Student Substance Use and Drug Testing Policy

Purpose/Background

UNR Med strives to provide a safe and healthy learning and work environment. In any situation where student responsibility for patients is required, or may be required, the student may never risk patient welfare by acting under the influence of drugs, including alcohol. The student who endangers patients or others through the use of alcohol or drugs, including prescription drugs, or who violates the trust of the special position granted to them as a trainee, is subject to disciplinary action through UNR Med, independent of any action, which may be taken by other authorities. In addition, many hospitals and healthcare facilities have policies requiring drug testing and/or criminal background checks for students or may adopt these policies in the future to mandate that students who test positive for drugs, or who have certain types of information in their criminal background checks, are ineligible to work in their facility and unable to complete their medical education requirements.

UNR Med adheres to the Substance Abuse Prevention policies for Students set forth in the University of Nevada, Reno University Administrative Manual.  See section 3,010 Substance Abuse Prevention Policies for Students.  UNR Med is unequivocally opposed to substance abuse and prohibits the abuse, unlawful possession, distribution and illegal use of drugs and/or alcohol by students, including marijuana and its related products.   The purpose of this policy is to define the policy and procedures that for testing medical students for prohibited substances, including alcohol and marijuana, and to delineate disciplinary sanctions UNR Med may impose on students who are suspected, or accused of, being under the influence.

We recognize that medical students may have pre-existing or develop alcohol and other drug use disorders. UNR Med is committed to assisting students in regaining their health while protecting the well-being of patients as well as classmates, faculty, staff and residents.

Who Needs to Know this Policy?

Faculty, staff, residents, medical students, clinical and other affiliates.

Policy

A. Routine alcohol and drug testing:  

An observed urine drug screen at a testing facility is required for participation in clinical activities at UNR Med. Routine testing will take place prior to Year 1 preceptorships, Year 2 preceptorships and Year 3 clerkships. Additional testing may be required to participate in Year 4 elective rotations.

The Office of Admissions and Student Affairs (ASA) will give instructions to students on obtaining a drug screen. The substances to be screened may include, but are not limited to alcohol, amphetamines, barbiturates, benzodiazepines, cocaine metabolites, cannabis metabolites, methadone, methaqualone, opioids, phencyclidine and propoxyphene.

Students must sign a release for the results to be sent to the Associate Dean for ASA from the testing facility. These results will become part of the permanent student record, which they have the right to review, and will not be shared with clinical affiliates without a student's permission. However, many facilities may not allow a student to train at the facility unless the students provides permissions to share results with others. 

If screening results come back positive for tested substances, a medical review will be performed by the testing facility prior to informing the Associate Dean for ASA. Prior to the facility completing the confirmation testing, the student will have the opportunity to discuss positive test results and provide any documentation for a legitimate medical explanation for the positive test result.

Students will be required to pay for drug screening.

Students who test positive on a drug test will be referred to the Associate Dean for ASA, who will review their test results. If a student refuses to complete a drug test or to share the test results, they will be subject to disciplinary procedures by the Student Promotion and Conduct Committee (SPCC) including potential dismissal.

All questions and concerns about drug testing may be directed to the Associate Dean for ASA.

If, in the judgment of the Associate Dean for ASA, a student represents a clear and present danger to self or to others, the Associate Dean may take immediate steps to remove the student from academic or clinical activities. They may also take additional steps that may be necessary to minimize hazards to the student or to others, including securing emergency professional assistance.

B. For cause testing:

To ensure compliance with institutional policies and to promote a safe and healthy work environment, UNR Med requires students to submit to drug and/or alcohol testing “for cause” based upon a) reasonable suspicion of substance use, b) the unauthorized use or possession of alcohol on campus or at a health care setting or c) the use of or possession of illicit drugs at any time. Reasonable suspicion of substance use may be based upon, but is not limited any of the following criteria:

• Direct observation by faculty, staff, clinical partners, residents or colleagues of drugs or alcohol use or possession and /or demonstration of physical symptoms of the influence of drugs or alcohol while engaged in UNR Med sanctioned or sponsored activities.
• A pattern of abnormal or erratic behavior, consistent with alcohol or drug abuse
• Arrest or conviction for a drug or alcohol related offense; identification as the focus of a criminal investigation into illicit drug use, possession or trafficking
• Evidence that a student has tampered with a drug or alcohol test, or
• Possession of drug paraphernalia

Reports of suspected substance use should be made to the Associate Dean for ASA and should document in writing the specific behavioral observations that form the basis for suspect of a violation and how the behavior is affecting the student’s performance. Whenever possible, corroborating statements from other administrators, faculty, staff, employees, or students as well as patients should be obtained. This information will be shared with SPCC.

