1.
Not across the board. We have a few groups who require it for regulatory or certification reasons – our internal police precinct, DOT drivers, and specialty pharmacy. It comes up every couple of year
for consideration. Awfully expensive for the yield.
2.
No - Interesting question. ACOEM has a position paper published in JOEM last year on this topic which you might find helpful:
http://www.acoem.org/uploadedFiles/Public_Affairs/Policies_And_Position_Statements/Guidelines/Guidelines/Guidance_to_Employers_on_Integrating.pdf Although the main focus of the paper is e-cigarettes, see page 339 for a discussion of the issues with biological
testing vs attestation for tobacco use. One main drawback to the use of cotinine is that it cannot distinguish between tobacco use and therapeutic use of NRT. To make that distinction you’d have to use another marker such as anabasine. The cost effectiveness
of doing this vs establishing an honor system is worth considering.
3.
N/A (just my opinion, but I can’t imagine how someone smart enough to get through med school could fail a pre-placement UDS. From what I’ve seen, physicians who become addicts are far too cunning to
fall for that!)
Good luck Dana!
Melanie
Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
From: MCOH-EH [mailto:mcoh-eh-bounces+melanie.swift=vanderbilt.edu@mylist.net]
On Behalf Of Sparhawk, Dana P MD
Sent: Wednesday, December 07, 2016 1:20 PM
To: MCOH/EH
Subject: [MCOH-EH] pre-placement drug and cotinine screening query/poll
My hospital group is starting pre-placement drug and cotinine screening next month and I have the program and policies just about set to go. I am now getting questioned from the GME leaders at our teaching hospitals about inclusion of
all interns and residents in this process, and they would like to know what is being done at other academic medical centers.
So three questions:
1.
Are you doing pre placement drug screens?
2.
Do you include cotinine?
3.
Are all interns/residents/fellows included in the screening?
Thanks so much. I will give feedback to the group after I receive the responses.
Dana
Dana Sparhawk, MD, MPH, FACOEM
Director, Lifespan Employee and Occupational Health Services
Clinical Assistant Professor, Alpert Medical School, Brown University
Grads Dorm, Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
(401) 444-7412
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