# Drug Testing Before EMT-Basic Courses?



## jrg (Apr 28, 2014)

I am currently a student at the University of Massachusetts on the pre-med track, and plan on taking EMT-basic courses over the summer. I am in fantastic academic standing, volunteer in my free time, and already have a job working in the hospital in my hometown, so please don't give me the "smoking pot is for lazy idiots" speech. I have been diagnosed with depression (specifically dysthymia) and self medicate by smoking cannabis. Getting a medical marijuana card is not possible for my situation, as my doctor is only willing to provide anti-depressants which don't quite do the trick as well as pot.  I'm aware that I will have to test prior to getting a job in the field, but am curious as to whether or not I should stop smoking prior to taking the COURSES (the other threads mainly discussed testing prior to a job). The courses will be taken in Massachusetts, if that makes any difference. There was already a similar thread posted, but it did not provide much help. Any insight into this topic would be much appreciated, thanks!


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## mycrofft (Apr 28, 2014)

Ask your potential employers. AND/or a lawyer. Or another doctor.

I imagine if it is not prescribed* and it's federally banned and you aren't in Colorado, you might be in a lurch.

Rule of thumb..if it takes more than two sentences to ask, the answer is probably "no" (and you already suspect that), and/or you need a lawyer to try for "yes" or even a definitive answer.

*PS: self-prescribing has led to the downfall of many medical persons through recent history. It's our version of "The lawyer who represents himself has a poor client". See your doc, get the best help.


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## Drax (Apr 28, 2014)

jrg said:


> I am currently a student at the University of Massachusetts on the pre-med track, and plan on taking EMT-basic courses over the summer. I am in fantastic academic standing, volunteer in my free time, and already have a job working in the hospital in my hometown, so please don't give me the "smoking pot is for lazy idiots" speech. I have been diagnosed with depression (specifically dysthymia) and self medicate by smoking cannabis. Getting a medical marijuana card is not possible for my situation, as my doctor is only willing to provide anti-depressants which don't quite do the trick as well as pot.  I'm aware that I will have to test prior to getting a job in the field, but am curious as to whether or not I should stop smoking prior to taking the COURSES (the other threads mainly discussed testing prior to a job). The courses will be taken in Massachusetts, if that makes any difference. There was already a similar thread posted, but it did not provide much help. Any insight into this topic would be much appreciated, thanks!



A couple folks were shocked to find out during my EMT course, that the hospital all of the sudden wanted volunteers to be drug tested prior to being able to do their clinicals. One guy had to wait all the way to the very last day of class before he figured he'd be able to pass the drug test because of his marijuana use.

So as a new condition of the program, you must be drug tested prior to taking the course I believe. Can't say the same for other courses out there; Ours kind of changed on its own. Frankly, if you're practicing any kind of medicine though, you shouldn't touch/take mind altering substances/medications, especially those that are illegal.

I'll add, that guy was nearly kicked out of the program, but because he had indicated he would be seeking legal action, he was permitted to stay. Again, this is also Washington state.


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## WuLabsWuTecH (Apr 28, 2014)

OP, the classes will indicate whether a tox screen is necessary.  For my EMT-B class, it was not, but we also didn't do any hospital time (only ride time).  For most medic programs that do hospital time, the hospital requires it.  But your best bet is to look at the program requirements which will outline what needs to be done before you start taking the course.

Without giving too much medical advice, I would just like to say that there are A TON of antidepressants out there with some very different mechanisms of action.  Just because one or two didn't work for you doesn't mean others might not.  They take 2-3 months to take full effect, so while I know it can be frustrating, your best bet is to keep going back to the doctor and trying something that might work better until you find something you like.  But if you want to go into EMS, your JOB will require you to get a drug test (I've never been to a department that didn't require it).  

Also, as a current medical student, I can tell you that testing positive on a drug test is not a fun thing to have happen to you.  If your first drug test comes back positive after acceptance but during orientation or really, anytime before matriculation, you can kiss that acceptance goodbye.  If after that, when they do random drug screens, you have one come back positive, you're immediately pulled out of all of your classes until you can sit down with the dean and explain what's going on.  The dean may or may not work with you to figure out a plan of action.  Either way, if your end goal is to become a physician, your current "medication" regimen isn't sustainable.  Start trying to find an antidepressant (prescribed legally!) now because it will take some time, and medical school isn't exactly the time you want to be trying to figure out which one works best!

