The skinny on testing?

[wrecked]

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Ok, I'll be the one to ask. What's up with the drug testing before residency? Anyone know what exactly they test for and how often? Opioids, benzos, and THC seem like the logical candidates, but what about performance enhancing? And what if you have scripts for the meds -- would you produce the script before the test or would you wait till you tested positive?

 

[Blade28]

Huh? Are you taking anabolic steroids?

 

[Sohalia]

Wow. Why are you even thinking about this?

 

[Laryngospasm]

Dont think they are going to go the extra expense of testing for performance enhancing drugs unless you are talking about amphetamines. They probably do a standard drug screen like on an ED patient, probably not looking for deca-durabolin 😉

 

[tigershark]

If youre talking about steroids/HGH/insulin, they'll never show up on any drug screen you'd be subjected to as a resident.

 

[streetdoc]

If youre talking about steroids/HGH/insulin, they'll never show up on any drug screen you'd be subjected to as a resident.

interesting, i never thought about drug testing. when is this done? i am addicted to lemon poppy seed muffins (pun intended) so when should i stop?
thanks for bringing this up,
streetdoc

 

[wrecked]

Wow. Why are you even thinking about this?

Why am I thinking about it? Thought it might be obvious, especially since it's in almost all sample contracts I've seen. I'm curious b/c I have a script from an ob/gyn for codeine. A colleague has a script for benzos 2/2 migraines and another takes GNC supplements. I've come across literature that implies residency programs ask you to list all meds you've ever been on, which is to say the least, concerning.

Thanks so all those who are taking the inquiry seriously.

 

[GATC]

Great thread....especially for some of us who have been around second hand smoke. As for the bagels, I think you would need to eat a lot of them to be over the cutoff.

All of the residency programs that I have attended have drug testing policies but they don't really explain them.

 

[freshity]

i once heard a story from a resident who had done a rotation in laboratory medicine at the hospital where she was completing her training (in medicine?, i can't remember...) anywho, her program required drug testing, but when she did the lab medicine rotation, she found out that they only ran the tests for some of the major street drugs, and left thc out, citing financial reasons. her sense was that everyone in her program assumed they were being tested for thc when the tests happened and would be surprised to know that the actual analysis for that wasn't done. moral of the story: ask a lab medicine resident/tech at the hospital what the tests entail not just for your own sake, but because it's kind of interesting in general.

 

[Sohalia]

Why am I thinking about it? Thought it might be obvious, especially since it's in almost all sample contracts I've seen. I'm curious b/c I have a script from an ob/gyn for codeine. A colleague has a script for benzos 2/2 migraines and another takes GNC supplements. I've come across literature that implies residency programs ask you to list all meds you've ever been on, which is to say the least, concerning.

Thanks so all those who are taking the inquiry seriously.

Hmm, well it's obvious you do drugs and I guess you'll have to explain that when the time comes.

 

[rugtrousers]

Hmm, well it's obvious you do drugs and I guess you'll have to explain that when the time comes.

It's that kind of judgment that will make your patients open up and disclose things to you, I'm sure. 🙄

 

[DRDARIA]

I'm curious b/c I have a script from an ob/gyn for codeine. A colleague has a script for benzos 2/2 migraines and another takes GNC supplements .

In my experience with other employers drug testing programs, you are given the opportunity to mention any prescriptions you take. I presume if you test positive you then produce the prescription. As long as it is a current, prescribed medication, you shouldn't have any concerns. However, if the prescription is expired, then I would suggest getting a new one, if you need the medication, or quit taking the expired medication. Also, although I don't know this for sure, I would presume that even valid prescriptions that may impair your ability to perform would be a concern if they are being used reguarly (i.e. not for a temporary condition). If needed long term, it might be worth exploring with the prescriber non-narcotic alternatives.

 

[BKN]

It's that kind of judgment that will make your patients open up and disclose things to you, I'm sure. 🙄

Well maybe Sohalia shouldn't jump to the conclusion, but let's say this clearly: if you test positive for a drug of abuse without a legal prescription (and that certainly includes THC), you may or may not get one chance to clean up your act. If you don't, you'll never get a chance top practice medicine. Is the drug worth it?

 

[robotsonic]

Well maybe Sohalia shouldn't jump to the conclusion, but let's say this clearly: if you test positive for a drug of abuse without a legal prescription (and that certainly includes THC), you may or may not get one chance to clean up your act. If you don't, you'll never get a chance top practice medicine. Is the drug worth it?

