Lost Residency Spot

[yeasports]

Its almost like an employer, who is giving you a job at their establishment, is setting up everything in their favor with the law on their side to be able to fire you or not hire you on purpose....
Because you tested positive for drugs.

another fun scenario if you care to read:

Local college outreach program for premed students q&a:

Students: Dr. Yeasports what made you want to go into medicine?
Yeasports: typical answer
Students: What was the hardest test: mcat, usmle, specialty boards?
Yeasports: None of the above, the hardest test I took was a drug test! Thank goodness they did a urine test, am I right? Oh and thank goodness they did not do a background check, right? lol
Students: ...

---

Members don't see this ad.

 

[Dr Tapatio]

Arguing about them "changing the rules" on drug testing is pretty much an admission of guilt. People who know they will test negative aren't going to make a huge deal about it. Plus, they can always request a "random" drug test at any time....guess who they are going to pick?

As far as getting sued, the hospital has much deeper pockets than you do, plus that lawsuit is going to drag on for a while before it is settled. And being the person who sued their employer to get out of a drug test is not going to endear you to future employers.

The hair test isn't typically positive for single use of a drug, so it is assumed there was repetitive use over time if it's positive. It catches the chronic users. Which is more concerning to hospitals and employers anyhow.

I mean, you'll be guilty either way. The alternative is to handover the evidence. I'm not saying that this is a clever way to appear innocent. I'm just saying this is the only move you have left.

Of course hospitals have deeper pockets, but they want to avoid lawsuits as much as the next guy. This is why corporations still settle with individuals.

Is there a licensing board that requires you to disclose if you entered a lawsuit? I am honestly asking because I don't know. Besides, we already established you aren't an employee at that point, so I don't know what new employer you'll have to tell that you're suing someone. I have certainly never been asked about lawsuits against other employers

 

[VA Hopeful Dr]

I mean, you'll be guilty either way. The alternative is to handover the evidence. I'm not saying that this is a clever way to appear innocent. I'm just saying this is the only move you have left.

Of course hospitals have deeper pockets, but they want to avoid lawsuits as much as the next guy. This is why corporations still settle with individuals.

Is there a licensing board that requires you to disclose if you entered a lawsuit? I am honestly asking because I don't know. Besides, we already established you aren't an employee at that point, so I don't know what new employer you'll have to tell that you're suing someone. I have certainly never been asked about lawsuits against other employers

If you're honest up front you can usually do OK.

For instance, when you get drug tested it you said something like:

"I was smoking marijuana back home but stopped the day Match results came out and I knew I was moving to a state where it hasn't been made legal at that level so this test might be positive."

There's a decent chance you'll be OK. Not a guarantee, but medicine will forgive a lot if you own up to it before you get caught.

As to your last paragraph, most licensing boards only care about malpractice lawsuits. If you got sued for rear-ending someone, that doesn't usually matter for licensure.

 

[Dr.LeoSpaceman]

Of course hospitals have deeper pockets, but they want to avoid lawsuits as much as the next guy. This is why corporations still settle with individuals.

They want to avoid lawsuits that might lose them money or make them look bad. This is neither of those situations. And you can be fairly sure they wouldn't want to allow a precedent which might give people a method of skipping a pre-employment drug screen. So the idea that they might capitulate in the face of legal action is far fetched.

 

[Dr Tapatio]

If you're honest up front you can usually do OK.

For instance, when you get drug tested it you said something like:

"I was smoking marijuana back home but stopped the day Match results came out and I knew I was moving to a state where it hasn't been made legal at that level so this test might be positive."

There's a decent chance you'll be OK. Not a guarantee, but medicine will forgive a lot if you own up to it before you get caught.

As to your last paragraph, most licensing boards only care about malpractice lawsuits. If you got sued for rear-ending someone, that doesn't usually matter for licensure.

That is a good point. It might be in your best interest to just go to the PD before there is even a test and just own up to it.

They want to avoid lawsuits that might lose them money or make them look bad. This is neither of those situations. And you can be fairly sure they wouldn't want to allow a precedent which might give people a method of skipping a pre-employment drug screen. So the idea that they might capitulate in the face of legal action is far fetched.

You would be surprised. Most places don't want to spend the money or the time dealing with things like this regardless of being right or wrong. Most places prefer to settle. I know this sounds counter-intuitive when you're in the right, but the cost/benefit analysis doesn't always work that way. For example, Michael Jackson settled a case because it would be pennies for him and it would go away, but he was adamant that he was not what he was being accused of. "This will just go away fast" is how the lawyers sold it to him. It could be the case that the program just agrees to just a urinalysis as a compromise. The hospital will likely know that they can't recoup court and lawyer fees from the other person, so it becomes cheaper and easier to compromise. Sure, they have the big pockets to do this, but you don't make money by being "right" but by keeping the money you acquired. You're welcome to believe otherwise, which I understand why you do, but in law, things don't always work out by that hard logic.

