does Kaiser test for drugs in the emergency room?

February 2, 2009 7:54 AM

does the Kaiser emergency room test for weed - particularly when it comes to a motor vehicle accident? (i was on a bike.)

ok, so for a few months now, i take a bike ride 2 or 3 mornings a week.

a friend dropped off a nice nug of weed last night, and i hit a bowl of it this morning before heading out on my ride. so then, as luck would have it, i get hit by a Nissan Frontier pulling a rolling stop. i went "flying" maybe 4 or 5 feet, bike did a couple flips, etc.

ok, ok, yes, i am a major dumbass for assuming she was stopping.

so i called Kaiser Permanente Urgent Care, and they told me that for motor vehicle accidents, i should to go to the (Kaiser) emergency room.

does anyone know if they are gonna test me for substances? and if they *do* test, and if they found substances, what would be the repercussions? loss of my insurance? lack of coverage for the incident?

yes, i am sure i have some paperwork filed away that would answer these questions, but i have so much Kaiser info that it would be an overwhelming task. plus, to be honest, i actually feel more shaken up than i would have expected (happened maybe 35 minutes ago now).

so anyway, does anyone know? and just in case it matters, i am in san diego.

thanks for any info, everyone.

posted by gcat to grab bag (14 comments total)

Were police involved? Did you get the driver's contact and insurance information?
posted by thirteenkiller at 8:09 AM on February 2

I have no personal experience of this particular emergency room (or any other in the US).

But, having been to a few emergency rooms myself in the past, I can really see no logical reason why emergency room staff would insist on performing any kind of drugs test on you - it's just not their job. And they certainly can't perform any tests on you without your consent. You haven't said what injuries you sustained, but I doubt blood tests will be necessary, and if they are, you can ask what they want to test for, and they'll tell you. They won't be doing any secret tests.

The only occasion where a drug test might be performed is pretty much the same scenario as for an blood alcohol test - i.e. if police at the scene felt you might be under the influence - and I assume that wasn't the case.

Maybe the weed made you paranoid.
posted by le morte de bea arthur at 8:10 AM on February 2

Oh, and don't admit to having been under the influence, even to medical staff. It'll go into your notes and may come back to haunt you later.
posted by le morte de bea arthur at 8:11 AM on February 2

I see it as unlikely they would test for cannabis use because determining whether you had THC in your system does not determine when or how it entered your system. Second-hand smoke is always a possibility. And unlike blood alcohol tests, there is not a test to determine current THC intoxication.

Beyond that, you should probably get checked out and worry whether you'll have to bid Kaiser good-riddance when you know you have no internal injuries.
posted by McGuillicuddy at 8:14 AM on February 2

Looks like the upward limit of the possible fine is $250.

IANAL. Go to the hospital.
posted by fleacircus at 8:15 AM on February 2

If your mental state isn't great they could do a tox screen; it's kind of standard. Thing is, THC lingers for a long time, so it's not real evidence that you were high at the time. Your weed last night looks just like weed a few days ago etc. I am not a doctor or lawyer, but last time I got hit by a car I wanted to get checked out.
posted by a robot made out of meat at 8:24 AM on February 2

hey, everyone, thanks for the quick responses.

thirteenkiller: i called police 10 minutes after, once i got home. she took my name, location of accident, and said to go get checked out and then if i wanted, i could file an Injury Accident report after that. and yes, i have the drivers contact and insurance info.

and no, le morte, haha, the weed did not make me paranoid. its just the fact that i was high and Kaiser feels connected to my job (which it is i guess) and my job has a Drug Policy. and no, im not admitting anything to them.

and as far as injuries, its not *too* bad. im scraped up a bit, and my back feels fairly tweaked. the side of my thigh hurts (point of impact i guess), and it would be convenient to have painkillers if i end up needing them. mostly, i just wanna get checked out Just In Case im underestimating my injuries.

ugh, now im just dreading the horrible wait. im guessing it will be several hours.

ok, thanks so much everyone, im off!
posted by gcat at 8:32 AM on February 2

First off, dont ride while high. Its impairs as much as alcohol and with better judgment and with quicker reflexes you could have avoided this situation.

Generally, no, there's no big conspiracy to test people for substances at the hospital. The piss test costs money and the hair tests costs even more. Blood tests cost a lot more. Why would a health insurance company pay for these tests to satisfy your company's policy? Companies pay out of pocket for drug testing, not through yoru doctor. Even if they did, the disclosure and privacy laws in this country dictate that you are told this.

