity and still do it anyway, is there a problem with your clinical judgment? I think so. It is an ethical issue IMHO, and that is my main reason for suggesting that (gulp), people do not break the law and go smoke pot.

As I mentione din an earlier post, if pot were legal and regulated, I'd feel differently about this (much as I feel about how people should watch their alcohol consumption as a professional. Wouldn't it be great to run into your psychologist puking outside of a bar at 3AM on a weekend night, or showing up to therapy with booze on their breath?).

With regard to other harmful effects, I do have an issue with people contributing to the illegal drug trade by purchasing weed, but that is less salient of an issue to me than one's overall judgment as a psychologist. The research on long-term effects of pot is varied, and I wouldn't suggest that it causes more impairment than many legal substances. but it is more of an unkown quantity because of the fact it is illegal (e.g., drug purity/laced with other stuff). This really isn't my main argument against psychologists smoking weed (or doing other illegal drugs), although i have to say, most of the people I know who still smoke weed or use illegal drugs aren't exactly "recreational" users.

I recognize that this debate stirs up a lot of political feelings. I'm not trying to to be political - I am trying to argue why I don't think psychologists should be using illegal drugs. That's it.

 

[Pragma]

I'm surprised so many people care about what their healthcare provider does in their own free time. I do not care if my GP occasionally smokes pot, drinks wine, eats doritos, even stays up late! They have their own life. As long as they're not impaired when they're at work, what does it even matter? How is that any of my business?

I agree that an addictions counselor who is currently addicted to a drug is a bad situation, and I could see advocating for drug testing in that circumstance. But others seem to argue that an addictions counselor can't work with a heroin addict because they themselves smoke pot on rare occasions, which strikes me as utterly ridiculous. I feel like the legality of the drug gets conflated with the actual harm caused by occasional use.

What about a psychologist who shoots up heroin "on occasion and recreationally" working with someone addicted to pot?

I mean, the amount of examples here are ridiculous. Yes, I recognize some of you are saying "pot is different" but you'll meet people who say the same about other substances as well.

I expect that my physicians don't use illegal drugs. If i found out they did, I wouldn't want them to be my physician.

 

[AnnoyedByFreud]

What about a psychologist who shoots up heroin "on occasion and recreationally" working with someone addicted to pot?

I mean, the amount of examples here are ridiculous. Yes, I recognize some of you are saying "pot is different" but you'll meet people who say the same about other substances as well.

I expect that my physicians don't use illegal drugs. If i found out they did, I wouldn't want them to be my physician.

What about a counselor who is working with an alcoholic but also enjoys having a few drinks when they go out? Is it the actual substance or the legality that is the issue? Alcohol is far more damaging than marijuana, yet we seem to have no issue with occasional drinking.

Also, pot is different. It doesn't matter if people say that about other drugs, research shows that pot is pretty much harmless (in terms of physical effects on the body) and is not physically addictive. This is especially true if it's not smoked, but ingested orally. It could be psychologically addictive, but then again, so can pretty much anything. Also, the reason pot keeps getting singled out is because drug-testing goes after pot smokers in particular.

 

[roubs]

What about a psychologist who shoots up heroin "on occasion and recreationally" working with someone addicted to pot?

I mean, the amount of examples here are ridiculous. Yes, I recognize some of you are saying "pot is different" but you'll meet people who say the same about other substances as well.

I expect that my physicians don't use illegal drugs. If i found out they did, I wouldn't want them to be my physician.

"Pot is different" aka "it's use carries minimal harm potential" aka "less harm potential than alcohol" is more than something "people say" -- it's a conclusion with a consensus of empirical support behind it.

I think it's dogmatic to dump your physician or dentist upon finding out they toke up on the weekends. Heroin on the weekends? There's basically a lot more evidence in the other direction.

 

[Pragma]

What about a counselor who is working with an alcoholic but also enjoys having a few drinks when they go out? Is it the actual substance or the legality that is the issue? Alcohol is far more damaging than marijuana, yet we seem to have no issue with occasional drinking.

