Abstract
Substance abuse alternative programs for professionals in positions that influence public safety are available for a number of industries and health care professionals, including nurses. The primary focus of alternative programs is to provide early identification, entry into treatment, and safe reentry of nurse professionals with known histories of substance abuse. A key component of these alternative programs is monitoring abstinence through drug testing, and program administrators must make careful decisions regarding drug screening standards and the appropriate drug testing profile. Recent improvements in technology offer tests using alternative matrixes, such as oral fluid, hair, fingernail, and dried blood spots. In addition, new options for monitoring have become routine. Boards of nursing and alternative program administrators must understand the extent of these new offerings as well as their advantages and disadvantages.
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