Random Drug Testing During Residency?

[prominence]

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do residency programs require their residents to give random urine samples?

i smoke marijuana in my spare time, and i wanted to know if need to get a masking agent to continue my habit.

 

[doc05]

you're an adult now. probably time to stop smoking weed.

 

[cabby]

do residency programs require their residents to give random urine samples?

i smoke marijuana in my spare time, and i wanted to know if need to get a masking agent to continue my habit.

MGH Anesthesia made it a point to stess they are starting to test.

 

[Jeff05]

you're an adult now. prno questions asked.


doc05....
i'm just wondering what your definition of adulthood is and at which point should one become an adult. i'm actually being completely serious, cause i'm curious about what you're thinking.

 

[14022]

you're an adult now. probably time to stop smoking weed.

So marijuana is something that is more acceptable when you're a child? I do not get this statement at all.

 

[Koko]

Obviously doc05 is the one to explain what he meant, but I interpreted him as saying that while some choose to smoke as college students, a resident needs to be mature and take his/her responsibilities seriously given the nature of their work. It's not uncommon for college students to experiment or smoke some j, but most people "grow up" and drop this after college when they enter the real world (i.e. family, work, etc.). I doubt he meant that children should be smoking wacky weed.

 

[hans19]

Despite my personal views to the contrary, it seems drugs are bad news for the health professional. Just imagine if you ever got busted and it became part of your public record. Who knows what this would do to your reputation. Its just not worth it anymore. If you get sued for malpractice, just think of what kind of crap a plantiffs attorney could pull. "Dr. X, that pot head, botched the job. Do you want a pot head doctor operating on you? Do you want to put your life in the hands of a pot head?"

Besides, pretty soon you'll be able afford the Johnnie Walker Blue label and some cubans. Its not the same, but its still damn nice.

 

[prominence]

you're an adult now. probably time to stop smoking weed.

hey tough guy, get off your high horse.

whether u like it or not, the reality is there are alot of medical students out there who smoke weed. i doubt that EVERY single of them have quit cold turkey once they began residency.

i am not asking people to approve/disapprove of weed, or to warn me of the harmful effects of it.

do most residency programs out there make their residents submit random urine samples to test for drug use?

 

[doc05]

Obviously doc05 is the one to explain what he meant, but I interpreted him as saying that while some choose to smoke as college students, a resident needs to be mature and take his/her responsibilities seriously given the nature of their work. It's not uncommon for college students to experiment or smoke some j, but most people "grow up" and drop this after college when they enter the real world (i.e. family, work, etc.). I doubt he meant that children should be smoking wacky weed.

right. It seems Koko is the only one here with any common sense.

 

[Sugar72]

There are all kinds of products to beat a urine test - there is no hope if they take a hair sample. Keep that in mind.

 

[doc05]

hey tough guy, get off your high horse.

whether u like it or not, the reality is there are alot of medical students out there who smoke weed. i doubt that EVERY single of them have quit cold turkey once they began residency.

i am not asking people to approve/disapprove of weed, or to warn me of the harmful effects of it.

do most residency programs out there make their residents submit random urine samples to test for drug use?

Smoking weed might be "ok" for a college kid, but that's because no college kid on earth has any real responsibilities. A resident does -- responsibilities that are as real as life and death. If I find that a fellow resident is on drugs, I'd personally have them thrown out. It compromises patient care and puts every member of the team at risk.

 

[prominence]

Smoking weed might be "ok" for a college kid, but that's because no college kid on earth has any real responsibilities. A resident does -- responsibilities that are as real as life and death. If I find that a fellow resident is on drugs, I'd personally have them thrown out. It compromises patient care and puts every member of the team at risk.

spare me your synogague's views.

as far as putting every member of the team at risk, i think that's being a little melodramatic. i'm only talking about smoking weed, not snorting lines of coke.

i know several pathologist or radiologist residents who like to toke, and this habit doesn't make them "deadbeat residents".

i only mentioned that i toked in my spare time. as a resident, i have no intention of coming into work "high." Keep in mind that marijuana has no hangover effect the next morning like alcohol does.

i hope this post doesn't cause u to wet ur panties, doc05.

