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Substance Use Guidelines

For Student Majors That Include A Clinical Component In The Curriculum

Background

Drexel University has an established policy that prescribes the standards of conduct expected of students and members of the University community. This standard of conduct includes the prohibition of the use or the possession or dissemination of narcotics or other mind-altering drugs, other than those medically prescribed, properly used, and in the original container, by students while representing the College. The policy can be found within the Code of Conduct located here. Drexel recognizes that medical marijuana is legal in the state of Pennsylvania and others. However, marijuana is currently classified as a Schedule 1 drug under federal law. As a result, any positive test for this drug will not be overturned by third party testing medical review officers, even if a medical marijuana card is presented.

The University has established disciplinary proceedings for when a student is charged or violates the drug and alcohol control guidelines. However, when a student violates the drug and alcohol guidelines and is enrolled in a major that includes a clinical health care component in the curriculum, it is incumbent upon the administration and faculty of the College of Nursing and Health Professions (CNHP) to provide oversight and remedial action for such a serious act by the student.

The University recognizes that drug use/dependence is a disease that is chronic, progressive, and if left untreated, fatal. Drug dependence can affect all facets of a student’s life, and result in the student’s departure from the University. The University can be supportive of a student receiving treatment and once sustained recovery is obtained, the student may seek re-admission. To request accommodations of a disability based on a history of substance use, contact the Office for Institutional Equity and Inclusive Culture.

Purpose

The purpose of these Substance Use Guidelines is to inform students enrolled in the College of Nursing and Health Professions, who are also enrolled in a major that includes a clinical health care component, about the guidelines and procedures related to any unlawful use, manufacture, distribution, or possession of controlled or illegal substances or alcohol. Aside from seriously affecting the physical and psychological integrity of the user, substance use may significantly affect the ability of students to administer safe care to patients entrusted to them in a clinical health care setting.

These guidelines assist the student in maintaining personal and professional integrity and facilitate the student’s success in their CNHP education. It promotes a healthy teaching/learning environment for the student and in the clinical setting ensures patient safety. It also fosters the development of a professional who is aware of and considers the prevalence and adverse physical, psychological, and social outcomes of substance use.

Guidelines

These guidelines apply to all students who have confirmed acceptance in any of Drexel University College of Nursing and Health Professions programs that include a clinical health care component in its curriculum and are effective immediately upon acceptance into the program.

Students are required to have a standardized drug screen prior to entering the clinical term environment which may be prior to starting in the program. This is typically a 10-panel urine drug test, and the results are expected to return negative for any of the tested drugs, as well as negative for adulteration or dilution of the specimen. A positive drug screen of an illegal substance (illegal substance or controlled substance without a prescription) or intoxication from alcohol shall result in an interruption in the student’s program of study or inability to begin in the enrolled program.

The day of a student’s urine drug test, if the student drinks an excessive amount of liquid prior to conducting the urine drug screen, the results may return as ‘diluted negative’. If the drug screen results do come back diluted negative, the student will be allowed one retest. This retest must be done within 48 hours of receiving an email from the compliance department regarding the diluted negative results, and the student will be responsible to pay for the retest. If the repeat for the diluted negative test comes back again diluted negative, the student will be required to complete a blood test (which runs around $250). This retest must be done within 48 hours of receiving an email from the compliance department. The student is required to have a negative drug test on file before the start of the clinical term. If the results of the initial test come back ‘diluted positive’, this result will be considered positive and will follow the same steps as a positive result.

Any unlawful possession, use, manufacture, or distribution of controlled or illegal substances or alcohol by any student in the College enrolled in a program that includes a clinical health care component in its curriculum while in academic sites, labs or at a clinical site may be considered substance use or possible dependency and may constitute cause for dismissal from the program. Students must also comply with all local, state, or federal laws and regulations controlling the possession, manufacture, use, or distribution of controlled or illegal substances and alcohol. CNHP reserves the discretion under extenuating circumstances to revisit the terms of these guidelines.

All students must also comply with Drexel University guidelines on alcohol and drug use. These guidelines can be found in the Code of Conduct online here.