If the doctor is worried about anything in your system then they will give you a test and should explain it to you. If drugs come up then you are protected from this being told to your company. All this depends on the state, but only things like gunshots get reported to the police and nothing gets reported to your company.
posted by damn dirty ape at 8:42 AM on February 2

And you posted this non-anonymously with some identifying details?
posted by vsync at 9:51 AM on February 2

i just wanna get checked out Just In Case im underestimating my injuries.

Slightly OT, but just to reinforce the wisdom of that attitude; the last time I had a reasonably dramatic incident on the bike (no car involved, but over the handlebars at about 25mph) I hopped up, checked out the rather dramatic road rash on each forearm, and after moving all my limbs around a few times, figured the skin-loss was my only issue -

About 36 hours later, no pain but simply couldn't lift my left arm above my belt - MRI showed a rotator cuff injury that didn't need surgery but took several months of physical therapy to sort out - hope everything turns out fine.
posted by jalexei at 10:07 AM on February 2

I don't know about Kaiser specifically, but anyone reading this thread might want to know that many emergency rooms routinely test all "trauma" patients for drugs and alcohol as part of their admissions labs. The results are part of the medical record and will only be given to police or employers of subpoenaed, but may be seen by insurers. In your case, however, you would be unlikely to get the full trauma treatment as you are coming in under your own steam some time after the accident, and are able to consent to or refuse any treatment or test. If you do not appear intoxicated it is unlikely they would test for anything. Additionally, if even a minor accident happens at work, many workman's comp programs in accordance with drug-free workplace policies require drug testing as a prerequisite for treatment and payment.
posted by TedW at 10:35 AM on February 2

Emergency rooms run on protocols, and often these protocols are carried out without a doctor's explicit order. Drug screens are one of those protocols.

The situations that would prompt a doctor, nurse, or some ER tech to perform a drug screen would be:

1. Altered consciousness
2. Significant head trauma
3. The possibility that they are going to administer medications that might interact with something in your system

I can't think of a situation in the past where I've seen anyone do a drug screen purely to determine if they were the cause of an accident. That's not the job of the doctor and it's not something they have time for or are interested in.

So that having been said, if your injuries are limited to being scraped and banged up and you are able under your own power to check in to an emergency room and you are talking sense, I would say it is extremely unlikely you'd be drug tested. They may ask for a urine specimen to look for signs of blood in the urine and if someone says you need this, I would strongly recommend doing it.

From a professional standpoint, most of the time THC is totally ignored by the doctors. We are much more interested in cocaine, methamphetamine, benzodiazepenes, and opiates. Similarly, no medical professional is going to turn you into the police if you test positive. Of course, if the accident becomes a big legal thing to determine if you were at fault, the lawyers will absolutely use this against you but I can't comment as much on that.

Hopefully by the time you read this you will already have been seen. You need to be. Hope you are okay.
posted by Slarty Bartfast at 10:36 AM on February 2

I went to the ER once complaining of extreme dizziness. Despite the fact that I swore up and down that I had never done drugs (which was true) they gave me a full toxin screen anyway when they started running out of other ideas. Kaiser won't waste a dime on a test they think is useless, but as soon as they have a reason to deny coverage, they will. It just depends on your symptoms.
posted by slow graffiti at 10:05 AM on February 3

so (for future readers), yes, they did ask for a urine sample, but i am assuming they did not test for drugs.

the nurse (or whoever that was) took me to the room, and told me to go to the bathroom down the hall and give a urine sample. and then she left.

there were little containers in the bathroom for this. i brought back the sample with me, and set it on the shelf.

a while later the doc came in, spent maybe 5 or 10 minutes with me, and toward the end, kinda pointed at the sample from 5 or 6 feet away and said "that your sample?"

"yeah."

"well, youre fine. theres no blood in it."

and then he left. an LVN came in after a bit and advised me on aftercare. then she left.

so, i was alone and leaving, and the sample still sat there. it hadnt been labled, hadnt been touched. i kinda wanted to throw it in the biowaste can, but i wasnt sure if that was the right place for it so i just left.

im assuming they didnt test it because every urine test i have taken before involved some level of Accountability of the sample.

thanks again for the input, everyone.
posted by gcat at 6:57 PM on February 4