Also, pot is different. It doesn't matter if people say that about other drugs, research shows that pot is pretty much harmless (in terms of physical effects on the body) and is not physically addictive. This is especially true if it's not smoked, but ingested orally. It could be psychologically addictive, but then again, so can pretty much anything. Also, the reason pot keeps getting singled out is because drug-testing goes after pot smokers in particular.

First point I addressed earlier in the thread

Second point is simply not true. Check out NIDA's summary documents.

 

[Pragma]

"Pot is different" aka "it's use carries minimal harm potential" aka "less harm potential than alcohol" is more than something "people say" -- it's a conclusion with a consensus of empirical support behind it.

I think it's dogmatic to dump your physician or dentist upon finding out they toke up on the weekends. Heroin on the weekends? There's basically a lot more evidence in the other direction.

Agree to disagree here.

 

[ClinicalABA]

if you engage in illegal drug use for recreation, your clinical judgment of people who engage in illegal drug use is hypocritical.

If your clinical judgement is based upon a belief or espouses the position that nobody, ever, should smoke/drink/etc., then you are being hypocritical if you smoke/drink/etc. If your clinical judgement is based upon a belief and espouses the position that the client, given her/his current circumstances, history, etc., shouldn't smoke/drink/etc., you are not being hypocritical if you smoke/drink/etc. unless you have the same current circumstances, history, etc. as the client.

For example, let's say I am working in a college setting with a 20 y.o. client who has been arrested for possession of marijuana, but was given a 6 months-continuance , contingent upon completing counseling and staying out of trouble (i.e.- no arrests for 6 months, and all charges are dropped). Furthermore, let's say this client is a student in the forestry department, with a goal of federal job as a Park Ranger (difficult to unattainable with certain criminal records). Now, this client describes a history of not being able to refrain from smoking pot when he drinks, as well as poor judgement and impulse control when drinking/smoking. My treatment might entail helping this client develop the skills and a plan to refrain from any drinking or smoking, on the grounds that he has a history of getting in trouble with drugs/alcohol, and the consequences of getting in trouble again might be significant (e.g. criminal record; inaccessible career options). I would certainly recommend that this client have a goal of total abstinence, based on his situation. I would not have the same goal for myself, as the situation is different. Me having a few drinks, or even taking a few hits, would not be hypocritical solely based on my recommendation to this client (which is not to say that it wouldn't be illegal, immoral, or unethical in a non-APA code way).

If your clinical judgement is impaired because of your own smoking/drinking/etc., or is unduly influenced by your opinions on what people in general should do, irrespective of your client's individual circumstances/history and without regard to the relevant empirical evidence, then you are being unethical (c.f. APA ethical principle 2.06). If you put yourself out there as a bastion of perfection, yet knowingly act in non-perfect way, you are a hypocritical jerk (but may not necessarily be unethical).

 

[AnnoyedByFreud]

First point I addressed earlier in the thread

Second point is simply not true. Check out NIDA's summarydocuments.

Oh, wow. Okay, well NIDA isn't exactly a good source for non-biased information, since they are of the attitude that pot must be kept illegal under all circumstances. Actual research done on marijuana shows it to be pretty much innocuous. I can see that you're not going to budge on this issue, but truly, you might want to have a look at the literature yourself.

 

[roubs]

Oh, wow. Okay, well NIDA isn't exactly a good source for non-biased information, since they are of the attitude that pot must be kept illegal under all circumstances. Actual research done on marijuana shows it to be pretty much innocuous. I can see that you're not going to budge on this issue, but truly, you might want to have a look at the literature yourself.

I find it interesting that the NIDA page that links to "Where can I get more scientific information on marijuana?" links ONLY to other .gov sites.

 

[Pragma]

Oh, wow. Okay, well NIDA isn't exactly a good source for non-biased information, since they are of the attitude that pot must be kept illegal under all circumstances. Actual research done on marijuana shows it to be pretty much innocuous. I can see that you're not going to budge on this issue, but truly, you might want to have a look at the literature yourself.

OK, I guess I will take your word for it that the empirical literature suggests that smoking pot is completely harmless.