 

[sb_MD]

I am a little curious how smoking MJ in one's leisure time differs from drinking alcohol, a habit that countless physicians enjoy, many times to excess.

 

[maxheadroom]

At my program, we had to give a urine sample during orientation. I think our contract says that we have to submit to drug screening at the discretion of the GME committee (i.e., if you're acting bizarre, they might test you). I only had to give the sample during orientation. I don't know of anyone who's been tested again since then.

It's probably best to just give up the recreational substances. Sure, most of us know that some occasional MJ probably won't do any more harm than a couple of beers, but why risk your career?

 

[prominence]

At my program, we had to give a urine sample during orientation. I think our contract says that we have to submit to drug screening at the discretion of the GME committee (i.e., if you're acting bizarre, they might test you). I only had to give the sample during orientation. I don't know of anyone who's been tested again since then.

It's probably best to just give up the recreational substances. Sure, most of us know that some occasional MJ probably won't do any more harm than a couple of beers, but why risk your career?

thanks bro, for answering my question.

 

[me454555]

I am a little curious how smoking MJ in one's leisure time differs from drinking alcohol, a habit that countless physicians enjoy, many times to excess

Brilliant point. While I no longer smoke, I feel the exact same way.

 

[Koko]

I am a little curious how smoking MJ in one's leisure time differs from drinking alcohol, a habit that countless physicians enjoy, many times to excess.

It's illegal.

 

[normalforce]

It's illegal.

So is speeding. Next time your going 70 in a 65 think about that. There are lots of things lots of adults do that are worse than a little pot. To the contrary, those smokin it, it's your risk. I wouldn't chance my professional career on it. If you get booted from residency for a drug infraction, there is a good likelihood you will struggle to land another decent spot. It may be rural FP for you in southeast Montana.

 

[f_w]

lay off the weed man !

- some programs will test. typically announced and scheduled, at times unscheduled.

- If you get busted for a drug offense you can kiss your prospects for a DEA number good-bye (and tied to that the ability to obtain attending staff privileges at many hospitals, the ability to get reimbursement from insurance companies etc.)

- if you get busted, look forward to getting conditions attached to your medical license. (e.g. regular drug tests and/or substance abuse counseling)

- if they fire you from residency for a dirty urine, good luck finding a different program to take you.

- if they just discipline you based on a dirty urine, it will show up every time your PD has to fill out one of these 'verification of training' forms.

- oh, and forget about defending yourself if you ever get sued. In addition to the usual question 'so doctor, when did you stop beating your wife' you will be painted as a drug using irresponsible uncaring selfish a**hole.

 

[Koko]

So is speeding. Next time your going 70 in a 65 think about that. There are lots of things lots of adults do that are worse than a little pot. To the contrary, those smokin it, it's your risk. I wouldn't chance my professional career on it. If you get booted from residency for a drug infraction, there is a good likelihood you will struggle to land another decent spot. It may be rural FP for you in southeast Montana.

My post was in response to someone who asked what the difference was between smoking marijuana and drinking. If you want to use that response as a jumping off point to post recycled arguments in favor of marijuana, that's fine. But please don't pretend that the speeding point will engender some epiphany on my part. I'm not stoned, so it doesn't strike me as profound.

There are reasons why our profession doesn't equate speeding with marijuana use. If you don't undertsand why or disagree with this position, speak out publicly and lobby for change.

 

[OldPsychDoc]

I am a little curious how smoking MJ in one's leisure time differs from drinking alcohol, a habit that countless physicians enjoy, many times to excess.

I suggest that you all Google the phrase "impaired physician" or "physician health program"--it will net you plenty of links for your educational perusal.

