How to Protect Your Missouri Nursing License After a Positive Drug Test

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Legal Strategies and Recovery Options for Nurses Facing Substance Abuse Allegations

A positive drug test can be a career-altering event for any nurse, especially in Missouri, where the State Board of Nursing takes allegations of substance use very seriously. Whether your test occurred after a workplace incident, random screening, or during an employment application, you may be facing disciplinary action that threatens your ability to practice.

However, a positive test result does not mean automatic license revocation. With the right legal guidance, documentation, and proactive steps, you may be able to protect your license and continue your career.

What Happens After a Positive Drug Test?

If you test positive for illegal substances or improperly used prescription medication while employed as a nurse, your employer is legally obligated to report the result to the Missouri State Board of Nursing under RSMo § 383.133.

The report typically triggers an official investigation. You may be:

  • Placed on administrative leave
  • Asked to submit additional drug tests
  • Required to explain the result in writing
  • Evaluated for impairment while on duty

From this point, your case may take one of two paths:

  1. A formal disciplinary process resulting in suspension, probation, or revocation.
  2. A referral to Missouri’s Alternative Program for Impaired Nurses, which allows you to maintain your license while undergoing treatment and monitoring.

Understanding the Alternative Program for Substance Use

Missouri offers a non-disciplinary option known as the Alternative Program (also called the Intervention Program), which is available to nurses who voluntarily admit a substance use issue and are willing to undergo structured treatment and monitoring.

This program can help nurses avoid formal discipline if they meet the following criteria:

  • No patient harm occurred
  • This is a first-time offense
  • The nurse is not currently under disciplinary action
  • The nurse voluntarily withdraws from practice until approved to return

Participation typically involves:

  • A substance abuse evaluation
  • Formal treatment or rehabilitation
  • Random drug testing
  • Workplace supervision
  • Restrictions on administering narcotics

While this program is challenging, it can preserve your license and allow for long-term recovery and reintegration into practice.

Legal Strategies to Consider

If you’re facing discipline after a positive drug test, an experienced nursing license defense attorney can help protect your rights and advocate for the most favorable outcome.

Here are key strategies your attorney may use:

1. Challenge the Test Validity

There may be issues with how the test was administered, stored, or reported. Your attorney can request lab documentation, chain of custody records, and explore whether testing protocols were followed.

2. Provide Legitimate Medical Explanations

If you were taking a legally prescribed medication, documentation from your physician may help resolve the issue without discipline—especially if the medication was used as directed and disclosed beforehand.

3. Negotiate Alternative Resolution

Even if the test result is valid, your attorney can request that you be referred to the Alternative Program rather than face public discipline. This route emphasizes rehabilitation over punishment.

4. Show Rehabilitation Efforts

Proactively entering treatment, attending therapy, or enrolling in a substance use support program (such as AA or NA) can demonstrate that you take the issue seriously and are committed to improvement.

5. Protect Your Right to Due Process

You have the right to contest allegations at a formal hearing. Your attorney can gather evidence, examine witnesses, and ensure you are not unfairly penalized for past mistakes or unsupported accusations.

Avoiding Additional Mistakes

Many nurses make critical errors after a positive test by:

  • Admitting fault in writing without legal advice
  • Failing to report the issue to the Board (if required)
  • Continuing to work while impaired or suspended
  • Ignoring requests from the Board or employer
  • Posting about the situation on social media

These actions can worsen the situation and limit your legal options. The most important step you can take is to remain silent and consult with a professional license defense lawyer immediately.

Can You Continue Working as a Nurse?

In some cases, you may be able to continue working under specific conditions:

  • Practicing under supervision
  • Avoiding medication administration
  • Complying with random drug testing
  • Notifying all employers of your status

However, this will depend on the nature of the drug involved, whether patients were affected, and your history with the Board.

What If You’re in Recovery?

If you’re already in recovery for a past substance use issue and test positive due to relapse, you still have options—but you must act quickly and demonstrate your continued commitment to treatment.

Your attorney can help you update the Board with:

  • A relapse prevention plan
  • Updated treatment program enrollment
  • Monitoring and support verification

Relapse does not automatically mean revocation—but failing to disclose or address it might.

🟦 Contact Sanger Law Office, LLC for a Free Consultation

If you’ve tested positive on a drug screen and your Missouri nursing license is at risk, we are here to help. At Sanger Law Office, LLC, we understand that addiction is a medical issue—not a moral failure—and we are committed to helping nurses recover and rebuild their careers.

📞 Call (816) 520-8040 today for your free consultation with a trusted Missouri nursing license defense attorney. You don’t have to face the Board alone—we’re ready to stand with you.