 

[Dr.LeoSpaceman]

1) When you have in-house cousel--as many hospitals do--the "cost" of litigating something like this is baked in. The potential additional cost is of they lose...which in this case they would not.

2) Refusing a drug test is a tacit admission that you've used a prohibited substance. It is absolutely in a hospitals best interest to prevent this person from starting their employment, and they would no doubt spend the time and money to prevent it. Why? Because the liability associated with an impaired provider outweighs any of the nuisance factor from dealing with your proposed lawsuit.

 

[Raryn]

That is a good point. It might be in your best interest to just go to the PD before there is even a test and just own up to it.


You would be surprised. Most places don't want to spend the money or the time dealing with things like this regardless of being right or wrong. Most places prefer to settle. I know this sounds counter-intuitive when you're in the right, but the cost/benefit analysis doesn't always work that way. For example, Michael Jackson settled a case because it would be pennies for him and it would go away, but he was adamant that he was not what he was being accused of. "This will just go away fast" is how the lawyers sold it to him. It could be the case that the program just agrees to just a urinalysis as a compromise. The hospital will likely know that they can't recoup court and lawyer fees from the other person, so it becomes cheaper and easier to compromise. Sure, they have the big pockets to do this, but you don't make money by being "right" but by keeping the money you acquired. You're welcome to believe otherwise, which I understand why you do, but in law, things don't always work out by that hard logic.

I can just imagine how this lawsuit goes.

Dr X: "They unjustly fired me. I shouldn't have to submit a drug screen!"

Hospital: "Your honor, Dr. X signed this piece of paper (the contract) that agrees to a pre-employment drug screen, the type of which was not specified. Subsequently, they were informed they must do this drug screen on June N. They refused to do the test, thus voiding their appointment per their contract. Magnanimously, we have decided not to countersue for the expenses incurred due to their noncompliance with the terms of the contract, namely the need to urgently replace them."

Case dismissed.

 

[WheezyBaby]

Just to put it out there before I comment, I'm in favor of nationwide legalization of recreational marijuana use and I'd be fine with a physician who uses treating my family or me, obviously not including active intoxication during work. This is an aside from the topic of OP. Once you are a resident, do not use. All it takes is one bad sequence of events (postcall and "sounding intoxicated", mdm error leading to patient harm, etc) to get yourself into a drug test that will **** you. I hope things work out for OP. I agree it's a stupid mistake but not one I think should be career ending

 

[Dr Tapatio]

I can just imagine how this lawsuit goes.

Dr X: "They unjustly fired me. I shouldn't have to submit a drug screen!"

Hospital: "Your honor, Dr. X signed this piece of paper (the contract) that agrees to a pre-employment drug screen, the type of which was not specified. Subsequently, they were informed they must do this drug screen on June N. They refused to do the test, thus voiding their appointment per their contract. Magnanimously, we have decided not to countersue for the expenses incurred due to their noncompliance with the terms of the contract, namely the need to urgently replace them."

Case dismissed.

If you are a dumb lawyer that is what you'd argue. If you're astute you'd say that they were asking for increasingly invasive testing and that the client was willing to do a urinary test, which is what had been asked of him to begin with

 

[Dr Tapatio]

1) When you have in-house cousel--as many hospitals do--the "cost" of litigating something like this is baked in. The potential additional cost is of they lose...which in this case they would not.

2) Refusing a drug test is a tacit admission that you've used a prohibited substance. It is absolutely in a hospitals best interest to prevent this person from starting their employment, and they would no doubt spend the time and money to prevent it. Why? Because the liability associated with an impaired provider outweighs any of the nuisance factor from dealing with your proposed lawsuit.

1. Doesn't matter if you have in-house counsel. Corporations reach settlements all the time. I remember I knew a guy that slipped in Walmart and put a lawsuit. Walmart gave him $5,000 in exchange for a ban for life at the stores even though they are one of the richest corporations, were in the right and have in house counsel. Do you have any expertise in law?

2. It doesn't matter that you believe it's a tacit admission. The law doesn't work that way. People have certain privacy rights, which is what this person would argue he's entitled to and anything in excess of the urinary test would be a violation

 

[Dr.LeoSpaceman]

People have certain privacy rights

Which only attach once your are an employee. If you can cite a law or decision which prevents pre-employment drug screening based on privacy rights, I'll concede.

