Drug test history in medical records

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Anon

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I’d appreciate some advice on the third class medical. My apologies if this has been asked. In 2018 I wasn’t feeling well and I went to my university’s clinic. They drew my blood and unbeknownst to me they ran a drug test and it tested positive for THC. This test was not for employment and I have no other history of substances use, and I no longer use any sort of illegal drug.

Would this warrant a “yes” for the medical history question “ Substance dependence; or failed a drug test ever; or substance abuse or use of illegal substance in the last 2 years”? Any advice is appreciated.
 
Get on the right side of this from the start,declare the test results.
 
I think you could argue the point, but it would be semantic. You're much better off disclosing the positive drug test from 5 years ago and explaining the circumstances rather than trying to defend yourself if it comes to light another way.
 
I'd be concerned that there was a reason for them to run a drug test in the first place. That's not like a vital sign that they get on everybody as a matter of routine. Whatever it was will be on that medical record, which the FAA in all likelihood will want to review, since you do need to report the visit and the reason. Somehow just "not feeling well" doesn't tell the FAA very much.
 
DISCLOSE.
Personal statement.
Random urine.
CADC level evaluation (educated to use DSM 4).
 
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dbahn said:
I'd be concerned that there was a reason for them to run a drug test in the first place. That's not like a vital sign that they get on everybody as a matter of routine. Whatever it was will be on that medical record, which the FAA in all likelihood will want to review, since you do need to report the visit and the reason. Somehow just "not feeling well" doesn't tell the FAA very much.
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When a student shows up at a university health clinic “not feeling well,” it’s entirely possible that they get it as a matter of routine.
 
OneCharlieTango said:
When a student shows up at a university health clinic “not feeling well,” it’s entirely possible that they get it as a matter of routine.
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That's quite possible, but I think that they should make the student aware of it and have consent to run it. That may well be buried in a standard consent document that the student signs, in which case it's more of a "trap" than a "consent", IMHO.
 
bbchien said:
DISCLOSE.
Personal statement.
Random urine.
CADC level evaluation (educated to use KDSM 4).
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curious- just about every ER visit at our hospital gets a drug test. Obviously lots of positives for THC, opiates, etc. I don't see this the equivalent of "failing" a drug test as it wasn't required as a condition of employment, licensing etc. So if this was >2y ago I think you could honestly answer "No" to the question. Plus it would take some pretty deep digging in EMR records to find this result as this isn't passed on to any federal or state reporting agency that I'm aware of
 
One could make an argument that this isn’t a “failed” drug test, as it wasn’t for employment and the OP didn’t suffer any consequences for it. Truth be told, I’m impressed he even remembers it.
 
OneCharlieTango said:
One could make an argument that this isn’t a “failed” drug test, as it wasn’t for employment and the OP didn’t suffer any consequences for it. Truth be told, I’m impressed he even remembers it.
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Thanks for your response. I wanted to review all of my medical records before I submitted the medxpress form, so I logged backed into my old student records and found it under lab tests.
 
He probably signed something agreeing to it when he was admitted. Probably didnt read and even know that a drug screening was even being done but had legally agreed to it.

As for whether it constitutes a drug "test" - I'll leave that one alone.
 
bbchien said:
FAA would consider that a failure (Now cometh the s__tstrom of those who will say, "it doens't say that...it's peferctly clear to us....why is this even being discussed....").

IMO, The more strident the poster, the less knowledge that person likely has.....
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Curious- (theoretically) if he was brought in by ambulance after MVA with questionable head injury from airbag, standard of care would be pan drug screen. He’s watched overnight and discharged the next day. Drug screen happens to be positive for THC, but since most docs don’t really care about that as it doesn’t affect his care, he’s never notified of the result. Your statement above says the FAA would consider this a failure. So is his requesting the records to find out if they did one the condemning factor? What if he was never aware of a test ever having been performed, but it comes out on some EMR database report? That is my biggest fear, is what potential issues are going to be found when the FAA figures out hey can mass scan EpiC, Cerner, etc?
 