The SPCC will review all information meet with the student to determine whether the student has violated the policy based on a preponderance of the evidence and discuss consequences and potential academic or professional difficulties arising from suspected drug use. The SPCC can vote to require subsequent and follow up drug testing.

When the determination to test for cause has been made, the student will be informed how to obtain a urine drug screen or other requested test. Cause testing will be paid for by UNR Med.

If, in the judgment of the Associate Dean for ASA, the student represents a clear and present danger to self or to others, the Associate Dean may take immediate steps to remove the student from academic or clinical activities. They may also take additional steps that may be necessary to minimize hazards to the student or to others, including securing emergency professional assistance.

1. Confidentiality: Every effort will be made to keep the results of alcohol and drug testing confidential. Students should be aware that test results may be used for administrative hearings and court cases and may be sent to state and /or federal agencies as required by applicable law.
2. Refusal to Consent to Testing: Any student, who refuses to consent to an alcohol or drug test for cause, fails to provide an adequate specimen or fails to appear to take a scheduled test will be subject to disciplinary actions by the SPCC as detailed in the Discipline & Due Process Policy, up to and including recommendation for dismissal.
3. Appeal and Retesting: Positive tests may be appealed by submitting a written request to the Associate Dean for ASA within three (3) business days after informed of the positive test results. The student has the right to have a confirmatory test performed on the original specimen at a certified laboratory of their choice and all expenses of such retest will be the responsibility of the student. The specimen transfer between laboratories will follow standard protocol.
4. Disciplinary/Actions: Any student who fails an alcohol or drug test will be subject to disciplinary actions including dismissal by the SPCC as detailed in the Discipline & Due Process Policy. A student’s participation in, and successful completion of, an approved drug or alcohol counseling program coupled with their consent to random testing may be considered in the disciplinary process but does not ensure that dismissal will not occur.

 C. Substance use Self-Referral 

UNR Med wishes to assist students before they develop academic or legal problems related to alcohol and drugs. When a student self-refers for treatment or counseling, no official report is made unless specific permission is granted by the student. Students who wish to receive assistance may be referred to non-UNR Med affiliated providers, including UNR Counseling Services and the Nevada Physician’s Assistance Program. The School of Medicine encourages students who have developed substance use problems to voluntarily identify themselves and to seek support and treatment.

1. A student who voluntarily self-identifies as a substance user may be permitted to continue their current course of study without suspension, provided:
   1. This self-identification occurs prior to any incident that is grounds for suspension or dismissal under institutional policy.
   2. The student immediately enters a treatment program for the drug or alcohol abuse approved by the Associate Dean for Admissions and Student Affairs.
   3. The student’s conduct and academic performance meet the curricular expectations.

2. If the student is in a clerkship, elective or other off-campus course, the student may need to be placed on a medical leave of absence until treatment is complete and/or they can safely return to the clinic and meet the Essential Functions of UNR Med students, as determined by the SPCC.
3. A Fitness for Duty evaluation may be requested by SPCC for students who self-refer.
4. A student who voluntarily self-identifies with a substance use problem and who, by their own admission, by the testimony of approved abuse counselors, or by the determination of institutional authority is no longer capable of acceptable academic and professional conduct will be required to take a medical leave of absence from UNR Med. Nothing in this paragraph will preclude UNR Med from suspending, dismissing or taking other appropriate action against the student for unacceptable academic performance or lack of professional conduct.

D. Notification of Arrests/Convictions

Students must notify and provide documentation to the Associate Dean of ASA of any drug or alcohol related arrests or convictions within ten (10) working days after charge of an offense. Failure to do so and subsequent notification during a required background check may result in disciplinary action including dismissal by the SPCC.

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