In this case, the prospective employee certainly has a right to privacy. But the employer has the right to set conditions to the terms of employment. The employer isn't legally compelling a test. They're asking them to make a choice 1) Take the test or 2) Work somewhere else.

 

[Dr Tapatio]

Which only attach once your are an employee. If you can cite a law or decision which prevents pre-employment drug screening based on privacy rights, I'll concede.

In this case, the prospective employee certainly has a right to privacy. But the employer has the right to set conditions to the terms of employment. The employer isn't legally compelling a test. They're asking them to make a choice 1) Take the test or 2) Work somewhere else.

Sure, lets go with that: Pre-Employment Drug Testing Laws - FindLaw

" Most state statutes also limit the type of testing that may be performed, whether it be through urine, breath, blood, or hair." Also " Maybe you have still have lingering questions after reading this article. Perhaps you want to know more about your rights during the hiring process, particularly your right to privacy. If so, it's a good idea to talk to an experienced employment attorney who can walk you through local employment laws and get you the information you need."

There's always a caveat, and the fact that they told him a urine test then try to change it up with him for a hair test, it seems like deceptive practices. Again, law is more complex than your idea that a company has a right to just do whatever they want and set forth whatever parameters they want. The fact that they changed it up on him is a valid point of contention. If he had denied the hair test, he could argue that he would have agreed to the urine test but now his privacy rights are in question once they try to covertly change them on him.

 

[Dr.LeoSpaceman]

There's always a caveat, and the fact that they told him a urine test then try to change it up with him for a hair test, it seems like deceptive practices.

Well of course, if the employer is asking for a type of test prohibited by state law then there is an issue. But that wasn't your suggestion, nor was there an indication that it was at play in this situation. Refusing a test which is otherwise permitted by state law means you will have your offer rescinded. (And to note, the vast majority of state do allow hair testing.)

It doesn't matter if it seems like deceptive practices. Is it a dick move? Probably. But being a dick is unfortunately not always legally actionable. Unless the written contract specified UDS, you're at their mercy of whatever test they decide to use when you show up. That being the case, the wise thing is simply to make sure you can/will pass any of them.

There wasn't anything covert in this situation. Covert would be if they secretly grabbed a piece of hair while you were doing the UDS and didn't say they were doing a hair test. And again, employee privacy rights don't apply as you aren't an employee prior to completion of the hiring process.

 

[spartan25]

I was on a golf course with a couple of guys I didn't know whom I was paried up with in a 4-some. Half way through, they pulled out a glass pipe and started smoking crack and offered me some.

There’s 0% chance that these guys were playing golf and smoking crack. It was probably a run-of-the-mill glass pipe for weed. Although it’s interesting imagining a posh group of old white men passing around a crack pipe in between hitting their 7 irons

 

[Dr Tapatio]

Well of course, if the employer is asking for a type of test prohibited by state law then there is an issue. But that wasn't your suggestion, nor was there an indication that it was at play in this situation. Refusing a test which is otherwise permitted by state law means you will have your offer rescinded. (And to note, the vast majority of state do allow hair testing.)

It doesn't matter if it seems like deceptive practices. Is it a dick move? Probably. But being a dick is unfortunately not always legally actionable. Unless the written contract specified UDS, you're at their mercy of whatever test they decide to use when you show up. That being the case, the wise thing is simply to make sure you can/will pass any of them.

There wasn't anything covert in this situation. Covert would be if they secretly grabbed a piece of hair while you were doing the UDS and didn't say they were doing a hair test. And again, employee privacy rights don't apply as you aren't an employee prior to completion of the hiring process.

We're obviously not going to see eye-to-eye on this. My point initially was that it was better to do this and throw a hail mary than to just hand over the evidence and get kicked out. Some people morphed that into the idea that I was saying that he must win, when, again, it was about playing the only cards you have left when you know you're about to get caught. Do I personally believe he'd lose, especially in a lawsuit? Yes. Do I think it's better to try this in an attempt that they might agree to UDS instead of hair follicle instead of handing them over evidence to get kicked out? Yes. You disagree, and that's okay

Thanks for the discussion

 

[Hork Bajir]

It’s disappointing that in this day and age, there still appears to be such a vocal chorus of doctors who believe that smoking pot is somehow an inherently bad thing which calls into question the morals, judgement, abilities, and trustworthiness of the user.