This is kind of strange, though, because I know residents who use illegal drugs. Not while they are caring for patients, or on call, but in their free time, like when many people drink alcohol. Are they managing to fool the system? And does that really matter? Who cares if someone smoked pot on the weekend when they weren't on call?

 

[GATC]

Hmm, well it's obvious you do drugs and I guess you'll have to explain that when the time comes.

Fire and brimstone.......relax. I think the main point of this forum is to discuss issues openly and in a supportive fashion. If you can't do either, I don't understand why you would post.

Anywho. While I do understand the purpose of testing, I think it takes away liberties which could be dangerous at the end. Setting precedents during the present could lead to dramatic effects and restrictions in the years to come.

 

[BKN]

This is kind of strange, though, because I know residents who use illegal drugs. Not while they are caring for patients, or on call, but in their free time, like when many people drink alcohol. Are they managing to fool the system? And does that really matter? Who cares if someone smoked pot on the weekend when they weren't on call?

Given the cannibinoids fat storage, I'm not at all sure that it's safe to smoke it on the weekend and then care for patients during the week.

But my point is that somebody does care. The american public doesn't want "druggy doctors" and the state licensing boards will carry out their wishes. Give it up or risk the consequences. 😎

 

[robotsonic]

Given the cannibinoids fat storage, I'm not at all sure that it's safe to smoke it on the weekend and then care for patients during the week.

Normally I enjoy hearing your opinions, but I think you've been watching too many old propaganda films.

This is a little off topic, but the fact that marijuana is illegal is completely ridiculous, and has more to do with politics than actual medical evidence. Sorry, but I would rather have a physician who smoked pot on the weekends than one who drank alcohol. Alcohol - through addiction and the physical harm it does - claims many more people than marijuana. But enough on that; I don't want to hijack this thread.

 

[GATC]

Normally I enjoy hearing your opinions, but I think you've been watching too many old propaganda films.

This is a little off topic, but the fact that marijuana is illegal is completely ridiculous, and has more to do with politics than actual medical evidence. Sorry, but I would rather have a physician who smoked pot on the weekends than one who drank alcohol. Alcohol - through addiction and the physical harm it does - claims many more people than marijuana. But enough on that; I don't want to hijack this thread.

Totally agree with this. It is all politics. Back to the original post.....

 

[BKN]

Normally I enjoy hearing your opinions, but I think you've been watching too many old propaganda films.

This is a little off topic, but the fact that marijuana is illegal is completely ridiculous, and has more to do with politics than actual medical evidence. Sorry, but I would rather have a physician who smoked pot on the weekends than one who drank alcohol. Alcohol - through addiction and the physical harm it does - claims many more people than marijuana. But enough on that; I don't want to hijack this thread.

I'm not disagreeing with you. And I would certainly never say that marijuana offers 1/10 the risk of alcohol. All I'm trying to say to you is that when a resident gets caught, it'll be out of his PD's hands. The medical facts won't matter.

p.s. Do you really want to instruct a child of the 60's on the nature of recreational drugs?

 

[locitamd]

Hmm, well it's obvious you do drugs and I guess you'll have to explain that when the time comes.

yup, the OP asked:

I'm curious b/c I have a script from an ob/gyn for codeine.

Well stated Rugtrousers:

It's that kind of judgment that will make your patients open up and disclose things to you, I'm sure. 🙄

 

[locitamd]

Ah hell, tact to the wind...

Sohalia, I can't believe the arrogance. Further can't believe they'll award you an MD with an attitude like that.

Hope your reality check is on its way.

 

[fourthyearmed]

I've come across literature that implies residency programs ask you to list all meds you've ever been on, which is to say the least, concerning.

This seems a little odd to me. My program did not ask me what meds I am on currently or in the past. It really isn't any of their business if you are on birth control or PPIs. And what if you take an SSRI, do they kick you out for being unstable? (yes, I know there are plenty of other reasons to be on SSRIs, I'm just making a point). This seems to be a breach of privacy in my opinion. Now illegal drugs, that's a whole different story.

 

[locitamd]

And what if you take an SSRI...This seems to be a breach of privacy in my opinion.

most certainly agreed. I think many would be hesitant to either reveal or to initiate tx if this were the case. If any current residents have been asked what meds by their program, please post.

Just proves the point that Wrecked started a good thread by asking, despite what Sohalia wrote. (sorry still fuming 😡)

 

[BKN]

This seems a little odd to me. My program did not ask me what meds I am on currently or in the past. It really isn't any of their business if you are on birth control or PPIs. And what if you take an SSRI, do they kick you out for being unstable? (yes, I know there are plenty of other reasons to be on SSRIs, I'm just making a point). This seems to be a breach of privacy in my opinion. Now illegal drugs, that's a whole different story.

