[MCOH-EH] pre-placement drug and cotinine screening query/poll

[Lawrence Budnick]

1.       Are you doing pre placement drug screens? Only for positions that require CDL.


2.      Do you include cotinine? No.



3.      Are all interns/residents/fellows included in the screening? No.

Lawrence D. Budnick, MD, MPH
Director, Occupational Medicine Service
Associate Professor of Medicine
Rutgers University - New Jersey Medical School
65 Bergen Street, Suite GA-167, Newark, NJ 07107
tel 973.972.2900
fax 973.972.2904
lawrence.budnick at rutgers.edu<mailto:lawrence.budnick at rutgers.edu>

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Wednesday, December 07, 2016 3:03 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] pre-placement drug and cotinine screening query/poll


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
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces+melanie.swift=vanderbilt.edu at 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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