The war on drugs is a product of racist, classist, xenophobic, cold-war-era paranoia and institutionalized oppression. A large number of people, doctors included, smoke or have smoked pot. These are the statistics. As far as I’m aware, there is zero evidence that marijuana use correlates with skill or abilities as a physician (anecdotally, I’m aware of a number of individuals in medicine who smoke occasionally, some of whom are the most capable and smartest doctors I know). There is heaps of evidence that drug policy and “the war on drugs” has been used to systematically marginalize people of color and poor people.

It’s one thing to say “I know my employer will test me, therefore I should abstain”. Not abstaining is taking a risk, and questioning what amount of risk if any is justified before calling one’s worthiness as a physician into question is a different conversation... Its a dumb conversation, and missing the forest for the trees IMHO, but if you want to debate about that then fine.

But can we at least stop acting like smoking pot is inherently a bad thing, or that adults who choose to use marijuana are all automatically less smart/capable/ethical people? Perpetuating that idea is just buying into a long and problematic history of racism, classism, and demonization of the proverbial “other”.

 

[deleted480308]

It’s disappointing that in this day and age, there still appears to be such a vocal chorus of doctors who believe that smoking pot is somehow an inherently bad thing which calls into question the morals, judgement, abilities, and trustworthiness of the user.

The war on drugs is a product of racist, classist, xenophobic, cold-war-era paranoia and institutionalized oppression. A large number of people, doctors included, smoke or have smoked pot. These are the statistics. As far as I’m aware, there is zero evidence that marijuana use correlates with skill or abilities as a physician (anecdotally, I’m aware of a number of individuals in medicine who smoke occasionally, some of whom are the most capable and smartest doctors I know). There is heaps of evidence that drug policy and “the war on drugs” has been used to systematically marginalize people of color and poor people.

It’s one thing to say “I know my employer will test me, therefore I should abstain”. Not abstaining is taking a risk, and questioning what amount of risk if any is justified before calling one’s worthiness as a physician into question is a different conversation... Its a dumb conversation, and missing the forest for the trees IMHO, but if you want to debate about that then fine.

But can we at least stop acting like smoking pot is inherently a bad thing, or that adults who choose to use marijuana are all automatically less smart/capable/ethical people? Perpetuating that idea is just buying into a long and problematic history of racism, classism, and demonization of the proverbial “other”.

if it helps you climb down off your high horse, I find it equally stupid regardless of race

 

[Hork Bajir]

if it helps you climb down off your high horse, I find it equally stupid regardless of race

...Why? Genuinely curious

 

[deleted480308]

...Why? Genuinely curious

because race isn't part of that opinion. It's illogical for you to assume it is

 

[Hork Bajir]

@sb247 I meant that I was curious why you find using marijuana to be "stupid"?

Until you tell me otherwise, my assumption is that you find it "stupid" because you believe that MJ users are lazy, hedonistic, slackers; that marijuana is a gateway drug; that marijuana use will inevitably lead to crime, health consequences, or performance decrements. My response would be that many people believe these things to be true because you have been told them your entire life: by your parents, your teachers, your government. My understanding it's pretty widely accepted these days that the history of these ideas are rooted in policies which were very explicitly designed to suppress and oppress people of color and the economically disadvantaged. I'm not arguing that rich white people who smoke pot are viewed differently than poor black people who smoke pot (though this is definitely true on a societal level, even if you yourself don't feel that way)... I'm arguing that the idea that "smoking marijuana is stupid" stems directly from racist/classist/xenophobic government propaganda. Which is why I am genuinely curious what exactly it is about using marijuana that you find to be inherently "stupid"?

 

[deleted480308]

@sb247 I meant that I was curious why you find using marijuana to be "stupid"?

Until you tell me otherwise, my assumption is that you find it "stupid" because you believe that MJ users are lazy, hedonistic, slackers; that marijuana is a gateway drug; that marijuana use will inevitably lead to crime, health consequences, or performance decrements. My response would be that many people believe these things to be true because you have been told them your entire life: by your parents, your teachers, your government. My understanding it's pretty widely accepted these days that the history of these ideas are rooted in policies which were very explicitly designed to suppress and oppress people of color and the economically disadvantaged. I'm not arguing that rich white people who smoke pot are viewed differently than poor black people who smoke pot (though this is definitely true on a societal level, even if you yourself don't feel that way)... I'm arguing that the idea that "smoking marijuana is stupid" stems directly from racist/classist/xenophobic government propaganda. Which is why I am genuinely curious what exactly it is about using marijuana that you find to be inherently "stupid"?

because we're on a medical forum and it's still federally illegal, so any doctor still partaking is making a decision I think is stupid

I also want to specifically say it's a poor debate tactic to try and call those who are critical of marijuana use as racist/classist/xenophobic. It's lazy and inaccurate argument formation.

