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 Drug Screen Testing

 POLICY

The purpose of random drug screen testing is to provide a record that the individual’s required abstinence of alcohol and unauthorized and illegal controlled substances is occurring and is being monitored on a routine basis. 

PROCEDURE

  1. Individuals being monitored by a Board Order that are required to have random drug screens will be assigned a color level depending on the appropriate monitoring level.  There are various color levels, which will require various numbers of collections, discards and analysis.
  2. Initially, an identified number of screens required on a random basis will be established during the development of the Board Order and are subject to change throughout the drug testing process.  Ethylgucuronide (EtG) and Ethylsufate (EtS) testing for the detection of alcohol may be utilized throughout the random drug testing process.  The frequency and type of screens depends on the diagnosis, substance abused, and practice issues.  Progression through the assigned color levels is dependent on the issues stated above and the individual’s drug screen testing results.
Color Level # Collections/Tested Cost/Lab Analysis• Collector Fee••
Blue 6/quarter Varies
Pink 3/quarter Varies
Purple 6/year Varies


 Note: 
• The cost of lab analysis is paid by the monitored individual and is $45 per test and is subject to change.

••There is an additional fee paid directly to the collector to collect the samples.  This is not included in the price for lab analysis.  Collection fees are also paid by the monitored individual and are established by the various collection sites and will vary in price. 

  1. The monitored individual will make initial contact with the drug testing company within 10 days of the date of the Board Order to obtain the designated collector and the collection site location. 
  2. All screens are done on a random basis.
  3. Specimen testing will be done through the program designated drug-testing laboratory.  All specimens are to be provided consistent with the protocols and collection procedures established by the designated laboratory.
  4. All drug screens are completed using an observed and/or secured dry room technique and following proper chain of custody.
  5. Dilute urine may be considered positive and must be repeated as soon as possible.  Drinking excess fluids prior to a drug screen may lower the specific gravity and creatinine level.  A low specific gravity/creatinine may invalidate the analysis.  The following criteria will be implemented for individuals who present with a specific gravity of less than 1.003 and a creatinine level of less than 20 mg/dL:

 1st Dilute -     Letter of Concern with a required $100 Administrative Fee is sent to individual. 

2nd Dilute -     Letter of Concern with a required $150 Administrative Fee is sent to individual.  Individual must pay for an additional drug test collection and analysis to replace the invalidated analysis.

3rd Dilute -      Letter of Concern with a required $200 Administrative Fees is sent to individual.  Individual must pay for two (2) additional drug test collections and analysis (1 to replace the invalidated analysis and 1 as a consequence).

  1. The individual is responsible for any and all fees and costs associated with the drug screens.  All drug screen payments are prepaid and must be postmarked by the 23rd of each month.  For example, all drug testing fees for July must be in the mail by June 23rd.
  2. Checks/money orders for drug screens are to be made payable and sent to:

Drug and Alcohol Testing Network, LLC
PO Box 7006
Bismarck, ND 58507-7006

  1. Drug screen results are reported directly to the Board’s designee at the Board of Nursing office.
  2. Guidelines for request for excuse from random drug testing:
    1. The individual must provide prior notifiation, in writing, a minimum of 1 week prior to the excuse date requested.
    2. Consideration for written excuse requests will be made based on the following criteria:
      1. Reason for the request
      2. Location where the individual will be during the requested excuse time
      3. Current compliance with the terms and conditions of teh Board order
      4. Frequency of excuses requested:  No more than a total of 14 calendar days in one calendar year may be approved per year
      5. Other exceptions may be approved after review by the Compliance Advisory Council
  3. The individual may voluntarily submit to drug screen testing at any time.
  4. The Board’s designee or the employer may request a drug screen test if there is suspicion of use/diversion of alcohol or drugs by the individual.  Refusal to immediately submit a specimen for a drug screen may be considered a positive and a violation of the Board Order.
  5. The individual is responsible for informing any employer and/or supervisor of the need to leave work to give a drug screen test.  In case of an emergency, if the individual is unable to leave the work site, the supervisor must contact the Board’s designee for an excused absence.
  6. A positive screen may necessitate additional review by a Medical Review Officer with an additional cost of $25 to be paid by the monitored individual (cost is subject to change).  Positive results will be evaluated in light of information provided in consent form (i.e. medication or drugs taken) and all other information available to the laboratory and the Board. The Board’s designee and/or Medical Review Officer shall examine alternate medical explanations for any positive drug test results.
  7. Noncompliance issues:
    1. A missed drug screen test or refusal to submit a specimen for a drug screen is considered a positive.
    2. The drug testing company will send a written notice of noncompliance to the individual for any late payments or NSF checks, with the information also submitted to the Board’s designee for possible disciplinary action.  The drug testing company will charge the monitored individual a $25 fee for any NSG check received.
    3. Any NSF payment will require all future payments in the form of a money order.
    4. Any collections not paid for in advance will not be analyzed and may be considered a positive.
    5. A drug screen will be considered a confirmed positive if the proper documentation from the prescribing practitioner has not been received.
    6. A positive screen will result in referral to the Compliance Advisory Council for review and may result in additional disciplinary action.
  8. Monitored individuals must have no dual conflicting relationship with the specimen collectors.  If a conflicting relationship develops, the individual may be referred to the Compliance Advisory Council for additional disciplinary action.
  9. Monitored individuals must call the drug testing phone number, (701-805--5468), by 11:00 am local time, Monday through Friday to obtain the color of the day and to determine if drug testing is required that day.  If the monitored individual is unable to connect with the drug testing number to obtain the color of the day, the monitored individual must then contact the designated collecter to check fo the color of the day.
    1. If drug testing is required that day, monitored individuals must report to the appropriate colletion site and submit a specimen within 2-6 hours and prior to 5:00pm local time or collection site closing time on the day of the requested drug screen.
    2. Provisions for testing after 5:00 pm local time must be approved by the drug testing company representative or the Board's designee.  
    3. There are no collections on state holidays.
  10. The individual must report the use of any PRN controlled substance medications or mood/mind altering substances to the Board's designee within 24 hours.  Written verification from the designated healthcare practitioner must also be submitted to the Board's designee within 3 working days.  
  11. Prior to drug testing, the individual will disclose to the designated collector the use of any substance which could alter a drug screen, including, but not limited to:
    1. Any and all mind altering substances and controlled substance medication, including, but not limited to:
      1. antidepressants
      2. antipsychotics
      3. antianxiety agents
      4. hypnotics
      5. narcotic analgesics
      6. sedatives
      7. stimulants
    2. Over-the-counter products and herbal perparations containing mind/mood alterling substances matching the categories listed, including, but not limited to:
      1. diet aids/diuretics
      2. digestive aids
      3. energy aids
      4. laxatives
      5. painkillers
      6. sleep aids
      7. Dietary intake
    3. Dietary intake and any other substances having similar effects:  It is important to know what products you are ingesting.  Your will nee to abstain from all substances known to interfere with the toxicology screening process, including but not limited to:
      1. Foods, beverages, over the counter medications, and products containing poppy seeds, hempseeds, and ethyl alcohol - Examples include:
      • Nonalcoholic beer or wine
      • Some desserts
      • Salad dressings
      • Soups
      • Herbal remedies
      • Some hand sanitizing and mouthwash products

‚ÄčThe ingestion or use of such products will not be accepted as an acceptable reason for a positive drug screen result.

  1. Any other substances having similar effects.
  2. Specific medications (both prescription and non-prescription AND any medications obtained out of the country, i.e. Canada and Mexico) that must be reported to the Board’s designee.

 

 


 

 

Approved: May 1998
Reviewed/Revised: 09/17