In addition, there are circumstances in which students may need to take over the counter or prescribed medications that may impair their ability to function safely in the clinical environment and thereby endanger patients and self. As such, all students are responsible for being aware of the effect these medications may have on their ability to function safely in the clinical practicum and must notify the Program Chair regarding the use of any medication that can impair performance prior to entering the clinical environment. Failure to do so may result in disciplinary action. In such circumstances, the student is encouraged to request medical leave from their studies.

Clinical education/practicum sites may also require that students undergo drug/alcohol testing prior to placement or during clinical rotations at the site. Therefore, students may also be tested in accordance with the clinical training site’s guidelines.

A student convicted of or arrested for violating any federal, state, or local law or regulation pertaining to the manufacture, possession, sale, use or distribution of a drug or alcohol or misuse of prescribed or over-the-counter medications must report this conviction or arrest to the Program Chair within five days of the conviction or arrest.

Failure or refusal to comply with any aspect of the substance use guidelines may impact academic progression. Examples of noncompliance include, but are not limited to, refusal to submit to immediate drug and alcohol testing or repeat testing, tampering or altering of specimens, attempts to submit the samples of another person as the student’s own, and failure to appropriately complete associated program or testing laboratory documents.

Procedures

I. Education

An objective within these substance use guidelines is to educate students about the risk of dependency among health care providers, enhance their ability to recognize impaired health care professionals, and reinforce the significance of appropriate intervention. Through selected courses, students will be educated about behavioral and clinical practice characteristics that are common indicators of substance use. Students will also acquire an understanding of the Drexel University College of Nursing and Health Professions Substance Use Guidelines and procedures guidelines.

General Testing Procedure for Routine or Repeat Testing
Drug and alcohol testing required by the College will be conducted utilizing the following measures:
A. The student must be tested at a laboratory designated and approved by the College of Nursing and Health Professions. The student may be asked to provide a witnessed sample.
B. The student will sign the chain of custody forms and any other documents provided by the testing laboratory. The student is expected to follow all the steps as per the lab.
C. The 10-panel drug test shall screen for the use of the controlled substances listed below:

  1. Amphetamine (methamphetamine)
  2. Barbiturates
  3. Benzodiazepine
  4. Cocaine
  5. Marijuana
  6. Methadone
  7. Methaqualone
  8. Opiates (Codeine, Morphine)
  9. Phencyclidine
  10. Propoxyphene

    In addition, a student could be tested for any other controlled substances that are suspected of being used or used by the student. Affiliation agreements may require additional substance screenings.

D. Urine, blood, hair and saliva analysis or a combination of these testing methods may be utilized.
E. The student must fully comply with the testing laboratory's methods and procedures for collecting samples.

Results
Results are posted to the student’s compliance packet. It is the student’s responsibility to review and be sure all compliance requirements are up to date and accurate.

In the event of a positive result, the student will first be contacted by the Medical Review Office (MRO); this is done before the recording of any positive result.

Drexel recognizes that medical marijuana is legal in the state of Pennsylvania and others. However, marijuana is currently classified as a Schedule 1 controlled substance under federal law. As a result, any positive test for this drug will not be overturned by third party testing medical review officers, even if a medical marijuana card is presented.

If the student disputes the accuracy of a positive test, the student may request a re-testing of the original sample by the laboratory, however the cost of the additional testing would be borne by the student. This re-test must take place within one week.

Substance use is verified if either: (i) the positive test result is not disputed or (ii) if the student-requested re-test is positive.

The testing laboratory will make a final report of the test results (positive, negative, or inconclusive) to the Program Chair or designee.

Confidentiality
The requirement that a student be tested as well as the test results will remain confidential and disclosed only to those individuals within Drexel University as well as any licensing, registering, or certification boards that have a need to know.