There's a joke in there asking to be let out. If we knew each other better and were discussing in person, this is where I would ask if your arguments were lazy because you smoke weed but you know...

 

[VA Hopeful Dr]

It’s disappointing that in this day and age, there still appears to be such a vocal chorus of doctors who believe that smoking pot is somehow an inherently bad thing which calls into question the morals, judgement, abilities, and trustworthiness of the user.

The war on drugs is a product of racist, classist, xenophobic, cold-war-era paranoia and institutionalized oppression. A large number of people, doctors included, smoke or have smoked pot. These are the statistics. As far as I’m aware, there is zero evidence that marijuana use correlates with skill or abilities as a physician (anecdotally, I’m aware of a number of individuals in medicine who smoke occasionally, some of whom are the most capable and smartest doctors I know). There is heaps of evidence that drug policy and “the war on drugs” has been used to systematically marginalize people of color and poor people.

It’s one thing to say “I know my employer will test me, therefore I should abstain”. Not abstaining is taking a risk, and questioning what amount of risk if any is justified before calling one’s worthiness as a physician into question is a different conversation... Its a dumb conversation, and missing the forest for the trees IMHO, but if you want to debate about that then fine.

But can we at least stop acting like smoking pot is inherently a bad thing, or that adults who choose to use marijuana are all automatically less smart/capable/ethical people? Perpetuating that idea is just buying into a long and problematic history of racism, classism, and demonization of the proverbial “other”.

You are making the incorrect assumption that we are against marijuana on principal. Several people in this thread have said they aren't and I have said as much in previous discussions on the subject. I'll go in record again and say I would legalize recreational use tomorrow if I could.

But that's not the point of this. The DEA still classifies marijuana as schedule 1. That makes it illegal on a federal level. The DEA is the same group that regulates our ability to prescribe controlled medications.

Those 2 facts being true, it is a huge risk to smoke marijuana once you begin medical education.

 

[Dr.LeoSpaceman]

It’s disappointing that in this day and age, there still appears to be such a vocal chorus of doctors who believe that smoking pot is somehow an inherently bad thing which calls into question the morals, judgement, abilities, and trustworthiness of the user.

Basically what @VA Hopeful Dr said.

Unless it's use veers into disorder, I make no judgments about the practice itself. But it is valid to judge those who know it might limit their ability to continue training or start a new job and seemingly can't be bothered to avoid it for a few months. At that point, the person is either irresponsible or it's not just "casual use". Both of which are valid reasons to question someones fitness to practice medicine. Even worse is when someone fails the test, then falls back on the "it should be legal anyway" argument. In my mind that signals immaturity and inability to accept responsibility for your actions.

 

[Raryn]

@sb247 I meant that I was curious why you find using marijuana to be "stupid"?

Until you tell me otherwise, my assumption is that you find it "stupid" because you believe that MJ users are lazy, hedonistic, slackers; that marijuana is a gateway drug; that marijuana use will inevitably lead to crime, health consequences, or performance decrements. My response would be that many people believe these things to be true because you have been told them your entire life: by your parents, your teachers, your government. My understanding it's pretty widely accepted these days that the history of these ideas are rooted in policies which were very explicitly designed to suppress and oppress people of color and the economically disadvantaged. I'm not arguing that rich white people who smoke pot are viewed differently than poor black people who smoke pot (though this is definitely true on a societal level, even if you yourself don't feel that way)... I'm arguing that the idea that "smoking marijuana is stupid" stems directly from racist/classist/xenophobic government propaganda. Which is why I am genuinely curious what exactly it is about using marijuana that you find to be inherently "stupid"?

I've been on this forum for the last 12 years, overlapping all or most of that with a lot of the other random folks above. I don't think I've ever seen them (or to be honest, anyone) advocate for any of the above arguments, at least not when talking about "all" MJ users.

The concerns that most of us have are that the risks of getting in trouble for marijuana (related to employment or legal difficulties) outweigh whatever benefits it has (which are nebulous at best the overwhelming majority of the time, other than just getting high). If the risks outweigh the benefits, then partaking is stupid. Many of us did stupid things when we were younger - but at this point, we can still acknowledge that they're stupid.

Does anyone above agree that these employment or legal difficulties are warranted? No. But they exist. And until they go away, it's not worth it.

(And there's definitely negative health consequences to at least some subset of marijuana use, but that's not relevant to the above argument).

