My boss would like me to give people second chances on their drug screens (actually said a 3 strike rule). I have an issue with this because the rules are clearly relayed to every patient who I start on meds or take over prescribing. For things like EtOH or another med prescribed by another provider I think a warning is warranted but with other things (illicits, meds off the street, etc.) I don't think there should be a strike system. How do most you all navigate these waters? It's obviously not good for business to discharge everyone, but at the end of the day you have to protect yourself, the practice, and your patients.