I think that what the doc is saying is that is considered a failure. I was indicating the same above - but what you are arguing is not that it was or was not a failure, but whether he has a right to know before a drug screen or test is conducted. And thats different than what the result of said test is. Just because it was a legal or not legal drug test - doesnt change in the eyes of the FAA. They look at it as a failed drug test or not in terms of what the result was. Not what the conviction or the surrounding parameters is/was. Sort of like whether you were guilty or not for a DUI. The fact that you were detained or arrested is all they care about. They dont actually care about whether the conviction was plead down, guilty or expunged.
 
But the “rules” under which the test is conducted SHOULD matter. Must be compliant with 49cfr40, or whatever.

Failing a flawed (or improperly administered) test should be irrelevant. This happens in the HIMS program all the time.
 
Tools said:
But the “rules” under which the test is conducted SHOULD matter. Must be compliant with 49cfr40, or whatever.

Failing a flawed (or improperly administered) test should be irrelevant. This happens in the HIMS program all the time.
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I dont think it does in the FAA case. They dont care whether there is a conviction. They only care if you "failed a drug test". Doesnt matter if its for high school sports or employment. You know whether you failed one or not. Just like you know whether you were drinking and driving or not. What the legal outcome doesnt concern them. They arent asking that it be followed to a certain standard. Just like they arent asking what the BAC method or who administered it, or what legality it has. If you were pulled over for DUI in France - and no one ever knew here - that doesnt change their wording that it must be reported and that you were pulled over for a DUI.

Now, you could make a case that they surreptitiously administered a drug test, and you never knew about it. So you knowingly filled it out correctly, but if they find out - that burden of proof falls on you to somehow convince them that you never knew about it to begin with.
 
Tokirbymd said:
. Drug screen happens to be positive for THC, but since most docs don’t really care about that as it doesn’t affect his care,
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Begs the question of why you test for something that you're not going to use in care.
 
flyingron said:
Begs the question of why you test for something that you're not going to use in care.
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Because you don't know what you don't know, as a doctor. Pan screens are common, especially if the patient is not conscious.
We're so sue-happy that I can actually see why that's done.
 
flyingron said:
Begs the question of why you test for something that you're not going to use in care.
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Done all the time in emergency medicine, if not elsewhere as well. No time for proper work up and too much liability to street someone with undiagnosed condition. So everyone gets pan-lab, pan-imaged.
 
Anthem said:
I dont think it does in the FAA case. They dont care whether there is a conviction. They only care if you "failed a drug test". Doesnt matter if its for high school sports or employment. You know whether you failed one or not. Just like you know whether you were drinking and driving or not. What the legal outcome doesnt concern them. They arent asking that it be followed to a certain standard. Just like they arent asking what the BAC method or who administered it, or what legality it has. If you were pulled over for DUI in France - and no one ever knew here - that doesnt change their wording that it must be reported and that you were pulled over for a DUI.

Now, you could make a case that they surreptitiously administered a drug test, and you never knew about it. So you knowingly filled it out correctly, but if they find out - that burden of proof falls on you to somehow convince them that you never knew about it to begin with.
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Let’s take that to its logical extreme. What if a pilot's parents performed an at home drug test when he was in high school/college and was positive for THC. They get angry, he stops getting high, gets it together and 4 years later wants to apply for a medical as he wants to be a pilot. By your rationale, he should report this as failing a drug test. I think the term “failure” should have some legal meaning- ie he was required to take the test for some reason, not just a random screen “just because”. Otherwise the question shouldn’t be have you failed a drug test, but “would you have tested positive on a drug test ever if someone had thought to administer one”
 
There is frequently a gap, sometimes large, where what OKC asks for is different than what they want. Pilots frequently have to interpret the gap, .

This is not really different than how they ask what drugs you are "currently" taking but they really want to know what you have taken for much longer.

..or how the regulations list 15 disqualifying conditions, but the bureaucrats will deny a medical for a much longer list. It's not published of course.