 

[ramses99]

Too long didn't read. Just curious from an ethicolegal standpoint: At what point of fourth year would a medical student need to avoid accidentally walking across any secondhand smoke in a legal state they travel through, in order to not risk a positive follicle test?

 

[deleted480308]

Too long didn't read. Just curious from an ethicolegal standpoint: At what point of fourth year would a medical student need to avoid accidentally walking across any secondhand smoke in a legal state they travel through, in order to not risk a positive follicle test?

There is nothing unethical about smoking weed unless you lie about it

it’s always federally illegal

doing it when you are in a highly regulated and specifically antiweed field is not smart, don’t do it and your follicles will be fine

 

[Mass Effect]

(And there's definitely negative health consequences to at least some subset of marijuana use, but that's not relevant to the above argument).

This. And as a psychiatrist, I can't tell you how many previously healthy young people/adolescents I've admitted to our inpatient unit for mania or psychosis following marijuana use.

 

[LucidSplash]

This. And as a psychiatrist, I can't tell you how many previously healthy young people/adolescents I've admitted to our inpatient unit for mania or psychosis following marijuana use.

Yes not psych but have watched my own sister’s ability to manage her bipolar disorder wane with increases MJ use and she refuses to see this as a contributing factor. But there is a stark difference when she is using MJ and when she is not.

 

[Goro]

Yes not psych but have watched my own sister’s ability to manage her bipolar disorder wane with increases MJ use and she refuses to see this as a contributing factor. But there is a stark difference when she is using MJ and when she is not.

I've seen this with my 17 year old nephew as well. Just spent six months in a residential treatment program.

My two closest friends from high school were heavy pot smokers. Oddly, one could be high and you'd never know it. The other you'd know it because he got stupid. Eventually he developed schizoid personality disorder. Still lives in his mom's basement, and imagines himself a screenwriter...counting his Oscars that his works will win.

 

[LucidSplash]

I've seen this with my 17 year old nephew as well. Just spent six months in a residential treatment program.

My two closest friends from high school were heavy pot smokers. Oddly, one could be high and you'd never know it. The other you'd know it because he got stupid. Eventually he developed schizoid personality disorder. Still lives in his mom's basement, and imagines himself a screenwriter...counting his Oscars that his works will win.

I personally never smoked just because I had no interest and also had a couple addicts (one alcoholic, one hard drugs) in my life as a kid that turned me off to the idea. But, I suspect like most people, I had tons of friends in college and early 20s who enjoyed it. The vast majority all went on to be productive members of society and a lot of them grew out of MJ use as their careers became more important to them. But a few unfortunately were not in this group and I think are an important cautionary tale in an age where MJ use has become more socially acceptable. Like alcohol, probably an innocuous social lubricant for the majority of users. But for a select subset, has significant added risk. Including those with already disordered brain chemistry and those under the age of 25, where the brain is still maturing.

 

[FatKid]

absolutely crazy...

 

[BocephusTim]

These days, plenty of women don’t.

Apparently it's also fashionable for the gents to go bald down below --- judging by all the Manscaping ads I see online

 

[IMGASMD]

Apparently it's also fashionable for the gents to go bald down below --- judging by all the Manscaping ads I see online

Maybe you searched specific products, position or groups. Google have ability to target their ads.....

 

[chocomorsel]

This. And as a psychiatrist, I can't tell you how many previously healthy young people/adolescents I've admitted to our inpatient unit for mania or psychosis following marijuana use.

Is the marijuana laced with something? Or does the THC cause the symptoms?
In your expert opinion, do you think these people would have developed mania/psychosis without MJ use? As in some stressor comes up in life and these pre-exposed people get the mania/psychosis anyway?
Is there any research behind this? Speaking from first hand experience, the paranoia is real and horrible.
Didn't help that I was getting high with strangers or a person with anger management issues either. Not for me.

 

[hallowmann]

Is the marijuana laced with something? Or does the THC cause the symptoms?
In your expert opinion, do you think these people would have developed mania/psychosis without MJ use? As in some stressor comes up in life and these pre-exposed people get the mania/psychosis anyway?
Is there any research behind this? Speaking from first hand experience, the paranoia is real and horrible.
Didn't help that I was getting high with strangers or a person with anger management issues either. Not for me.

There's a multitude of studies on cannabis and psychosis. At best they have demonstrated a clear correlation, and it seems most evident in individuals who smoke both large amounts and do so daily. Most likely, these are individuals who are predisposed to developing such a condition, but marijuana may play a role in both increasing the frequency and/or hastening the onset. The problem with many of these conditions is that often each hit (e.g. episode of psychosis) is debilitating and even if it resolves, there likely are longterm adverse effects on cognition.