No offense, but I do read this stuff (wrote my dissertation in a related area) and I do not think pot is all that bad. But I think it is bad for psychologists to use illegal drugs. Able to grasp that?

 

[JeyRo]

I think it's dogmatic to dump your physician or dentist upon finding out they toke up on the weekends.

But then, who are we or anyone else to begrudge people's bona-fide consumer preferences? Like I said, I can imagine a situation where the market could easily sort such an issue out, if given a chance. If I was operating in a private practice situation I certainly would decline if a potential client requested a drug test from me as a condition of hiring me as their therapist. However, if a patient wanted to pay me a premium on top of my standard fee in order to get a drug test from me, I might consider it.

If there was enough latent consumer demand out there for teetotalling therapists, I could imagine a voluntary system of healthcare provider certification springing up to meet the needs of thusly concerned citizens ("go with our certified 100% drug free therapists! For an extra 10 dollars per session we offer caffeine-free therapists as well!")

However, I don't suspect that there's much of a demand out there. Most people just want their therapists or healthcare providers to be competent, attentive, and caring, and aren't interested in prying into their private business. For the most part people respect each other and are reasonable about this sort of thing. It's only when government gets involved that people start going kind of crazy about this issue. Just one psychologists' opinion.

 

[Qwerk]

There are guild ethics here people! To me, it goes like this: 1) Don't do anything illegal.

I don't think this is anywhere in your code of ethics. (I'm going to assume you're a clinical psychologist or psych student.) I don't think it's anywhere in my own code of ethics (social work) either.

The APA code of ethics does say this:

a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.(b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance and determine whether they should limit, suspend or terminate their work-related duties. (See also Standard 10.10, Terminating Therapy.)

And the NASW code says this:

(a) Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility. (b) Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others.

In other words, it's not wrong to practice while being treated for a mental illness/substance abuse, grieving for a family member, or experiencing legal difficulties. It is, however, wrong to let personal difficulties or mental health issues interfere with professional responsibilities. I agree -- I would not want to be treated by a clinician experiencing major difficulties with marijuana or alcohol, or who could not abstain during work hours. (Same with personal problems -- I wouldn't want to work with someone who brought up his/her divorce every few minutes.) However, I wouldn't fault a clinician for engaging in recreational marijuana use, even if it broke the law, as long as they were otherwise competent. You keep bringing up clinicians coming to work high or having alcohol on their breath, but it simply doesn't apply here -- we're not talking about problem use or use during work.

Honestly, this might have to do with the differences between our professions. Social work has traditionally been friendly to civil disobedience -- not to mention that it's traditionally a hippie occupation.

Pragma, did you think about the question I asked in a previous post about legality? If marijuana were legalized tomorrow (or if we lived in a country in which it was legal), would your position change?

 

[JeyRo]

OK, I guess I will take your word for it that the empirical literature suggests that smoking pot is completely harmless.

No offense, but I do read this stuff (wrote my dissertation in a related area) and I do not think pot is all that bad. But I think it is bad for psychologists to use illegal drugs. Able to grasp that?

A functioning market for mental health care services, I would think, would potentially be able to meet any number of reasonable consumer demands, such as the demand that my psychologist refrains from illegal drug use, or alcohol use, or whatever.

 

[Pragma]

But then, who are we or anyone else to begrudge people's bona-fide consumer preferences? Like I said, I can imagine a situation where the market could easily sort such an issue out, if given a chance. If I was operating in a private practice situation I certainly would decline if a potential client requested a drug test from me as a condition of hiring me as their therapist. However, if a patient wanted to pay me a premium on top of my standard fee in order to get a drug test from me, I might consider it.

If there was enough latent consumer demand out there for teetotalling therapists, I could imagine a voluntary system of healthcare provider certification springing up to meet the needs of thusly concerned citizens ("go with our certified 100% drug free therapists! For an extra 10 dollars per session we offer caffeine-free therapists as well!")

However, I don't suspect that there's much of a demand out there. Most people just want their therapists or healthcare providers to be competent, attentive, and caring, and aren't interested in prying into their private business. For the most part people respect each other and are reasonable about this sort of thing. It's only when government gets involved that people start going kind of crazy about this issue. Just one psychologists' opinion.