Bottom line: you drop dirty, you divert a little Percocet or Ativan for personal use, you show up for work with a touch of alcohol on your breath, or blow 0.10 on the way home from the country club--it doesn't matter what the substance is. You're putting your license and career at risk, because you're assumed to be putting your patients at risk. Time to back up all that there book l'arnin' with a bit of basic professional maturity, folks.

 

[AJM]

So is speeding. Next time your going 70 in a 65 think about that. There are lots of things lots of adults do that are worse than a little pot. To the contrary, those smokin it, it's your risk. I wouldn't chance my professional career on it. If you get booted from residency for a drug infraction, there is a good likelihood you will struggle to land another decent spot. It may be rural FP for you in southeast Montana.

Um, speeding is a traffic violation and does not give you a criminal record. I never had to report my speeding tickets to any state medical boards or residency programs. On the other hand, smoking pot is a misdemeanor at best and a felony at the worst, depending on whether you're buying or selling, how much you're carrying, etc. Smoking pot can not just cause you to get kicked out of residency, but even worse, you can lose your medical license. If you are ever arrested for smoking or carrying pot you will also have to report it to any state medical board that you are applying for medical licensure in.

Not something to be toyed with lightly.

 

[AJM]

I suggest that you all Google the phrase "impaired physician" or "physician health program"--it will net you plenty of links for your educational perusal.

Bottom line: you drop dirty, you divert a little Percocet or Ativan for personal use, you show up for work with a touch of alcohol on your breath, or blow 0.10 on the way home from the country club--it doesn't matter what the substance is. You're putting your license and career at risk, because you're assumed to be putting your patients at risk. Time to back up all that there book l'arnin' with a bit of basic professional maturity, folks.

Psych doc is right on. Practicing medicine while impaired is not only unethical, but it is illegal. Doesn't matter what drug or drink the impairment is from.

By the way - if you ever get a DUI, even though it's technically "on your own time" and not at work, you can lose your medical license along with your driver's license. Even if you've never had a drop to drink before a shift in your life.
Just be careful.

 

[DireWolf]

Psych doc is right on. Practicing medicine while impaired is not only unethical, but it is illegal. Doesn't matter what drug or drink the impairment is from.

By the way - if you ever get a DUI, even though it's technically "on your own time" and not at work, you can lose your medical license along with your driver's license. Even if you've never had a drop to drink before a shift in your life.
Just be careful.

Physicians get DUIs all the time. I know one who has 3 of them. You pay a ton of money for a good lawyer and your medical license is not in jeopardy. An exception would be if you caused an accident with injuries while driving impaired.

 

[f_w]

sorry to rain on your frat party here. If you want to read up on this, go on your medical boards website and scroll through the 'disciplinary actions'. 80% are for smoking pot or diversion of schedule 2 substances, 15% for fondling patients during conscious sedation and 5% for utter incompetency.
(and btw. you loose one medical license, you loose them all. It is sort of a domino effect with one board reporting your misdeeds to the next)

 

[Caffeine]

My friend knows an anesthesiology resident who got busted with a trunk full of cocaine (transporting for pay in order to support his own habit). He lost his license, but it looks like he will be getting it back soon. His residency program has told him that as long as he gets his license back, he can rejoin the residency.

So even if you get busted for smoking weed, it's probably not the end of your career.

 

[AJM]

Physicians get DUIs all the time. I know one who has 3 of them. You pay a ton of money for a good lawyer and your medical license is not in jeopardy. An exception would be if you caused an accident with injuries while driving impaired.

I did not mean to imply that you WILL lose your license if you're caught with DUI. But you are certainly at risk of losing your medical license. It is a different story if you injure someone - from what I hear, that almost guarantees a lost license.

Besides, not everyone can afford a good lawyer. 🙂
Best not to risk it in the first place. Besides, not to point out the obvious, but it's dangerous...