Personally I agree that legal enforcement of drug use is very problematic for a number of reasons, and in turn legalization makes sense. That said, it would be foolish to not recognize that marijuana, and honestly likely more alcohol, have significant adverse societal (including significant medical) effects on a small subset of the population.

 

[Mass Effect]

There's a multitude of studies on cannabis and psychosis. At best they have demonstrated a clear correlation, and it seems most evident in individuals who smoke both large amounts and do so daily. Most likely, these are individuals who are predisposed to developing such a condition, but marijuana may play a role in both increasing the frequency and/or hastening the onset. The problem with many of these conditions is that often each hit (e.g. episode of psychosis) is debilitating and even if it resolves, there likely are longterm adverse effects on cognition

This.

I especially want to highlight that after an episode of psychosis, people rarely "return to baseline." These are usually individuals predisposed or vulnerable to psychosis/psychotic/bipolar illness, but who knows if they would ever develop the symptoms without marijuana? What we do know is they didn't have the usual course of a psychotic illness and instead, they went from baseline to psychotic pretty rapidly and ended up in the psych ward.

 

[JamaicanHerb]

@sb247 I meant that I was curious why you find using marijuana to be "stupid"?

Until you tell me otherwise, my assumption is that you find it "stupid" because you believe that MJ users are lazy, hedonistic, slackers; that marijuana is a gateway drug; that marijuana use will inevitably lead to crime, health consequences, or performance decrements. My response would be that many people believe these things to be true because you have been told them your entire life: by your parents, your teachers, your government. My understanding it's pretty widely accepted these days that the history of these ideas are rooted in policies which were very explicitly designed to suppress and oppress people of color and the economically disadvantaged. I'm not arguing that rich white people who smoke pot are viewed differently than poor black people who smoke pot (though this is definitely true on a societal level, even if you yourself don't feel that way)... I'm arguing that the idea that "smoking marijuana is stupid" stems directly from racist/classist/xenophobic government propaganda. Which is why I am genuinely curious what exactly it is about using marijuana that you find to be inherently "stupid"?

As a person of color,

I have used marijuana since 21 years old and stopped 1 year ago. I can tell you for a fact that marijuana made me lazy, it was a gateway drug to my tobacco use which I have stopped for 1 month now. Smoking marijuana had lead me to transporting and selling weed in my college years. The minute I stopped smoking I could tell the beneficial emotional and physical benefits.

 

[IMGASMD]

As a person of color,

I have used marijuana since 21 years old and stopped 1 year ago. I can tell you for a fact that marijuana made me lazy, it was a gateway drug to my tobacco use which I have stopped for 1 month now. Smoking marijuana had lead me to transporting and selling weed in my college years. The minute I stopped smoking I could tell the beneficial emotional and physical benefits.

You were in med school and residency while you were still using? Just asking, not judging.

Congrats on quitting both! Good luck!

 

[JamaicanHerb]

You were in med school and residency while you were still using? Just asking, not judging.

Congrats on quitting both! Good luck!

Yes

 

[Dr Tapatio]

As a person of color,

I have used marijuana since 21 years old and stopped 1 year ago. I can tell you for a fact that marijuana made me lazy, it was a gateway drug to my tobacco use which I have stopped for 1 month now. Smoking marijuana had lead me to transporting and selling weed in my college years. The minute I stopped smoking I could tell the beneficial emotional and physical benefits.

I'm not saying this to judge, but it sounds like a you problem more than a MJ problem. There are many adults that use it recreationally on occasion without it interfering with their lives

 

[Raryn]

I'm not saying this to judge, but it sounds like a you problem more than a MJ problem. There are many adults that use it recreationally on occasion without it interfering with their lives

I mean, this isn't the time nor the place, but many of us have seen plenty of adults with side effects from marijuana that are significantly interfering with their lives too. Early psychotic breaks is one discussed above. Cannabinoid hyperemesis syndrome is another - one where the people suffering are often in *extreme* denial that it could be related to their use of cannabis. Is it common? Well, I've seen a half dozen or so cases personally, so it's more common than a lot of things I learned about in medical school.

Regardless, *most* people using cannabis have minimal to no adverse effects from it. But the same is true with most people drinking alcohol. Hell, it is even probably true for most people smoking cigarettes, though the proportions of harm there certainly are getting larger.