They could change the regulations to be clear, but if they published some of their nonsense they'd get laughed out of the NPRM process. For example, I got denied and had to get an SI for Prostate Cancer. Could you imagine a bureaucrat on the hot seat trying to explain why they thought Prostate Cancer presented an unreasonable risk to the public?

In this case, you could easily conclude that a positive THC test is not the same as a failed test, but I'd guess that would not be how they interpret it.

It's not that they are not "English Proficient", it is that they are intentionally vague and want you to send them everything and they'll let you know. They like it that way.
 
jbarrass said:
For example, I got denied and had to get an SI for Prostate Cancer. Could you imagine a bureaucrat on the hot seat trying to explain why they thought Prostate Cancer presented an unreasonable risk to the public?
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I wondered the same thing when I went through the same thing. Their "thinking", as I understand it, is that prostate cancer can spread to the neuro-axis (brain and spinal cord) and cause neurologic symptoms, including seizures or loss of motor skills. They don't take into consideration that those situations are rare and usually have other symptoms first, so they require the airman to prove that there is no evidence of metastases at the time of certification, which typically involves an MRI, often at the airman's expense. Ironically, there probably hundreds or even thousands of pilots over the age of 60 who have prostate cancer and don't even know it. (They haven't been falling out of the sky either.)
 
The issues of a failed test
Tokirbymd said:
Let’s take that to its logical extreme. What if a pilot's parents performed an at home drug test when he was in high school/college and was positive for THC. They get angry, he stops getting high, gets it together and 4 years later wants to apply for a medical as he wants to be a pilot. By your rationale, he should report this as failing a drug test. I think the term “failure” should have some legal meaning- ie he was required to take the test for some reason, not just a random screen “just because”. Otherwise the question shouldn’t be have you failed a drug test, but “would you have tested positive on a drug test ever if someone had thought to administer one”
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The issue of a failed test - however you define it - is largely immaterial. The FAA wants to know about any federally illegal drug use. In most cases where that use is long in the past (e.g., experimenting in HS/college) and did not cause social, occupational, or legal issues, a personal statement is all that's required.
 
But isn't the "illegal" use a 2 year lookback and the failed drug test a "have you ever" lookback.
 
To take this to its next logical place, if you tested positive for THC in a legal-use state more than 2 years ago, would it still be considered a "fail"? Words have legal meanings, and it isn't clear that "failed" has a proper legal definition in this context. In the OPs example, I think the FAA would have a hard time winning an enforcement case. At most, I think a failure to disclose in this non-consequential circumstance would likely be a short license suspension (which of course does nothing to further safety, it would merely be punitive).

Look up the Steve Martin "I Forgot" stand-up bit for a relevant chuckle.
 
WingmanMed said:
The issues of a failed test


The issue of a failed test - however you define it - is largely immaterial. The FAA wants to know about any federally illegal drug use. In most cases where that use is long in the past (e.g., experimenting in HS/college) and did not cause social, occupational, or legal issues, a personal statement is all that's required.
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And when they reply, certified that you have 48 hours to do a drug test from when the certified is timed, that that test be negative.
 
jbarrass said:
But isn't the "illegal" use a 2 year lookback and the failed drug test a "have you ever" lookback.
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It is. And they ask about failing a drug test to discover something other than nere use. Something that isn't necessarily revealed by an incidental positive test on an ER screening, but is by "failing" a test you could/should have anticipated.
 
flyingron said:
Begs the question of why you test for something that you're not going to use in care.
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in the ER, they do use it for care....the approach to a ER patient who is intoixcate is far more documentary, than to a normal. Just aks the attorneys as to "credibilyt of reporting"...the docs move to "all objective management" (pretty much like the LEOs).

