drug testing


Ms.Breuer: I am a nurse practitioner who was recently offered a position by a detox center/drug rehab facility. As per their pre-employment policies, I underwent their mandatory drug testing (urine) procedure. I provided them with a list of the medications that I take (sustiva, zerit, epivir,videx, naldolol, aldactone, and trazadone). After about a week I received a call that my urine was found to be positive for cannabis and methamphetamine. I have never in my life used methamphetamine and have not smoked pot in years. While I understand their unwillingness to hire someone who tests positive for drugs, I am mystified by why my urine tested positive for these substances. The bottom line is that they said they cannot hire me. I stressed to them that there must have been some error but both the center and the lab who did the test said that they stand by their results. I asked if I could repeat the test which was refused. This witch trial logic of theirs concerns me since I have no recourse. By disclosing the meds I am on, I obviously disclosed my HIV+ status. Is there anything I can do in the future to comply with company drug testing and protect my professional reputation (and licensure) while I'm job searching? Thank you.


You have waited a long time for this answer, not because that was my intention, but because I have had to wait for responses from a number of people whose counsel I sought on this complex question. All three partners of The Positive Workplace –- Lynne Gabriel, Allan Halcrow and I -– have collaborated on this response. At last, with my apologies for the delay, here it is. I hope the response will be useful to you and to others. Here goes:

If the urine or hair test for drugs was done post-offer and pre-employment, that is fairly standard practice. If they tell you that the results came back positive for marijuana and cocaine, they should be prepared to stand behind those results, that is, show you the results. If you are not a user, I would recommend that you request written proof of the results. You could also offer to retake the test.

If you are not a user but have been in the presence of a user of marijuana in the two weeks previous to the test, while that person was smoking pot, it is possible for your results to be positive for marijuana, according to my physician expert.

You may know that the simple act of eating a poppy seed muffin in the days before a urine test can yield a positive result for marijuana. They apparently have a chemical in common that triggers an inaccurate positive. Do you recall eating anything with poppy seeds in it before the test?

According to a pharmacist who specializes in HIV-related medications, none of the antiretrovirals will trigger a positive response on a drug test. You might ask your own pharmacist whether any other HIV-related meds you are taking could trigger a positive response.

As to being asked to list your medications: this one is complicated. The most likely logic is that they are concerned about any medications that would or could interfere with your performance of the job. For example, are you taking anything that would interfere with your ability to operate machinery? To rely on fine motor skills?

It matters who asked for the list of meds. If the request came from the clinic that does the company's physicals for post-offer, pre-employment candidates, it's a good idea to ask what they do with the information and to write a statement on the form itself that you understand medical information to be confidential and anticipate that the only information to be shared with the employer is whether or not any of your meds would interfere with the performance of your job. In short, a pre-employment physical exam and medical questionnaire should simply lead to a yes or no to the employer about your fitness to perform the job, not to disclosure about aspects of your health.

If the HR department or recruiter is giving you the form to list your meds, I strongly recommend that you ask the purpose of the question. Whatever the answer, offer to review your prescriptions with your physician and then bring back a note detailing any negative interaction between your meds and your job description. And smile as you say it; this is a friendly offer on your part, not a hostile parry. You're just acting like a person who knows his/her rights.

There is a difference between withholding information on an application for health, disability or life insurance (never a good idea) and seeking to maintain the confidentiality of your medical information in a job interview. Many employers are sloppy about medical confidentiality just out of ignorance of the boundary; others cross it knowingly. In either case, you may be surprised by their willingness to have your physician respond to the question about your prescriptions.

And a final note to an employer who may be reading this response: the less detail you have about an employee's or candidate's health, the less you can be accused of using it in your decisions about employment. One of the best ways to avoid allegations of discrimination is to sharply limit the medical information you have about the person, and to make it clear that you recognize and respect that boundary.

Please let me know if you try these ideas and they don't work. As cold as the comfort is when you go through the job interview process and get this far, only to find that they're pushing you to the wall on revealing confidential medical information, you could reassure yourself that a such a firm might not be a great place to work. And please remember that if they claim you failed a drug test, you can demand a copy of the results. I wish you well!

Nancy Breuer