Substance Use Disorder Policy

PURPOSE
To outline processes and systems that are in place to ensure a drug-free and safe learning and work environment for all.

AUDIENCE
All medical students

LCME STANDARD
3.5 Learning Environment/Professionalism

POLICY

  1. The UC Davis School of Medicine (i.e., the School) is opposed to substance use and prohibits the use, unlawful possession, distribution, and illegal use of drugs and alcohol by students. 
  2. Students may never be under the influence of illicit drugs, including alcohol and cannabis, when responsible for patients or when interacting with peers or instructors.
  3. A student who endangers patients or others through the use of alcohol or drugs, or who violates their privileged access to drugs is subject to disciplinary action through the School, independent of any action which may be taken by other authorities.
  4. The School is committed to a program that will assist impaired students in regaining their health while protecting the well-being of patients, classmates, faculty, staff, residents, and fellows. All students are supported in seeking substance use disorder assistance from employee support programs, health centers, and counseling or psychological services available at UC Davis locations or through referral. 
  5. In a situation where a medical student brings with them to the School, or develops alcohol, cannabis, and other psychoactive drug use patterns and behaviors that may be diagnosed as substance use disorder while a student, if the student self-identifies the disorder, the School will consider altering the student’s academic schedule without suspension while regaining their health. Self-identification criteria includes:
    1. Identifying the issues before any incident occurs that is grounds for suspension or dismissal (See the School of Medicine Bylaws and Regulations, Regulation 80-D).
    2. The student immediately enters and satisfactorily participates in an approved treatment program for problematic drug or alcohol use. 
    3. The student agrees to engage in a contract with the School that allows monitoring of participation in an approved treatment program. 
    4. The student’s conduct and academic performance remain consistent with the demands of the curriculum and profession.
  6. A student who voluntarily self-identifies as having a substance use disorder and who, by their own admission, by the testimony of an approved substance use counselor, 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 the School. Nothing in this paragraph will preclude the School from suspending, dismissing, or taking other appropriate action against the student for unacceptable academic performance or lack of professional conduct.
  7. Routine alcohol and drug testing is common in the health care setting. Students must comply with the testing for clinical education experiences.
  8. In a case of suspected problematic substance use, the unauthorized use or possession of alcohol on campus or in a health care setting, or known use or possession of illicit drugs at any time, will result in mandatory “for cause” testing. Reasonable suspicion of problematic substance use may be based upon but is not limited to, the following criteria.
    1. Direct observation of drugs or alcohol use or possession and/or demonstration of physical symptoms of the influence of drugs or alcohol. 
    2. A pattern of abnormal or erratic behavior, consistent with problematic 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 previous drug or alcohol test. 
    5. Possession of drug paraphernalia, including any materials used to produce, conceal, and consume illicit drugs.
  9. Any student who refuses to consent to an alcohol or drug test for cause or fails to provide an adequate specimen will be subject to discipline, up to and including a recommendation for dismissal.
  10. Students who are known to use drugs that produce physical dependence or excessively use alcohol or cannabis will be requested to go through a consultation.
  11. Students must notify the School of any drug or alcohol-related arrests or convictions within 72 hours of a charged offense. Failure to do so and subsequent notification during a required background check may result in disciplinary action including dismissal.