 

[OldPsychDoc]

My friend knows an anesthesiology resident who got busted with a trunk full of cocaine (transporting for pay in order to support his own habit). He lost his license, but it looks like he will be getting it back soon. His residency program has told him that as long as he gets his license back, he can rejoin the residency.

So even if you get busted for smoking weed, it's probably not the end of your career.

Most states have very good physician recovery programs which allow impaired physicians and other licensed health professionals to keep their licenses while undergoing treatment for chemical dependency. That said, it's not easy--doctors who are accustomed to calling the shots for their lives and the lives of others tend not to submit quietly to accountability and close supervision.

Just keep that in mind while you're all complacently toking at home.

 

[normalforce]

My post was in response to someone who asked what the difference was between smoking marijuana and drinking. If you want to use that response as a jumping off point to post recycled arguments in favor of marijuana, that's fine. But please don't pretend that the speeding point will engender some epiphany on my part. I'm not stoned, so it doesn't strike me as profound.

There are reasons why our profession doesn't equate speeding with marijuana use. If you don't undertsand why or disagree with this position, speak out publicly and lobby for change.

ya sound a little peeved Koko. I was just messing with ya. Everybody makes their own choices and has to deal with them. I think anyone is med school knows that when it comes to smoking pot as a physician, "the risks outweigh the benefits". And BTW, I won't be on Capitol Hill lobbying anytime soon. Also, watch your speed. Speeding and speed related auto traffic injuries kill exponentially more people than pot-related anything. Same is true of EtOH.

 

[f_w]

> as long as he gets his license back, he can rejoin the residency.

Rejoining his residency is the EASY part. Later on it will make him practically unmarketable, particularly in GAS. Every patient or journalist who runs his name on the medboard website will find that conviction. Hospitals just LOVE the local newspaper headline: 'St Elsewhere employs drug-running anesthesiologist'.

His career is over, he just doesn't know it yet.

 

[OldPsychDoc]

> as long as he gets his license back, he can rejoin the residency.

Rejoining his residency is the EASY part. Later on it will make him practically unmarketable, particularly in GAS. Every patient or journalist who runs his name on the medboard website will find that conviction. Hospitals just LOVE the local newspaper headline: 'St Elsewhere employs drug-running anesthesiologist'.

His career is over, he just doesn't know it yet.

Plus, many hospitals have a little bit of a mental block about allowing an addict--even a recovering one--unfettered access to little things like IV Fentanyl, etc...

 

[Peds ERDoc]

Just out of curiousity, for those of you who do drink alcohol, smoke cigarettes, and use illegal drugs (including marijuana), what do you plan on using as anticipatory guidance when speaking to children and adolescents about mind-altering products?

Do you plan to advise children and adolescents (and even adult patients) against using tobacco, alcohol, and illicit drugs? Or, because of your own moral stances, plan to omit or exclude this topic from your conversations with your patients on their health?

 

[joshmir]

Legal disclaimer: I do not puff the cheeba

This is an excerpt from a prior solid post:

"If you want to read up on this, go on your medical boards website and scroll through the 'disciplinary actions'. 80% are for smoking pot or diversion of schedule 2 substances, 15% for fondling patients during conscious sedation and 5% for utter incompetency.

Also, for those who judge marijuana users as being "impaired physicians", I would:

-question whether there is evidence out there to prove this (or is this "common sense", like HRT, the safety of vioxx, and withholding b-blockers from MI/CHF patients once was)

-remember that in almost all other western countries (canada, UK, netherlands, etc) marijuana is decriminalized if not legal. those physicians are not considered impaired. there must be a reason for that.

-different people use pot differently and it effects them differently. generalizing and assuming is dangerous and closed-minded.

-remember that this country not long ago had prohibition laws against alcohol, then changed them.