Good luck to you.


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## Rin (Apr 28, 2014)

jrg said:


> I am currently a student at the University of Massachusetts on the pre-med track, and plan on taking EMT-basic courses over the summer. I am in fantastic academic standing, volunteer in my free time, and already have a job working in the hospital in my hometown, so please don't give me the "smoking pot is for lazy idiots" speech. I have been diagnosed with depression (specifically dysthymia) and self medicate by smoking cannabis. Getting a medical marijuana card is not possible for my situation, as my doctor is only willing to provide anti-depressants which don't quite do the trick as well as pot.  I'm aware that I will have to test prior to getting a job in the field



Not only to GET the job, but to STAY in the job.  Realize that if at any time you are involved in an incident on the job (you get hurt, you ding the squad, you ding another vehicle...you ding a patient *wince*) you will be immediately required to get another drug test.  If you fail the test, you can expect to be terminated and likely sued if there was a patient or other vehicle involved in the incident.  Don't leave yourself open to that.


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## Ewok Jerky (Apr 28, 2014)

Smoking pot is not just for lazy idiots. But if you intend to work in ems or become a physician, you need to demonstrate responsible behavior.  That meens not breaking the law. Which meens not using a controlled substance without a prescription. Self medicating is an ethical no-no and also a legal no-no with legal medications.  Depression is not an indication for marijuana, as far as I know.  Seek the advice of your doctor and be willing to experiment with legal, medically indicated drugs.

Personally I think pot should be legal for recreational use just like alcohol. But it's not. So don't do it.

And to echo what has already been said:
You WILL be drug tested on the job. I was involved in an MVA at work, as the tech in the back, and I still got tested because company policy is anytime an incident happens the crew gets tested.


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## Handsome Robb (Apr 28, 2014)

I had to take a drug test in medic school prior to starting clinicals and internship but not EMT-B or I.


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## WuLabsWuTecH (Apr 28, 2014)

Rin said:


> Not only to GET the job, but to STAY in the job.  Realize that if at any time you are involved in an incident on the job (you get hurt, you ding the squad, you ding another vehicle...you ding a patient *wince*) you will be immediately required to get another drug test.  If you fail the test, you can expect to be terminated and likely sued if there was a patient or other vehicle involved in the incident.  Don't leave yourself open to that.



I completely forgot about this aspect. But yes, anytime there is an incident, no matter how minor, my department makes me go do a tox screen.  This is for liability purposes so later the other party can't claim "Well, the EMT on scene was acting erratically and could have possibly been high/drunk!"  When the tox screen comes back negative, the department can say, "Nah, he was acting weird just because that's his personality!" 

But in all seriousness, the immunities afforded to EMS personnel does not cover "willful or wanton" disregard for the law and as such, you could easily be sued with no department support to back you up.


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## EMTbasicGirl (Apr 29, 2014)

*drug screens*

No courses that I know of require drug screens.


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## EMTbasicGirl (Apr 29, 2014)

In the state of NC there are no drug tests for courses.


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## SandpitMedic (Apr 29, 2014)

WuLabsWuTecH said:


> .....the immunities afforded to EMS personnel.....



What immunities? Please do tell. As far as I knew I was a regular old Citizen and was not afforded special privileges under the law. 



jrg said:


> I am currently a student at the University of Massachusetts on the pre-med track.....



Don't follow others' mistakes young man. 

First of all, why even bother with an EMT class for all the hassle of it interfering with your 420 habit? Just be a doc... And make sure you don't screw that up, like others have forewarned.

I can say I know a lot of RNs and Docs and EMS folk who dabble in this and dabble in that. I can also say mostly none of them did it on the road to certification, as they would not be where they're at today if they had been careless or risky. Although, the most important thing I can say is that they are actively risking their careers, livelihoods, personal possessions, certifications, friendships, marriages, and even their liberty in doing so. Should they have an unlucky event, or complaint, or just plain old bad timing they could lose it all due to their little vice(s). We are all human, and all have temptation and make mistakes. 

