VA Blood tests and drug screening

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Posted on: Monday, November 01, 2010
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Jim;

When disabled veterans have their yearly lab tests done (blood&urine) for diabetes does the VA...
A. Check to see if you have your prescribed meds in your system?
B. Check for illegal drugs in your system?


Reply:

I don't know that vets have yearly tests for diabetes. You may be referencing routine lab work (blood tests and urinalysis) during physicals that may note high blood sugars as well as high cholesterol and many other abnormalities.

You may at that time be checked for illegal drugs. That is almost accidental because sometimes VA does check you for legal drugs. Here is how it works...

If you have a condition that causes chronic pain, you may be on long term therapy with oral narcotic medications. In both the civilian world as well as the veterans world, most treating caregivers today require that you will sign a "pain contract". That agreement tells your doctor that you will only take the narcotic strictly as prescribed and that you won't share it with anyone else. It will also say that you agree to take a drug test to see if there is a therapeutic level of the drug in your system. These tests may be random or scheduled.

There has been an infrequent problem that patients will use their narcotics to turn a profit...they may sell the pills to others. If you are tested for your particular drug and you do not have any of it in your system, you'll have some explaining to do. For example, if your prescription says you are to take 3 pills each day for your pain and you have none of the medicine in your blood or urine, that would indicate that you haven't taken the medicine for days and that you probably don't need it.

When you are tested, the most frequent test is by urinalysis. Each test kit has a cost associated with it. There are different types of test kits that detect different types of drugs. The lower cost testing supplies usually test for 4 drugs at the same time. Other kits will test for 6 or 8 or more. As you would guess, the more drugs detected, the higher the cost of the kit.

http://en.wikipedia.org/wiki/Drug_test

Much of the testing in both civilian and VA and military settings is done with a standardized 4 drug detection kit. The test of your urine would show the presence of narcotics (Vicodin, Oxycontin, morphine, etc.). marijuana, cocaine (or crack) and amphetamines. In some tests benzodiazepines (Valium and similar) may be detected.

Therefore, if you are tested to ensure that you are taking your prescribed medication and you have been smoking marijuana, you'll likely get a call from your doctor.

VA has recently issued a policy about the use of marijuana by patients. State laws regarding medicinal marijuana are changing across America but federal laws aren't. VA is a federal institution and must walk a fine line between condemning the use of marijuana or endorsing it.

The policy is here www1.va.gov/vhapublication/ViewPublication.asp?pub_ID=2276

What they did in the policy statement was to leave it up the the individual treating doctor as to how to handle such a thing. VA will not allow doctors to prescribe medicinal marijuana but your doctor can pretty much ignore your use of it if he or she doesn't see a problem.

If your doctor believes that you have a conflict with the use of prescribed medications and smoking marijuana, you may be instructed that you must make a choice of marijuana or prescribed medications. That is strictly a therapeutic decision by the provider and little appeal is available should it happen to you.

Beyond all that, to my knowledge veterans are not routinely tested for illegal drugs. The expense alone would be huge and in a more or less routine circumstance, testing of all patients at a given facility may show that hundreds or even thousands were using marijuana. The question of "What then?" arises. Once VA identified all these veterans what should they do?

There are instances where mental health patients who are taking psychotropic drugs will be tested to ensure that they are not taking illegal drugs. That's a very serious situation as the mental health patient can negatively affect the treatment plan by mixing their prescribed medicines with recreational drugs. Patients who are candidates for organ transplants may also be counseled (and tested) about using recreational drugs because of the amount of anti-rejection medicines they are likely to be required to take.

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Comments

Submitted by frank549 on Thu, 2014-01-23 13:12

I am a Service Connected veteran and retired from the military after nearly 30 years service. I am seen at my local VA for Cholesterol pills and Flonase for allergies. I went to the lab today (23 Jan 2014)for a blood draw. After the draw she handed me a urine bottle and said I can go to the bathroom for provide a sample. I looked at the bottle and it had my information on it and included the word in para (Random). I asked her what it was for and she said to check if I have a Urinary Tract Infection (UTI). I said I'd know if I had one and I'll let them know. I refused the sample. I am not a VA employee and felt this was a violation if not a HIPAA violation. I'm already giving them my blood and they can check for drugs in that if they want to. I am clean, I look clean, and do not see any reason for them to do a random urinalysis on me. I provided these random (mandatory) tests for an entire lifetime in the military so I appreciate being able to tell someone no today.

Submitted by admin2 on Mon, 2014-01-27 10:56

Hey, I told Jim about your post and he had this response:

"I'm not sure why anyone would refuse a simple urine test? If you were told that you were being checked for a UTI, there must have been a reason for that.

You say, "if I have a Urinary Tract Infection (UTI)...I'd know if I had one and I'll let them know." That isn't quite right. In my health care career we routinely identified low grade UTI's in people who had no symptoms whatever. The point of such screening is to identify minor undetected problems while they're minor and prevent them from becoming a bigger issue. VA is big on preventative medicine.

There are 2 options I can think of. (1) Your doctor decided that checking your urine was a good idea because of some of your symptoms or (2) there may be a study taking place where random urine samples are collected to see if there is a percentage of veterans who may harbor an undiagnosed UTI. I bring up the idea of a medical/scientific study because those things go on all the time at VA hospitals. VA hospitals conduct more pure clinical research than almost any medical program anywhere.

You seem to feel that you were being subjected to a drug test. To my knowledge and belief, VA doesn't conduct random drug tests. VA does conduct drug screenings to aid in the treatment of patients but the tests aren't random. Random drug screens are expensive and VA doesn't conduct them.

There was no HIPAA violation in such a test. HIPAA rules address the exposure of your private data to unauthorized persons. If your doctor ordered a urine test, or if your urine was being collected for a study, your data would not have been released in a way that violated your rights of privacy.

Beyond that, any time VA conducts a drug screen as ordered by a physician, the veteran patient is told that he is getting a drug screen. There is no reason anyone at VA would say that it was a simple urine test to check for UTI.

I have a feeling that you may have missed an opportunity to either have a test that your doctor ordered completed or that you didn't participate in a study that wouldn't have harmed you and could have helped other vets."