And, Ron, do you really want to let that Alaska jumpseat pilot anyplace near the controls of an aircraft?
 
bbchien said:
in the ER, they do use it for care....the approach to a ER patient who is intoixcate is far more documentary, than to a normal. Just aks the attorneys as to "credibilyt of reporting"...the docs move to "all objective management" (pretty much like the LEOs).
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He said they didn't use it for care, which is why I posed the question.
bbchien said:
And, Ron, do you really want to let that Alaska jumpseat pilot anyplace near the controls of an aircraft?
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I didn't say anything about that. I was referring to ordering tests in a clinical setting that weren't going to be used for patient care.
 
It is always used for patient care in the ER. Read the post again. the approach to a ER patient who is intoxcated is far more documentary, than to a normal. Just ask the attorneys as to "credibility of reporting"...the docs move to "all objective management". THIS IS ABOUT WORKING IN THE ER.

Many moons ago in the Iowa City ER I collected that can of quarters in the 0.20-.20 BAC can (in the resident's room). We used to privately bet, based on bahvior, what the BAC would be. And you sure can bet it affected where the care had to go (in that case to the ICU).

I suppose now you're going to tell me what appropriate clinical care is, DOCTOR Ron.
 
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Is the question on the medical form have you ever tested positive for drugs or have you ever failed a drug test?​

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Clip4 said:

Is the question on the medical form have you ever tested positive for drugs or have you ever failed a drug test?​

​

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8500-8 is:
"18.n. Substance dependence; or failed a drug test ever; or substance abuse or use of illegal substance in the last 2 years. "Substance" includes alcohol and other drugs (e.g., PCP, sedatives and hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive drugs or chemicals). For a "yes" answer to Item 18.n., the Examiner should obtain a detailed description of the history. A history of substance dependence or abuse is disqualifying. The Examiner must defer issuance of a certificate if there is doubt concerning an applicant's substance use."
 
I would think a drug test would be standard procedure for two reasons. First being that they want to rule out substances as the source of your symptoms. Secondly, if they have to prescribe you something, they have to know if there are any chemicals in your system that the meds may not play nice with.

"Failed a drug test ever" reads to me as a wild card of sorts, as it does not specify the reason for the test. Notice it does not say "Failed a pre-employment, employment, or post-arrest drug test ever". It plainly says "Failed a drug test ever".
 
Jeff Oslick said:
8500-8 is:
"18.n. Substance dependence; or failed a drug test ever; or substance abuse or use of illegal substance in the last 2 years. "Substance" includes alcohol and other drugs (e.g., PCP, sedatives and hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive drugs or chemicals). For a "yes" answer to Item 18.n., the Examiner should obtain a detailed description of the history. A history of substance dependence or abuse is disqualifying. The Examiner must defer issuance of a certificate if there is doubt concerning an applicant's substance use."
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I will just say in the FAA medical form fashion the question is poorly worded. If they wanted to know if you ever tested positive for illegal drugs that is what they should have asked.
 
Jon Wilder said:
I would think a drug test would be standard procedure for two reasons. First being that they want to rule out substances as the source of your symptoms. Secondly, if they have to prescribe you something, they have to know if there are any chemicals in your system that the meds may not play nice with.

"Failed a drug test ever" reads to me as a wild card of sorts, as it does not specify the reason for the test. Notice it does not say "Failed a pre-employment, employment, or post-arrest drug test ever". It plainly says "Failed a drug test ever".
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Notice it also doesn't say, "Tested positive for drugs ever," which is functionality equivalent to "used drugs ever," which it also doesn't ask. And it doesn't specify illegal drugs, either. This question isn't about mere use.
 
Lindberg said:
Notice it also doesn't say, "Tested positive for drugs ever," which is functionality equivalent to "used drugs ever," which it also doesn't ask. And it doesn't specify illegal drugs, either. This question isn't about mere use.
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The key word is "failed". Tests done for medical reasons are positive or negative, not pass/fail. "Fail" means there was an administrative criterion against which it is being judged. That the question goes on to ask about illegal drug use only in the past two years supports the interpretation that a positive, but not "failed" drug test older than 2 years would not be relevant.
 
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