That said, in our profession, you are expected to be a responsible, stable, and suitable adult who displays the ethical and moral characteristics that are expected of us. Illegal conduct and use of mind altering substances are not indicators for proper suitability for someone who is responsible for the lives of others. Furthermore, as a doctor you are held to an even higher standard. Imagine a hospital or medical group that hires a doctor with an (as it stands) illicit and illegal drug habit or conviction who is responsible for maintaining access to and prescribing controlled substances.... Yeah, no way. Oh yeah, and that DEA permit/cert--- bye bye. Good luck even getting it with a drug offense on your record, and a "green card" application or copy will be on some DEA desk rider's stack of papers to hassle you later. You want to live that MD life? You had better be aware of the consequences of your actions. Is it some egregious violation that is going to get you locked up for life? No. However, it will put a quick roadblock on your path to that dream of yours.

I do think small amounts of recreational pot should be no different than beer or liquor, but I don't make the rules. Personally I don't smoke or use cannabis products. I see the country headed there in the next 5 years. However, as of now ... It is illegal. Even in CO & WA where it is legal it is still illegal on the federal level. What level of law enforcement is the DEA again? 

In summary, I think the fact that your doctor won't even prescribe you a "green card" combined with your unwillingness to try new (equally as bad, yet legal and corporate money making) antidepressants indicate you use the guise of "medicinal" use to cover up your little habit. 

It's okay, mostly everyone is else is doing it too, but you are not yet held to a higher standard. 

The quagmire in this is that you can be all hopped up and polypharmed to high heaven, so long as it is deemed "legal" by the establishment. The ubiquitous prescription medication abuse and over use in this nation does not garner the attention it deserves. In most cases, it is Rx medication that is the leader in substance abuse nationwide. Unfortunate as that may be in regards to reefer still being illegal. Of course, even coming into work still drunk or on your pain meds is bad news bears as well, and are cause for termination papers most ricky-tick. 

On a tangent, I am curious, although I can hypothesize, what the legislation says about those in public service and equal professions in regards to pot usage in CO & WA? I assume that it would still be a violation of institutional and/or company policy regardless of whether it is legal or not.


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## zachogden (Apr 29, 2014)

Here's an idea: your doctor won't give you a card because cannabis isn't actually treating your condition. Getting high isn't a substitute for SSRIs and therapy (things doctors might recommend perhaps?). Swap dope for booze and you'll get the same effect but be able to pass a screen. Cannabis cards don't get handed out so you can get high and forget you're depressed for a couple hours, if you're serious about being an EMT or a physician, start thinking like one and choose a treatment that will affect the underlying issue, not provide an escape. Every day you put off treatment for a blunt is a day you could have been getting better.


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## Handsome Robb (Apr 29, 2014)

Alright I'm going to be that guy here.

There are some places out there saying moderate to low dosing schedules can be an effective treatment of psychological disorders, primarily bipolar and depression. 

Heavy use depletes serotonin levels whereas low to moderate doses actually increase serotonin levels.


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## rmabrey (Apr 29, 2014)

I got tested in EMT class.  I did not get tested in medic class.


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## joshrunkle35 (Apr 29, 2014)

I got tested prior to medic class as a requirement to start. 

I think pot should be legal, however it isn't. Your behavior shows a pattern that you are willing to break the law in order to do what you feel is best for your psychological state.

While I don't believe that pot is a gateway drug, or chemically addictive, I do think that there is a psychological issue at question here: can you be trusted to see/deal with emergencies that are psychologically traumatic and simultaneously be trusted with much stronger narcotics at your fingertips? 

Let's say you have that one awful day where you get a suicide, a SIDS baby and a four year old that dies in a car accident. Frankly, that kind of day might make any person depressed. Like, crazy depressed. People in EMS without drug habits have started skimming morphine just to sleep after something like that. Go around and ask your local agencies. Just about all of them have some horror story of someone who has stolen morphine and the crazy ways they did it to avoid inventory. Many of these people had no prior drug or criminal history. In many cases, they just didn't receive help for something psychologically traumatic. 

If you are willing to break the law in order to make yourself feel better, why should you be trusted to work in a profession that could make you more depressed at some point and potentially give you access to something that might really make you feel good? Why as an MD should you have a DEA license if you currently break the rules?

The issue is not about what substance you take, or what effect that substance has on your body. The issue is that you cannot be trusted to follow the rules. I'm worried not only that you could hurt yourself but that you could hurt others. In most of the cases I've heard of in my area regarding morphine theft, the drug was often substituted with water. Some patients died because they did not get the drug they needed.