 

[Dr Tapatio]

I mean, this isn't the time nor the place, but many of us have seen plenty of adults with side effects from marijuana that are significantly interfering with their lives too. Early psychotic breaks is one discussed above. Cannabinoid hyperemesis syndrome is another - one where the people suffering are often in *extreme* denial that it could be related to their use of cannabis. Is it common? Well, I've seen a half dozen or so cases personally, so it's more common than a lot of things I learned about in medical school.

Regardless, *most* people using cannabis have minimal to no adverse effects from it. But the same is true with most people drinking alcohol. Hell, it is even probably true for most people smoking cigarettes, though the proportions of harm there certainly are getting larger.

I agree with you that those things happen. I also agree with you when you said most people get minimal to no adverse effects

I am hesitant to say it's the same with alcohol considering alcohol poisoning or withdrawals (untreated) can kill you

As for cigarettes, we know it's dose and age dependent, whereas I haven't seen something comparable in MJ

 

[TonsilPlucker]

I'm going to be very transparent. I was supposed to begin my residency position soon, however, I failed my pre-employment hair follicle examination, because I tested positive for cannabis. They informed me yesterday that they decided to terminate my contract due to the failed pre employment drug screen, which is in my contract. However, in my contract I was supposed to be given an opportunity to defend myself, and never received that chance. I also live in a state where cannabis is legal for recreational use. Also one last side note, I had received an email that stated that I was going to get a urine drug screen, and I found out two days before hand that it was going to be a hair follicle examination.

So I guess some of my questions are:

1) Can I fight this? (And in that regard is it worth it, because it would obviously create some tension between me and my program)
2) Can I find a residency spot still somewhere else? (speaking to people, it seems like I may be able to find a spot in an unfilled program, and just be a bit delayed in terms of my start date)
3) Where could I find a list of unfilled residency spots? (I contacted The Match and they told me that they do not have that information)
4) At what point am I considered an "employee" is it when I matched? Or my first day?


Thanks and I appreciate any help in this situation

Something is off. I've known incoming interns who test positive for cocaine who are put on probation but still allowed to start training. With cannabis being legalized in more and more states, I have a hard time believing termination was the first action.

If true, then I think it's worth at least consulting with a lawyer. However, like you stated, once you're on the radar of the PD/Chair, it's really hard to get off the radar but worth it if the alternative is no residency spot.

 

[WheezyBaby]

Something is off. I've known incoming interns who test positive for cocaine who are put on probation but still allowed to start training. With cannabis being legalized in more and more states, I have a hard time believing termination was the first action.

If true, then I think it's worth at least consulting with a lawyer. However, like you stated, once you're on the radar of the PD/Chair, it's really hard to get off the radar but worth it if the alternative is no residency spot.

I don't find it hard to believe. I've heard there are hospital systems that will terminate a contract for positive cotinine testing. These are c-suite level driven decisions that a PD likely doesn't have a dramatic amount of sway over

 

[BicepsTriceps]

I don't find it hard to believe. I've heard there are hospital systems that will terminate a contract for positive cotinine testing. These are c-suite level driven decisions that a PD likely doesn't have a dramatic amount of sway over

That's just sad.

 

[JamaicanHerb]

I'm not saying this to judge, but it sounds like a you problem more than a MJ problem. There are many adults that use it recreationally on occasion without it interfering with their lives

Well it didn't interfere to a great extent, since, you know, I became a doctor and all...

Also, everyone has different distribution and amount of cannabinoid receptors in the brain. So of course there are going to be "many" adults that use it recreationally without interfering with their lives, its the ones that it does, you don't hear from or is confounded with other problems.

 

[WheezyBaby]

That's just sad.

Granted this is not 1st hand knowledge, and for a staff as opposed to a trainee, but agreed

 

[Dr Tapatio]

Well it didn't interfere to a great extent, since, you know, I became a doctor and all...

Also, everyone has different distribution and amount of cannabinoid receptors in the brain. So of course there are going to be "many" adults that use it recreationally without interfering with their lives, its the ones that it does, you don't hear from or is confounded with other problems.

Like I said, not judging. Obviously you did become a doctor. I'm just saying you can't generalize that it will make you lazy because it did to you

 

[JamaicanHerb]

Like I said, not judging. Obviously you did become a doctor. I'm just saying you can't generalize that it will make you lazy because it did to you

I did say that "to me" part in my post did i not? And whats not judgmental on saying i had more of a problem than weed? Are you high right now?

 

[Mad Jack]

This is so scary man. It's so easy to screw up

And can someone answer his question #2 and #4? @NotAProgDirector

It's... Pretty easy to not screw up. Just don't smoke it