-*until recently, it was NOT CONSIDERED IMPAIRMENT to operate after 36 hours of continous duty*

There are definitely some high horses to get down off of. Do not slander based on generalizations and assumptions.

 

[blue2000]

My mom does employment law, and it's my understanding that your employer has to inform you, in writing, if there is a random-drug testing policy in effect and what the schedule is if there is a scheduled drug testing policy.

At interviews I went to where universities had drug testing policies in effect, the policy was announced at the interview orientation. At the very least it should be in your contract.

Not to detract from the fascinating rehash of legalizing marijuana.

 

[Jeff698]

Fascinating arguments about why pot ain't so bad.

My only question is how comfortable would you be if your local paper ran a front page story about your pot use (sort of like Warren Buffet's NYT-test)? Do you think your patients would be terribly sympathetic to your arguments?

I don't think it is relevant at all to this discussion (appropriateness of physician use) if pot has been given a bad rap (I think it has). I think a majority of our patients would not look favorably on the idea of their doctor toking up, even if it was 'off duty'.

The arguments you make about it not being so bad are very relevant, however, to the dicussion of if it should be decriminalized or not (I think it should).

Take care,
Jeff

 

[OldPsychDoc]

Legal disclaimer: I do not puff the cheeba
....Also, for those who judge marijuana users as being "impaired physicians", I would:
....There are definitely some high horses to get down off of. Do not slander based on generalizations and assumptions.

Just be aware that it is your State Licensing Board, not us slandering high-horse riders, who will judge who is and is not impaired. I'm sure they'll listen most sympathetically to these arguments before they suspend your license.

 

[f_w]

I am puzzled why you would choose my post to make an argument for the legalization of ganja.

But we are not talking about whether 'tha weed' it is a good or bad thing, we are talking about whether it is a good idea to consume it as a resident .

Btw. For the general public, it is also not illegal to :
A. fondle someone while they are under conscious sedation (e.g. through the sweet red wine they used to call 'can-opener' back home).
B. to be utterly incompetent.

It is just illegal to to A or B AS A PHYSICIAN and while under the jurisdiction of a regulating body put in charge of you by the people of your state.

 

[prominence]

But we are not talking about whether 'tha weed' it is a good or bad thing, we are talking about whether it is a good idea to consume it as a resident

whether u want to smoke weed during your spare time as a resident, that is an individual decision each of us must make.

nobody is stupid enough to claim that smoking marijuana does not have harmful risks. if i choose to put my medical license at risk by toking in my free time as a resident, that is my decision.

unfortunately, the majority of posters have twisted this thread (as is often the case on SDN threads) into a moral issue or a legalization issue, which was not the original intention of this thread.

i simply aked how prevalent drug testing is throughout residency.

for those hypocrites out there who are so concerned for my well-being, feel free to pay off my $151,000 debt in student loans.

 

[sb_MD]

Just out of curiousity, for those of you who do drink alcohol, smoke cigarettes, and use illegal drugs (including marijuana), what do you plan on using as anticipatory guidance when speaking to children and adolescents about mind-altering products?

Do you plan to advise children and adolescents (and even adult patients) against using tobacco, alcohol, and illicit drugs? Or, because of your own moral stances, plan to omit or exclude this topic from your conversations with your patients on their health?

I'm sorry, but this is the biggest load of crap ever. Because I consume alcohol, sometimes in large amounts, is it therefore hypocritical of me to advise adolescent patients not to? Even though I did consume alcohol in my adolescence, and smoke some cigarettes, and smoked a fair amount of weed before my clinical years (and all while maintaining a near perfect GPA and appearing the PERFECT candidate for medical school throughout high school and college), should I not tell my younger patients not to use these substances? That is ridiculous.

I know this is off the topic, but I had to respond. BTW, my residency program has already informed us that we will be drug tested during orientation. And I fully defend smoking weed as a leisure activity. As I am in favor of the legalization of all drugs.