Sure...but i think that many consumers operate under the assumption that their health care providers aren't taking illegal drugs, either. Until this thread, I guess I didn't think that was an unreasonable assumption, but now I am beginning to question that.

 

[JeyRo]

Sure...but i think that many consumers operate under the assumption that their health care providers aren't taking illegal drugs, either. Until this thread, I guess I didn't think that was an unreasonable assumption, but now I am beginning to question that.

I personally think most people just don't care enough to even think about it one way or the other.

EDIT: And of course, you know what they say about assuming. It makes an ass out of Uma Thurman.

 

[Pragma]

I don't think this is anywhere in your code of ethics. (I'm going to assume you're a clinical psychologist or psych student.) I don't think it's anywhere in my own code of ethics (social work) either.

The APA code of ethics does say this:
And the NASW code says this:

In other words, it's not wrong to practice while being treated for a mental illness/substance abuse, grieving for a family member, or experiencing legal difficulties. It is, however, wrong to let personal difficulties or mental health issues interfere with professional responsibilities. I agree -- I would not want to be treated by a clinician experiencing major difficulties with marijuana or alcohol, or who could not abstain during work hours. (Same with personal problems -- I wouldn't want to work with someone who brought up his/her divorce every few minutes.) However, I wouldn't fault a clinician for engaging in recreational marijuana use, even if it broke the law, as long as they were otherwise competent. You keep bringing up clinicians coming to work high or having alcohol on their breath, but it simply doesn't apply here -- we're not talking about problem use or use during work.

Honestly, this might have to do with the differences between our professions. Social work has traditionally been friendly to civil disobedience -- not to mention that it's traditionally a hippie occupation.

Pragma, did you think about the question I asked in a previous post about legality? If marijuana were legalized tomorrow (or if we lived in a country in which it was legal), would your position change?

No the ethics code doesn't say "don't smoke weed." But my reading of the general principles suggests that refraining from illegal activity is implied, unless it is in conflict with ethical principles.

I answered your question about legality. I said I would view legalized pot similar to how I view alcohol - still a potential problem for clinicians to use and something to be extremely careful not to abuse. My problem is with people thinking they know better and can break the law. I think that's a problem, and to be honest, I have never heard anyone out there professionally (until this thread) suggesting that they should be able to smoke weed as a psychologist.

I'm surprised at how many people must be putting themselves/their careers at risk, and I question the maturity and competence of someone who knowingly breaks the law because they want to get high, no matter how benign it is, as a psychologist.

 

[erg923]

I'm surprised at how many people must be putting themselves/their careers at risk, and I question the maturity and competence of someone who knowingly breaks the law because they want to get high, no matter how benign it is, as a psychologist.

Just to clarify, I don't think anyone here has said that they do. I don't smoke pot. But I don't cause I don't like it, and plus I have exercise-induced asthma, so Its def not good for me there. Its hard on your lungs (unfiltered) and I like to run and genrally stay healthy. I also don't because I'm not willing to put my career on the line (random drug screening at the VA). So my judgment there is sound. But, to not do it because of what my patients might think of me? No, none of their business. The fact that its an "illegal" drug? Um, no. Come on... This is 12 years of catholic school talking here...I'm used to questioning and dismissing nonsensical authority. Thats not gonna stop cause I earned a state license to practice a profession.
.

 

[JeyRo]

Just to clarify, I don’t think anyone here has said that they do. I don’t smoke pot. But I don’t cause I don’t like it, and plus I have exercise-induced asthma, so Its def not good for me there. Its hard on your lungs (unfiltered) and I like to run and genrally stay healthy. I also don’t because I’m not willing to put my career on the line (random drug screening at the VA). So my judgment there is sound. But, to not do it because of what my patients might think of me? No, none of their business. The fact that its an "illegal" drug? Um, no. Come on... This is 12 years of catholic school talking here...I'm used to questioning and dismissing nonsensical authority. Thats not gonna stop cause I earned a state license to practice a profession.
.

I like you more and more, erg....