II. Observation of Visual Behavior

A student in the College may be required to undergo drug or alcohol testing when the Program Chair, or designee, determines through direct observation or reports received from faculty or clinical supervisors and there is reasonable suspicion that the student is impaired due to illegal drug or alcohol use, the use or misuse of prescribed over-the-counter medications based upon, but not limited to:

  1. Unusual or aberrant behavior
  2. Physical symptoms indicative of being under the influence
  3. Patterns of abnormal or erratic behavior
  4. Inconsistent quality of work performance
  5. Conviction for drug-related offenses
  6. Being identified as the subject of a drug-related criminal investigation
  7. Credible information from independent sources
  8. Evidence of drug tampering or misappropriation
  9. Consistently discrepant daily drug counts
  10. Accidents or illnesses caused by substance use
  11. Impairment or intoxication in the clinical and/or didactic setting
  12. Patterns of absenteeism and/or lateness
  13. Alterations in student clinical and/or didactic performance that may not be attributed to other causes
  14. Following a work-related injury or illness
  15. Observation of poor judgment or careless acts which caused or had the potential to cause patient injury, jeopardize the safety of self or others, or resulted in damage to equipment.

A faculty member suspecting possible substance use by a student must report the suspicious behavior immediately to the Program Chair or designee. (See Appendix 1).

Once the Program Chair is notified that a student has been suspected of violating the substance use guidelines, the student will be instructed to report to the designated testing laboratory in accordance with the Program Chair’s instructions, which will take into consideration a safe mode of transportation given the suspected level of impairment of the student. The cost of any drug or alcohol testing requested by the Program Chair will be borne by the Program. The Program Chair has the authority to temporarily remove the student from the clinical practicum pending the results of any drug or alcohol tests.

III. Documentation

Appropriate documentation will commence at the time of the initial suspicion that a student may have a substance use problem and will include the rationale for such suspicion.

All documentation regarding drug testing results and a student’s medical condition will remain in a secure location in the custody of the CNHP Compliance Department. Such records will be maintained separately from the student’s permanent program file.

CNHP will refer a student with a positive test result to Residential Living and Student Conduct (RLSC) at Drexel University for possible disciplinary action in accordance with the University Student Code of Conduct as it relates to process, and not clinical placement.

IV. Impact on Clinical Standing

The student will be removed from the clinical practicum or unable to start that upcoming clinical term following a positive test result. Depending on where the student is within their plan of study, the time away from their academic program can vary. In addition, if the student has a professional license, the College is obligated to report the results to the licensing agency.

Failure or refusal to comply with any aspect of the substance use guidelines will be reported to Residential Living and Student Conduct (RLSC) at Drexel University for possible disciplinary action in accordance with the Student Code of Conduct. In addition, any perceived attempts to tamper with the testing procedure or results will be reported to such committees as well.

Students will be informed of counseling and other treatment resources that are available to the student.

V. Treatment and Counseling Resources

Students who are concerned that they may have a substance or alcohol use problem are encouraged to seek appropriate assessment, treatment, and counseling from qualified health care professionals. Students who voluntarily self-disclose a substance or alcohol abuse problem prior to having a positive drug test result and are willing to enter in and complete an appropriate program of treatment may be granted a medical leave of absence while they undergo treatment.

The following website lists some local treatment and counseling services that are available to students:

At all times, it is incumbent upon the student to make the decision not to attend a clinical assignment if he/she feels impaired and will present a risk to patients.

VI. Re-entry into the Academic and Clinical Environment

A student who has been dismissed, administratively removed, withdrawn or taken an approved leave of absence from the Program due to substance use may be eligible to re-enter the Program in certain circumstances. A student in recovery who is permitted to re-enter the program will comply with the documented conditions of readmission set forth by the Program.

A student will be required to submit to subsequent random drug testing by the Compliance department as a condition to returning to the Program. The student will bear the expense of all subsequent random drug testing required by the Program. The student must fully comply with the testing laboratory's methods and procedures for collecting samples. A second positive test result will lead to a program dismissal.

Factors that have been identified as helpful for re-entry into practice include 12-step program participation, random drug screens, and sponsorship on a peer-assisted support group. The student may be requested to provide medical clearance from the appropriate individual coordinating the therapeutic intervention. If the student is a licensed nurse, they must provide evidence of a current, active nursing licensure if enrolled in the MSN, DNP, or PhD Nursing Program.

A student in active recovery from substance use will be monitored closely particularly in clinical practice. A Program and student contract with guidelines and expectations will be developed and signed by both parties. Frequent evaluations will be mandated and stipulated in the contract delineating the contingencies of programmatic return.

A student in recovery should be aware that their state licensing or certifying bodies may not allow students to take qualifying, licensing, or certification examinations. Students should refer to requirements with the applicable licensing board.