 

[f_w]

> for those hypocrites out there who are so concerned for my
> well-being, feel free to pay off my $151,000 debt in student loans.

The best way to ensure that you will be able to pay back these loans is not to risk your career by
- smoking weed in your private time
- diverting drugs
- writing triplicates for your buddies
- fondling patients
- fondling employees/nursing-students/medstudents

As for your initial question:

Drug testing is quite prevalent at larger programs, most programs rotating to VA or other publicly owned hospitals.
They will give you a notification of their testing policy sometime during orientation. Some will make you pass a screen before you start, so if you have a habit, kick it now, shave your head and pull out your finger and toenails. You should be clean by july 1st.

 

[prominence]

As for your initial question:

Drug testing is quite prevalent at larger programs, most programs rotating to VA or other publicly owned hospitals.
They will give you a notification of their testing policy sometime during orientation. Some will make you pass a screen before you start, so if you have a habit, kick it now, shave your head and pull out your finger and toenails. You should be clean by july 1st.

thanks for the advice.

 

[f_w]

Oh, and if you need good information on washout times, contact your local minor league baseball team, they can refer you to an expert.

http://www.sptimes.com/2005/04/05/Sports/38_minor_league_playe.shtml

 

[Whodathunkit]

What if you "toked" when you were in say The Netherlands...where it is not considered illegal.

I've often wondered if you could be held accountable then.

 

[prominence]

Oh, and if you need good information on washout times, contact your local minor league baseball team, they can refer you to an expert.

http://www.sptimes.com/2005/04/05/Sports/38_minor_league_playe.shtml

 

[prominence]

What if you "toked" when you were in say The Netherlands...where it is not considered illegal.

I've often wondered if you could be held accountable then.

there would no point of random drug testing during residency because then everyone could use this "excuse". good thought though.

 

[f_w]

> there would no point of random drug testing during residency because
> then everyone could use this "excuse". good thought though.

Well, not quite. As there is no 'legal limit', you are considered to be 'under the influence' the moment a trace of THC metabolites is found in your system. (this is the same mechanism that the department of childrens services uses to take kids from crack using moms. It is not illegal to damage your fetus using drugs, it is however illegal to 'give drugs to a minor'. So, if the first urine collected in the nursery is positive, the kid is owned by the goverment.)

WHERE you smoked (or cookied) makes no difference to them. If your urine is dirty, you are out.


I used to work with a surgeon who went on medical relief missions to Afganistan in the 80s (you remember when the Taliban where our friends and mudjahedin was translated into 'freedom fighter'). Every time he returned from these trips into the afghan mountains, he got detained at the airport. After sleeping on mattresses made from poppy straw for 3 months, the customs service dogs were getting ready to eat him.

 

[prominence]

how long does weed stay in your system?

 

[OldPsychDoc]

how long does weed stay in your system?

up to (and sometimes beyond) a month in heavy users. Occasional users, 3, 7, 15 days... THC's very lipophilic, so it will depend somewhat on your body fat content.

 

[f_w]

But it will stay traceable in your hair, finger and toenails for however long they stay on you. So, if you show up with a shaved head and they still think you are a pothead, they will pull out your great toenail to proove your misdeeds (realistically they will have you pee and leave it at that. The hair/nail thing is more relevant if you are dead and the ME needs to proove your drug use)

 

[f_w]

The fact that you are looking into ways on how to cheat the system is a bit worriesome. OldPsydoc is probably more qualified to comment on that, but some of the hallmarks of chemical dependency (back when I was in medschool) used to be:

- Continued use despite adverse consequences or the threat of adverse consequences
- Denial, minimization, rationalization, projection.

As a physician, the threat of adverse consequences is very real. And your long explanations as to
- how you can stop at any time (denial)
- how pot is really not that bad (minimization)
- how it is not worse than alcohol (rationalization)
- how working 36 hours is an impairment far worse (projection on others)
fit very nicely into the second category.