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## Carlos Danger (Apr 29, 2014)

SandpitMedic said:


> On a tangent, I am curious, although I can hypothesize, what the legislation says about those in public service and equal professions in regards to pot usage in CO & WA? *I assume that it would still be a violation of institutional and/or company policy regardless of whether it is legal or not.*



This is a big part of the problem right here for anyone in healthcare who wants to use.

I can envision pot becoming legal or at least de-criminalized in many more states and at the federal level within the next 5 years or so. But even if that happens, it will likely be years more before certifying bodies, licensing boards, insurance companies, and healthcare institutions allow it.

The bottom line, whether we agree with it or not, is if you want to work as a professional in the field of healthcare, then you can't do pot, period. And it will probably be many years still until that changes.


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## Drax (Apr 29, 2014)

Halothane said:


> This is a big part of the problem right here for anyone in healthcare who wants to use.
> 
> I can envision pot becoming legal or at least de-criminalized in many more states and at the federal level within the next 5 years or so. But even if that happens, it will likely be years more before certifying bodies, licensing boards, insurance companies, and healthcare institutions allow it.
> 
> The bottom line, whether we agree with it or not, is if you want to work as a professional in the field of healthcare, then you can't do pot, period. And it will probably be many years still until that changes.



Every agency I've applied for does not allow concurrent use. Some differ on the length of the period in between last use and hire. I'm sure with the surplus of EMS personnel, anyone admitting to prior use has like a 1 in 100 chance of getting hired on top of their current chances.

Aside from every absolutely valid point in this thread so far. One of the primary reasons it will never be allowed is because of the way it is handled. If you pop hot on a test and the media gets wind of it, it has the potential to ruin an entire agency's reputation and affect future funding/grants.

"This just in, ambulance driver responsible for the death of his partner and patient. More at 11."

Don't know if tests can determine between you using two weeks ago and using two hours ago. Either way, as a lay person tax payer, I could see myself voting to send my dollars else where.


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## WuLabsWuTecH (Apr 29, 2014)

SandpitMedic said:


> What immunities? Please do tell. As far as I knew I was a regular old Citizen and was not afforded special privileges under the law.



I just took an EMS Medicolegal class, and at least in my current state (OH), EMS Providers are immune from legal suits provided that they are not willful or wanton in their disregard of the law.  Let me see if I can find that citation...

From: http://codes.ohio.gov/orc/4765.49


```
4765.49 Emergency medical personnel and agencies - immunity.

(A) A first responder, emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic is not liable in damages in a civil action for injury, death, or loss to person or property resulting from the individual's administration of emergency medical services, unless the services are administered in a manner that constitutes willful or wanton misconduct. A physician, physician assistant designated by a physician, or registered nurse designated by a physician, any of whom is advising or assisting in the emergency medical services by means of any communication device or telemetering system, is not liable in damages in a civil action for injury, death, or loss to person or property resulting from the individual's advisory communication or assistance, unless the advisory communication or assistance is provided in a manner that constitutes willful or wanton misconduct. Medical directors and members of cooperating physician advisory boards of emergency medical service organizations are not liable in damages in a civil action for injury, death, or loss to person or property resulting from their acts or omissions in the performance of their duties, unless the act or omission constitutes willful or wanton misconduct.
```

If you follow that link, there are a few exceptions (the one that stands out to me being driving an ambulance without "due regard") but my understanding is that this law was the response to EMT's not being covered by the Good Sam laws in Ohio and therefore, after a few high profile cases where EMTs stopped to render aid and ended up in court--EMTs were starting to just drive by accidents regardless of how bad it looked.



> Don't follow others' mistakes young man.
> 
> First of all, why even bother with an EMT class for all the hassle of it interfering with your 420 habit? Just be a doc... And make sure you don't screw that up, like others have forewarned.
> 
> I can say I know a lot of RNs and Docs and EMS folk who dabble in this and dabble in that. I can also say mostly none of them did it on the road to certification, as they would not be where they're at today if they had been careless or risky. Although, the most important thing I can say is that they are actively risking their careers, livelihoods, personal possessions, certifications, friendships, marriages, and even their liberty in doing so. Should they have an unlucky event, or complaint, or just plain old bad timing they could lose it all due to their little vice(s). We are all human, and all have temptation and make mistakes.