Relax, the screens are for potential drugs of abuse. Nobody is analyzing for SSRIs, PPIs, BCPs or anything like that.

I think whether the whole thing is a breach of privacy is a very real question. But when we think of train wrecks, airplane crashes and other disasters by drunk or drugged up engineers, pilots etc, public safety is an issue. Checking health care workers is a natural extension and you'll lose the argument.

 

[shindog]

I think what they test for may also depend on the collection method. At our institution, they take hair samples.

What method do other places use?

 

[fourthyearmed]

Relax, the screens are for potential drugs of abuse. Nobody is analyzing for SSRIs, PPIs, BCPs or anything like that.

I think whether the whole thing is a breach of privacy is a very real question. But when we think of train wrecks, airplane crashes and other disasters by drunk or drugged up engineers, pilots etc, public safety is an issue. Checking health care workers is a natural extension and you'll lose the argument.

I was simply responding to what the poster had stated and he reported that he had literature to back him up. No need to tell me to relax, I'm an intern and through with all that starting residency junk. And anyway, no one's going to list the dangerous stuff anyway I'll bet.

 

[rugtrousers]

I think the breach of privacy issue has more to do with asking about prescription medications and preexisting conditions. I don't think anyone would argue against testing healthcare professionals for illegal drug use, no matter what drugs you think should be legal 🙂

 

[caroladybelle]

Given that virtually any staff member in the vast majority of facilities that you will be working, is required to be drug screened, repeatedly, sometimes without warning, it is logical that you will be screened.

If they require the housekeepers that empty the garbage and dietary techs that delivery trays to pass drug screens, it is only natural that they require it of those in jobs of greater concern.

And it begs the question. If you cannot give up illegal, or nonprescribed drugs, long enough to pass a simple drug screen, is being an MD all that important? If it is important enough, you will stop using, or produce a legal script.

There are certain prices that we pay to work in healthcare. One is that we obey the law with regards to some behaviors. It does not matter whether MJ should be legal or not....what matters is that it is illegal, and if you want to work in healthcare, you cannot use.

And I get screened 1-4 times per year and have always passed. And I use SSRIs, eat poppyseed bagals, and have ocasionally been on codeine for cough. No problems.

 

[CANES2006]

Given that virtually any staff member in the vast majority of facilities that you will be working, is required to be drug screened, repeatedly, sometimes without warning, it is logical that you will be screened.

If they require the housekeepers that empty the garbage and dietary techs that delivery trays to pass drug screens, it is only natural that they require it of those in jobs of greater concern.

And it begs the question. If you cannot give up illegal, or nonprescribed drugs, long enough to pass a simple drug screen, is being an MD all that important? If it is important enough, you will stop using, or produce a legal script.

There are certain prices that we pay to work in healthcare. One is that we obey the law with regards to some behaviors. It does not matter whether MJ should be legal or not....what matters is that it is illegal, and if you want to work in healthcare, you cannot use.

And I get screened 1-4 times per year and have always passed. And I use SSRIs, eat poppyseed bagals, and have ocasionally been on codeine for cough. No problems.

Agree. They can drug test me till their heart's content. I've got nothing to hide.

 

[matakanan]

Or simple... move to Colorado...i think the state legalised Ganja in Denver 😉

The problem with pot is that it stays longest in ur system as far as detection is concerned...like 30 - 60 days (please confirm the exact days though). So it means stopping pot 2 mths before internship...till then what the hell u gona do? drink cough syrups and suck on eclairs?

 

[caroladybelle]

The problem with pot is that it stays longest in ur system as far as detection is concerned...like 30 - 60 days (please confirm the exact days though). So it means stopping pot 2 mths before internship...till then what the hell u gona do? drink cough syrups and suck on eclairs?

Maybe you need to spend that 30-60 days....oh, maybe getting a life!!!!

Seriously, if you have to live stoned and can't stay straight 30-60 days, you have much bigger problems than passing a drug screen.

 

[kamikaze]

I'm on ritalin for ADD. I think this is a private matter and I'd rather not let everybody in the program know. will it come up in a urine test? I'll show them my prescription if I have to but I'd rather keep this issue between me and my psychiatrist not the PD and everybody else.

 

[snowinter]

Totally agree with this. It is all politics. Back to the original post.....

doesn't Marijuana cause "amotivational syndrome" ??

who wants a physician who doesn't care?

 

[zedpol]

doesn't Marijuana cause "amotivational syndrome" ??

who wants a physician who doesn't care?

I don't care