Student Substance Use and Drug Testing Policy

Approved by Student Promotion and Conduct Committee 03/06/2025, effective 08/04/2025

To whom this policy applies

University of Nevada, Reno School of Medicine (UNR Med) Medical Students, including students in any phase of a dual degree program.

Definitions

UNR Med: University of Nevada, Reno School of Medicine

SPCC: Student Promotion and Conduct Committee at UNR Med

Co-Curricular Activities: These activities are programs or learning experiences that complement the academic curriculum or professional development of students. These activities include, but are not limited to, the Student Outreach Clinic, research, preceptorship, clinical shadowing, and other volunteer activities where the student is participating as a member of the UNR Med Community.

Purpose/Background

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. UNR Med strives to provide a safe and healthy learning and work environment. In any situation where students are or may be responsible for patients, the student may never risk patient welfare by acting under the influence of drugs, including alcohol. Any 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; see also Section III: Core Values and Prohibited Conduct, UNR Student Code of Conduct. In addition, UNR Med adheres to the prohibition against the use, possession or cultivation of marijuana, including for medical purposes, on any NSHE or NSHE Foundation owned or leased property, or at any NSHE sponsored or authorized activity pursuant to the University of Nevada Reno University Administrative Manual 7,008. Any NSHE sponsored or authorized activity includes but is not limited to all clinical activities, away rotations and co-curricular activities.

The purpose of this policy is to define the procedures 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.

Policy

Routine alcohol and drug testing:
1. A 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, Year 3 clerkships and Year 4 clinical rotations. Additional testing may be required to participate in Year 4 away rotations.
2. Students must sign a release for the results to be sent to the Associate Dean of Student Affairs from the testing facility. These results will become part of the permanent student record, which students 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 permission to share results with others is provided.
3. Student Affairs will give instructions to students on obtaining a drug screen. The substances screened may include, but are not limited to alcohol, amphetamines, barbiturates, benzodiazepines, cocaine metabolites, cannabis metabolites, methadone, opioids, and phencyclidine. All samples must be deemed adequate by the testing facility.
4. Students will be required to pay for drug testing. Students may screen at the following locations: University of Nevada Reno Student Health Center, the Nevada Drug and Alcohol Testing, or such other facility as directed by Student Affairs.
5. Retesting will be at the student's expense.
6. All questions and concerns about drug testing may be directed to the Associate Dean of Student Affairs.
7. If a student fails to provide an adequate sample or testing results come back positive for tested substances, the Associate Dean of Student Affairs will be notified. The student will have the opportunity to discuss any positive results and provide any documentation for a legitimate medical explanation for the positive test result. However, pursuant to UAM 7,008, the use, possession or cultivation of marijuana, including for medical purposes, is prohibited.
8. If, in the judgment of the Associate Dean of Student Affairs, 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, pursuant to NSHE Code 10.4.10 and Section 8 of the Medical Student Discipline, Dismissal & Due Process Policy. The Associate Dean of Student Affairs may also take additional steps that may be necessary to minimize hazards to the student or to others, including securing emergency professional assistance.
For cause testing:
1. In addition to the above stated routine testing, 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:
  1. 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.
  2. A pattern of abnormal or erratic behavior, consistent with alcohol or drug use
  3. 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
  4. Evidence that a student has tampered with a drug or alcohol test
  5. Possession of drug paraphernalia
  6. Reports of suspected substance use should be made to the Associate Dean of Student Affairs 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, students, or patients should be obtained.
2. When the determination to test for cause has been made, the student will be informed how to obtain an observed urine drug screen or other requested test. For cause testing will be paid for by UNR Med. If, in the judgment of the Associate Dean for Student Affairs, 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, pursuant to NSHE Code 10.4.10 and Section 8 of the Medical Student Discipline, Dismissal & Due Process Policy, and also the Medical Student Fitness for Duty Policy. The Associate Dean of Student Affairs may also take additional steps that may be necessary to minimize hazards to the student or to others, including facilitating emergency professional assistance.
Appeal and Retesting:
1. A student challenging the integrity of a positive test, disputing any positive test result, or failing to provide an adequate sample will be offered one (1) opportunity to retest at a facility selected by Student Affairs. The retest must be completed no later than three (3) business days from the date of notice to the student from Student Affairs as to a failed test. Failure to retest or to provide an adequate specimen will subject the student to disciplinary actions by the SPCC as detailed in the Medical Student Discipline, Dismissal & Due Process Policy, up to and including potential for dismissal. Retesting will be at the student's expense.
2. A second failure to provide an adequate sample will require the student to appear before the SPCC.
Disciplinary Actions:
1. If testing results come back positive for tested substances, the Associate Dean of Student Affairs will be notified. The student will have the opportunity to discuss any positive results and provide any documentation for a legitimate medical explanation for the positive test result. However, pursuant to UAM 7,008, the use, possession or cultivation of marijuana, including for medical purposes, is prohibited.
2. The Associate Dean of Student Affairs will refer any student who tests positive and presents no allowable, legitimate medical explanation, to the SPCC. A positive test will subject the student to disciplinary action by the SPCC, as detailed in the Medical Student Discipline, Dismissal & Due Process Policy, up to and including the potential for dismissal. The SPCC can vote to require subsequent and follow up drug testing.
3. Any student who refuses to consent to an alcohol or drug test, 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 Medical Student Dismissal, Discipline & Due Process Policy, up to and including potential for dismissal.
Substance use Self-Referral
1. UNR Med wishes to assist students. 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 will be referred to non-UNR Med affiliated providers, including UNR Counseling Services and the Health Professionals Assistance Program. The School of Medicine encourages students who have developed substance use problems to voluntarily identify themselves and to seek support and treatment
2. A student who voluntarily self-identifies as a substance user may be permitted to continue their current course of study provided:
  1. This self-identification occurs prior to any incident that is grounds for discipline or dismissal under institutional policy.
  2. The student immediately enters a treatment program for the drug or alcohol use approved by the Associate Dean for Student Affairs.
  3. The student's conduct and academic performance meet the curricular expectations.
3. If the student is in: a preceptorship course, simulated patient experience, clinical skills course, clerkships, electives, 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 and meet the Essential Functions (link when available) of UNR Med students, as determined by the SPCC.
4. A fitness for duty evaluation may be requested by SPCC for students who self-refer.
5. 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.
Notification of Arrests/Convictions
1. Students must notify and provide documentation to the Associate Dean of Student Affairs of any drug or alcohol related citations, arrests, or convictions within ten (10) calendar days after charge of an offense. Failure to do so may result in disciplinary action including potential for dismissal consistent with the Medical Student Discipline, Dismissal & Due Process Policy.
2. Results of alcohol and drug testing will remain confidential to the extent possible. 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.