I would be lying if I said I hadn't thought about trying this or trying that, but as a medical student, and even in my pre-med days, there is no room for error and I would never risk it, even the small risk as it is.  When I'm off at college, my department at home obviously won't come out 6 states away to drug test me, but I work for the hospital and they still can if I have an accident at work (or if my boss is just bored one day).  Could I have gotten away with something during a break?  Probably.  But once again, not worth my entire career path to me.


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## WuLabsWuTecH (Apr 29, 2014)

Robb said:


> Alright I'm going to be that guy here.
> 
> There are some places out there saying moderate to low dosing schedules can be an effective treatment of psychological disorders, primarily bipolar and depression.
> 
> Heavy use depletes serotonin levels whereas low to moderate doses actually increase serotonin levels.



Until there are RCTs showing that _smoking_ it is better than just the active ingredient, I don't think it'll be accepted as mainstream medicine.  I'm not in a state where medical marijuana is legal, so we don't touch on it in school, but I would guess a lot of docs in the states that do either don't prescribe those cards, or if they do, do so reluctantly for business purposes and justify it by using other THC studies in the non-inhaled route.


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## Strap (Apr 29, 2014)

In my EMT-B program (Alabama) we had to get drug tested and background check within the first few weeks of the course, prior to starting clinicals.


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## mycrofft (Apr 29, 2014)

*OK off into the maryjane patch*

A good article, not a professional journal though, about quality control and abuses for recreational marijuana. Indicates where medical marijuana has issues as well as others.:

http://www.foodsafetynews.com/2013/11/colorado-considers-cannabis-potency-regulations/#.U1tczVxm13Y

Apparently there exists no national standard (USP) for marijuana as far as overall potency, preponderance of given chemical agents (psychoactive versus not-so psychoactive), consistency between crops, between brands, or even standards for number of insect parts or amount of pesticide acceptable . It was removed from the USP in 1941.


But of course it is all organic.


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## SandpitMedic (Apr 29, 2014)

WuLabsWuTecH said:


> I just took an EMS Medicolegal class, and at least in my current state (OH), EMS Providers are immune from legal suits provided that they are not willful or wanton in their disregard of the law.....



Ah, I see what you mean. I see I overshot your target; I apologize for my poorly conceived response.

Yes, in terms of official duties and protections therein of responders, there may be cause for throwing those protections out the window if one could allege that you were "high on the job."


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## rails (Apr 29, 2014)

My EMT-B course involved a drug test before clinicals could begin. I assume it was related to hospital policy or liability.


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## phideux (Apr 30, 2014)

jrg said:


> I am currently a student at the University of Massachusetts on the pre-med track, and plan on taking EMT-basic courses over the summer. I am in fantastic academic standing, volunteer in my free time, and already have a job working in the hospital in my hometown, so please don't give me the "smoking pot is for lazy idiots" speech. I have been diagnosed with depression (specifically dysthymia) and self medicate by smoking cannabis. Getting a medical marijuana card is not possible for my situation, as my doctor is only willing to provide anti-depressants which don't quite do the trick as well as pot.  I'm aware that I will have to test prior to getting a job in the field, but am curious as to whether or not I should stop smoking prior to taking the COURSES (the other threads mainly discussed testing prior to a job). The courses will be taken in Massachusetts, if that makes any difference. There was already a similar thread posted, but it did not provide much help. Any insight into this topic would be much appreciated, thanks!



We were tested before classes started, class involved ride time and clinicals. Self medicating for any condition is stupid. With your self medicating you are basically treating depression with what is mostly a depressant, not a good medical practice.
I learned the trick about passing drug tests a long time ago, don't do drugs.


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## InNoViSiOn (Apr 30, 2014)

Got about 3 weeks left of the semester for this EMT course.  We were required to get a physical and make sure out immunizations were up to date, but there was no drug testing.  I think it's cause I'm in CA and I know a few people in my class who wouldn't have passed


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## OnceAnEMT (Apr 30, 2014)

phideux said:


> I learned the trick about passing drug tests a long time ago, don't do drugs.



Glad somebody finally said it flat 

As was said on the last page, it really doesn't matter (today) whether or not your state allows the use in any way. If the company or agency doesn't allow it, case closed.


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