When EMS Providers Have Drug Addictions

[rock_shoes]

No, the bigger problem is this: Most departments say it is OK for you to fail a drug test as long as you have a prescription for what you test positive for. How many medics are on Lortab for their backs and coming to work high ? How can you prove when they took it, the test just shows a positive, there is no way of knowing when they took it.

Now to insert some realism. You absolutely can not discriminate against someone for taking medication as prescribed. If taking a medication as prescribed impairs a persons ability to function in the capacity to which they are assigned they will require alternate duties and or alternate employment. You can't simply fire them.

[usalsfyre]

No, the bigger problem is this: Most departments say it is OK for you to fail a drug test as long as you have a prescription for what you test positive for. How many medics are on Lortab for their backs and coming to work high ? How can you prove when they took it, the test just shows a positive, there is no way of knowing when they took it.

This doesn't even make sense. Does you service have some problem of absolutely epic proportions? One med used to to treat a condition I have pops positive for amphetamines on a urinalysis, should people taking this med not be allowed to work anywhere because we might be secretly smoking crystal on breaks?

I see several people mentioning how no offer of EAP is made to medics. Often one of the parts of an EAP agreement for drug addiction is that the healthcare provider will refrain from handling controlled substances for "X" amount of years. This simply isn't possible for a medic.

[tniuqs]

Now to insert some realism. You absolutely can not discriminate against someone for taking medication as prescribed. If taking a medication as prescribed impairs a persons ability to function in the capacity to which they are assigned they will require alternate duties and or alternate employment. You can't simply fire them.

The forensic analysis on this topic of random drugs of abuse testing has been proven to be pointless and not as effective as a good safety program. The fact of the matter is that timely performance evaluations are far more effective. (ps alcohol in the vast majority of situations is the biggest drug of abuse in our society) The concept that any industry can change societal standards is huge folly, IMHO a waste of effort.

Raise this question if ever "requested for a random sample of urine" if asked for a blood sample this is very close to a rights infringement .. So does your employer EVER ask for a physical before being employed ? It will tell you a lot (and in Canada) the intent of the DOA testing legislation is the well being of the worker which in vast majority of cases is never the real goal with Industry ... The companies that do this are more concerned for their legal liability, ONLY but they must have 1- pre hire testing and 2- counselling program in place before even thinking that this DOA testing will be anywhere near effective as it targets primarily only one drug .. THC.

Why does this not work effectively is a Pandora's box :

1- Firstly false positives and false negatives (false negatives are a huge problem, put buddy back on the job with clear signs of impaired and one becomes liable) as there are typically only 5 major groups of catabolite testing. (urine dip test or saliva) every one of these test strips has a disclaimer clearly posted ... mass spec is the only reliable method.

2- There has yet to be established "what are impaired levels" for Opiates, Benzos, the amphetamines, Cains or THC ... ONLY ETOH has an established value for Level of Impaired, your employer is just asking for a huge legal problem if ever a value (non ETOH) is to be used as termination. Legally IMPAIRED is a different hound ! (I know of more than one employer that allows one to WORK if the breath sample is > .04 OK HUH, seriously hung over is not impaired ?

3- Then those that have legal RX the plethora of medical underlying conditions that require long term or short term medications and those that are NOT impaired they are therputic, this zero tolerance concept is a crack pipe dream that will never become an effective deterrent OR a pragmatic reality.

4- Each drug group is subject to different pharmodynamics in elimination ... testing for meth is a waste of effort as it is eliminated in a very short time and others types of rx take weeks.

5- Then the unknowns .. the poppy seed cake, the legal OTC as in Vicodin, Codeine, and skeletal muscle relaxants.

6- Then just suspect aspects ... accused is not necessarily results in conviction, (as if the emplyers EVER take it to that level) and false accusations can ruin a career in a heartbeat.

What I do know from statistical analysis is that ETOH, Nicotine, Caffeine, and FOOD addictions are far more systemic problem and because of social acceptance far more insidious, point being if we wish to change our culture in EMS we should focus on the REAL Problems.

That said: does a narcotic or benzo abuse problem's exist? YES, we have as medical providers have access which predisposes 'us' to abuse and this is be a screaming call for help, but proper control policies are the way to deal with this but pragmatically we SHOULD be focused on the horses not the zebras.

cheers

ps Sleep impaired is HUGE in MVC, just how does one test for that in EMS ?

Edited June 2, 2011 by tniuqs

[flamingemt2011]

really, really, really ????????????????