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How do I respond to a failed pre-employment drug screening?

Monday September 10, 2012
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Dear Nancy,

I have been an LPN for eight years. I had a car accident resulting in several surgeries, and I did not work for two years. I have applied to several long-term care centers and had a pre-employment drug screening. They said I failed on prescriptions and they would contact me on resolution. The Department of Public Health contacted me because the facility alerted them. I donít know what to do.

I have one valid and one expired migraine pill I was taking two years ago. What would be the worst-case scenario? Should I tell them about the expired medication or question their results? The public health department was hinting that they wanted to check my pharmacy history, but I would like to keep them out of my personal health history. What should I do?


Nancy Brent replies:

Dear Natali,

Your situation should be discussed with a nurse attorney or attorney in your state who can advocate on your behalf in this situation. It is understandable that you do not want the public health department in your life, but unfortunately it has information the agency must investigate. Keep in mind that the public health department must do so to be consistent with the policies and procedures. You would not be in a position to know them or to represent yourself, so legal counsel is essential.

For your information, there are false positives to drug screenings, just as there are false negatives. Perhaps a false positive occurred in your case or perhaps the drug specimen tested was not your own. Also, keep in mind many drugs taken legitimately (by prescription) will cause positive test results for certain narcotics. And, the specimen taken from you (blood or urine?) might not have been collected and/or labeled properly.

Your attorney can help you with the best approach to handling this situation. Seek legal counsel as soon as possible.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.