Drug test history in medical records

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This is instructive. It appears to only require verified/confirmed tests to be reported under the particular regs. That begs the question of whether an employer would even have to report a drug "screen" that it knows about from the ER.


Also, the use of the term "test" as mentioned above may be important. Perhaps the ER is actually administering a drug "screen". While I truly appreciate the issues here, absent the background from the rulemaking, we are all speculating what the FAA wants.
 
Jeff Oslick said:
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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The FAQs use the word "positive":

 
airbear said:
The FAQs use the word "positive":

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It is true in the FAQ they use "positive"; however, on the medexpress form 18n they use "failed". Looks like the "positive" may be included in the definition of "substance abuse" though, which is also part of 18n - or at least as "substance abuse" is defined in the FAQs. How a layman that isn't trained in this type of legalese interpretaion is supposed to parse all this language out is beyond me.
 
Michael T. Runyan said:
It is true in the FAQ they use "positive"; however, on the medexpress form 18n they use "failed". Looks like the "positive" may be included in the definition of "substance abuse" though, which is also part of 18n - or at least as "substance abuse" is defined in the FAQs. How a layman that isn't trained in this type of legalese interpretaion is supposed to parse all this language out is beyond me.
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I agree that the whole thing is insanely and unnecessarily overly complicated. And that is unfortunate...
 
Michael T. Runyan said:
It is true in the FAQ they use "positive"; however, on the medexpress form 18n they use "failed". Looks like the "positive" may be included in the definition of "substance abuse" though, which is also part of 18n - or at least as "substance abuse" is defined in the FAQs. How a layman that isn't trained in this type of legalese interpretaion is supposed to parse all this language out is beyond me.
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...and so do the pulldowns on the Medxpress....
 
airbear said:
The FAQs use the word "positive":

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This language comes directly from part 67. And the only way to read it that really makes sense is in the context of a DOT test. Otherwise you would be deemed to abuse alcohol if you ever had a .04 BAC anywhere at any time, which isn't the case (unless someone is aware of a contrary holding).
67.107(b) No substance abuse within the preceding 2 years defined as: . . . (2) A verified positive drug test result, an alcohol test result of 0.04 or greater alcohol concentration, or a refusal to submit to a drug or alcohol test required by the U.S. Department of Transportation or an agency of the U.S. Department of Transportation; or . . . .
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A careful reading will reveal several drafting errors.
 
bbchien said:
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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When I flew Medevac we used to play "BAC Bingo" with the Med Crew, where we'd guess the BAC of the Patient we were about to pick up pre takeoff based on the "evidence." And I thought Pilots had dark senses of humor.......
 
RadialGal- LOL!

I had never heard it called that but we sure did it too. One night in 1979, in the UIHC emergency room, I put a dollar in the can for BAC .20-.299 and won the pot. A young man went up against the Washington St Bridge abutment in his Honda 750-4 and....well the bridge won...as his "airbag" failed him (there was nonesuch back then).

So for those interested, any BAC at any time tells the agency a lot about TOLERANCE. A BAC of (ed, corr'd) 0.26 and operating a motorcycle tells us the guy is TOLERANT and that you only get with lots of long term drinking (I'd be on a ventilator). So, a pos. drug test in any setting tells us a lot.

If you have one, you've probably used at least eight other undetected times. So the agency's view is any postiive test is a "failed test". Ignore or "dance and dutch" all you wish, at your own peril. Remember omission is a class 4 felony should the agnecy decide you are worth the pursuit. Then you can't even drive a school bus.
 
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When I was a deputy sheriff, one afternoon I was dispatched to the ER to pick up a drunk who’d been brought in ambulance and was ready for release. They called us because he was still intoxicated, but medically cleared for the jail.

I go to his bed, and he’s sitting up and speaking clearly enough. Yep, able to stand on his own, so he can go to the tank and finish sobering up.

As I’m walking him to the patrol car, a nurse hands me the packet for the jail medical staff, and it shows his BA as of a few minutes earlier was .36. He’d been there for six hours. That meant he was around .42 when brought in.

I had a DUI once who was a serious professional drunk. The only objective symptoms were early onset nystagmus and a slight lean as she did the field sobriety tests. But we could smell the alcohol from 20 feet away. She blew a .26. By her admission, she was going through at least a fifth of vodka daily.
 
The FAA definition of tolerance is great. Awesome. Thank God they’re so amazing…

But…

I’m afraid to say that if they want to use their own made up definition, insurance shouldn’t cover it. No insurance for the medical, the inpatient “treatment”, intensive out care, cog tests, shrink reports, psych reports or loss of income. That’s fraud, just like lying on the medical application. Punishable by jail time….

Or, making up a diagnosis to get insurance to pay is malpractice. Of course there is insurance for that.

Or… maybe the APA should adopt the FAA standards. Have the rest of the world see how well we’re doing it. We will be revered, I’m sure….

I know tons of guys whose insurance won’t cover medically outdated or unnecessary heart testing procedures. They don’t get the benefit of fraud HIMS offers…

Or…

They could rely on MEDICAL PROFESSIONALS. Actual practicing ones. Maybe reconsider their approach every fifty years or so… like congress just told them to do.
 
bbchien said:
So for those interested, any BAC at any time tells the agency a lot about TOLERANCE. A BAC of .026 and operating a motorcycle tells us the guy is TOLERANT and that you only get with lots of long term drinking (I'd be on a ventilator).
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That's one, maybe two, drinks for most men. How would that show long-term tolerance or put anyone on a ventilator? Admittedly I've never ridden a motorcycle, but I'd have no problem riding a bicycle after one drink.
 
Here in rural Alaska people drink to oblivion........highest I saw flying medevac was .41. I'm not kidding.
 
Lindberg said:
That's one, maybe two, drinks for most men. How would that show long-term tolerance or put anyone on a ventilator? Admittedly I've never ridden a motorcycle, but I'd have no problem riding a bicycle after one drink.
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I think he inserted an extra zero and meant .26BAC. Certainly enough to shout TOLERANCE.
 
Mason said:
I think he inserted an extra zero and meant .26BAC. Certainly enough to shout TOLERANCE.
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That's makes a lot more sense. But I wouldn't consider that "any BAC at any time." I would describe that an exceptionally high BAC while DUI.
 
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