PROCEDURE

  1. If a student is noncompliant with a requested consultation (Policy I and J) or a required alcohol and drug testing procedure (Policy G) they will be referred to the Associate Dean for Students.
    1. A Physicianship Form (see the Professionalism Policy) will be submitted to document the occurrence.
    2. The student will be subject to Academic Dismissal (see the School of Medicine Bylaws and Regulations, Regulation 80-D).
  2. A person wishing to report a “for cause” concern (Policy H) should notify the Associate Dean for Students via email. 
    1. A completed ‘Observation of a Potentially Impaired Employee Form’ is recommended to be included with the email. The form is available through the UC Davis Health Policy Manager online system. Manuals, Administrative and Clinical Policy Attachments, Administrative Policy 2909 – Drug Free Workplace: Suspected Employee Impairment. 
    2. If not included in the form, the email must outline the following:
      1. The exact reason(s) why they suspect a substance use violation.
      2. The student’s behavior and how the behavior is affecting the student’s performance.
      3. Specific facts that led to reasonable suspicion of unauthorized drug or alcohol use.
    3. If possible, corroborating statements from others who observed the behavior should also be sent to the Associate Dean for Students via email. 
  3. When the determination to test “for cause” (Policy H) has been made by the Associate Dean for Students, the student will be notified of the allegation and given instructions on how to obtain a drug screening kit for the collection of a urine sample for testing. 
    1. Testing costs will be borne by the School. 
    2. Testing will be done according to standard procedure for these settings. 
    3. The School will direct the Drug Screening Report to be sent to the Associate Dean for Students (and Chair of the Committee on Student Promotions (CSP) should the CSP mandate the drug/alcohol screening).
    4.  Before making a final decision to confirm a positive test, the student will have the opportunity to discuss the test results and provide any documentation for a legitimate medical explanation for the positive test result.
    5. The Associate Dean for Students will submit a Physicianship Form to document this occurrence.
    6. If, in the judgement of the Associate Dean for Students, the student represents a clear and present danger to self or others, the Associate Dean for Students may do one of more of the following:
      1. Take immediate steps to suspend the student.
      2. Secure emergency professional assistance.
      3. Notify the School’s legal counsel.
  4. Failed (positive) drug or alcohol testing actions
    1. The results of a failed test will be reported to the Associate Dean for Students.
    2. A Physicianship Form will be submitted to document the occurrence.
    3. The student will be subject to disciplinary sanctions and a hearing before CSP that could result in academic dismissal. 
    4. An individual’s participation in, and successful completion of, an approved drug and alcohol treatment program coupled with their consent to random testing may be considered in the disciplinary process but does not ensure that dismissal will not occur.
  5. Positive tests may be appealed by submitting a written request to the Associate Dean for Students (and Chair of the CSP if CSP mandated the screening) within three business days after being informed of the positive test results. 
    1. The student has the right to have a second test performed on the original specimen for qualitative presence only at a certified laboratory of their choice and all expenses of such retest will be the responsibility of the student. 
    2. The specimen transfer between laboratories will follow standard protocol.
  6. Any student given the option to participate in a drug and alcohol treatment program will comply with the treatment and rehabilitation requirements as follows:
    1. Satisfactorily participate in a drug and alcohol treatment program approved by the Associate Dean for Students for this purpose.
    2. Provide evidence satisfactory to the Associate Dean for Students of continued outpatient therapy in an approved program appropriate to the treatment recommendation.
    3. Remain substance-free after completing a drug and alcohol treatment program for substance use disorder and participate in random drug and/or alcohol screening during treatment and for the duration of their medical education at the School.
    4. Failure to comply with these requirements may result in a recommendation for dismissal.
  7. 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.

        RESPONSIBILITY
        Associate Dean for Students

        REFERENCES

        1. UC Davis School of Medicine Bylaws and Regulations
        2. UC Office of the President Policies (https://policy.ucop.edu/index.html)
          1. University of California Policy on Substance Abuse
          2. Implementing Guidelines for the University of California Policy for Substance Abuse 
        3. UC Davis Administration of Student Discipline (http://sja.ucdavis.edu/disciplinary-process.html).
        4. UC Davis Policy & Procedure Manual (http://manuals.ucdavis.edu)
          1. Section 270-21, Sales, Service and Consumption of Alcoholic Beverages.
          2. Section 290-70, Controlled Substances. 
          3. Section 380-22, Drug and Alcohol Testing of Transportation Employees. 
          4. Section 390-30, Disruptive Behavior in the Workplace.
        5. University of California Davis Health, Administrative Policies, Personnel - 2909: Drug-Free Workplace: Suspected Employee Impairment (https://ucdavishealth.ellucid.com/)
        6. United States Code (https://uscode.house.gov/) 
          1. Drug-Free Schools and Communities Act, 20 U.S. Code 1011i. 
          2. Drug-Free Workplace Act, 41 U.S. Code Sections 701-707
          3. Schedule of Controlled Substances Act, 21 U.S. Code Section 812. 
        7. California law
          1. Drug-Free Workplace Act of 1990, Government Code Section 8350-8357. 
          2. Uniform Controlled Substances Act, Health and Safety Code, Division 10, Section 11000 et seq.

        RELATED POLICIES
        Background Check Policy
        Code of Academic and Social Conduct Policy
        Dismissal Policy
        Professionalism Policy
        Technical, Non-Academic, Standards
        UC Davis Health Policy 2909, Drug Free Workplace: Suspected Employee Impairment

        POLICY OWNER
        Associate Dean for Students

        REVIEWED BY
        Associate Dean for Students*
        Director of Wellness
        Committee on Student Promotions

        REVIEWED DATE and REVIEW CYCLE
        September 2024; Annual review cycle

        * Indicates the policy owner