Confusing Drug Question

[Armenia 18]

I don't see SLMCEC as awful people, it's there job to weed out the bad seeds!

It is SLMCEC's job to perform medical tests. It is out of place to make conclusions based on a single question and a, usually, one-word answer.

If SLMCEC asks, "Have you ever used drugs"

And the client answers "Yes"

And SLMCEC writes "substance abuse" on the client's record..

That is an awful, illogical practice. My apologies for using "people." That should have been "SLMCEC is awful. Some SLMCEC people are awful."

If SLMCEC asks, "Have your ever used drugs?"

And the client answers "Yes"

And SLMCEC asks "When and for how long?"

And the client answers something like "When I was 15, first year college. I was at a party and there were some who were smoking cigarette that smelled funny. I was curious and asked what it was. I tried it. That was the only time I tried/used marijuana."

And SLMCEC doesn't write Substance Abuse in the client's record...

That's sensible and logical.

If SLMCEC asks, "Have your ever used drugs?"

And the client answers "Yes"

And SLMCEC asks "When and for how long?"

And the client answers something like "When I was 15, first year college. I was at a party and there were some who were smoking cigarette that smelled funny. I was curious and asked what it was. I tried it. That was the only time I tried/used marijuana."

And SLMCEC writes Substance Abuse in the client's record...

That is an awful, illogical practice. The SLMCEC physician should go back to grade school and learn the meaning of the word "abuse" or be terminated for not understanding its meaning and writing false information on the report.

Now, an SLMCEC employee can be specifically awful when, by his demeanor and tone, he/she comes across as more of an interrogator rather than a medical specialist - wanting to trip up clients by asking questions without clearly explaining the context and meaning of the question.

If SLMCEC is going to use the phrase "substance abuse" in their reports, then the question shouldn't simply be "Have you ever used drugs?" There is a time and/or dosage element when you use the word "abuse."

[VanessaTony 3,567]

It is SLMCEC's job to perform medical tests. It is out of place to make conclusions based on a single question and a, usually, one-word answer.

Using drugs even once is substance abuse. You might not agree with it but it doesn't make it "illogical".

The panel physicians are given specific instructions. ANY drug use is bad.. whether just a "taste" or whatever and by USCIS standards is considered "substance abuse" unless proven otherwise.. She would need to speak to a psychologist about it who would then determine whether the use is bad enough to be excluded for. If it's' just "a taste" you wouldn't usually have any issue.

Look, whether you agree with it or no, drug use is bad. USCIS can exclude people for it. Let's hope she got lucky

[Armenia 18]

Using drugs even once is substance abuse. You might not agree with it but it doesn't make it "illogical".

The panel physicians are given specific instructions. ANY drug use is bad.. whether just a "taste" or whatever and by USCIS standards is considered "substance abuse" unless proven otherwise.. She would need to speak to a psychologist about it who would then determine whether the use is bad enough to be excluded for. If it's' just "a taste" you wouldn't usually have any issue.

Look, whether you agree with it or no, drug use is bad. USCIS can exclude people for it. Let's hope she got lucky

I stand corrected then as I didn't know that Substance Abuse includes even a few seconds of a single puff. Where is that written though - that definition of Substance Abuse that considers usage regardless of behavior pattern, duration or dosage?

Look, whether you agree with it or no, drug use is bad

I do not disagree. I believe that drug use is bad. I am one of a small segment of urban earthlings (based on how common it is for people to say "We've all done this in the past blah blah") who have never tried/used/puffed marijuana nor been curious to taste or try or use it.

[Armenia 18]

I stand corrected then as I didn't know that Substance Abuse includes even a few seconds of a single puff. Where is that written though - that definition of Substance Abuse that considers usage regardless of behavior pattern, duration or dosage?

I take that back. I do not stand corrected.

"HHS/CDC Part 34 regulations require that all immigrants and refugees coming to the United States be screened for physical and mental disorders with associated harmful behaviors and substance abuse and addiction..." http://www.cdc.gov/i...structions.html

From the 2010 Technical Instructions for Physical or Mental Disorders with Associated Harmful Behaviors and Substance-Related Disorders for Panel Physicians http://www.cdc.gov/i...alth-pp-ti.pdf:

"Substance abuse is characterized by a pattern of recurrent substance use despite adverse consequences and impairment. To establish any substance-related diagnosis, the examining physician must document the pattern of use and behavioral, physical, and physiological effects associated with the use or cessation of use of that substance."

"For the purpose of classification, an applicant is determined to be Class A for substance dependence (drug addiction) or repetitively abusing substances (drug abuse), if he or she meets current DSM diagnostic criteria for substance dependence or abuse with any of the specific substances listed in Schedules 1 through V of Section 202 of the Controlled Substances Act (Appendix C)."

From the US DoS Foreign Affairs Manual http://www.state.gov...tion/86936.pdf:

"For a Class A determination under Section INA 212(a)(1)(A)(iv) (8 U.S.C. 1182(a)(1)(A)(iv) for Drug (Substance) Abuse or Addiction (Dependence), an applicant must meet current DSM diagnostic criteria for substance dependence or abuse with any of the specific substances listed in Schedule I through V of Section 202 of the Controlled Substances Act. .."

DSM-IV Substance Abuse Criteria http://www.sis.india...-Criteria.aspx:

"Substance abuse is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of intoxication and physical fights).

Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:

1. Tolerance, as defined by either of the following: (a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect or (b) Markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for the substance or (b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3. The substance is often taken in larger amounts or over a longer period than intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)."

So based on the criteria that the US government follows, it is not correct for the first level physician to write "Substance Abuse" on your record based solely on the client answering "Yes, I've used drugs" to the question "Have you ever used drugs." Now, the first level physician is not a psychologist which is presumably the reason why clients, who admit to drug use, have to take an evaluation test. That having been said, it is more correct then for the first level physician to write "possible substance abuse" since "substance abuse" (which comes across as a definite diagnosis) can only be established only upon further questioning and testing of the client.

[sjr09 155]

It is SLMCEC's job to perform medical tests. It is out of place to make conclusions based on a single question and a, usually, one-word answer.

If SLMCEC asks, "Have you ever used drugs"

And the client answers "Yes"

And SLMCEC writes "substance abuse" on the client's record..

That is an awful, illogical practice. My apologies for using "people." That should have been "SLMCEC is awful. Some SLMCEC people are awful."

If SLMCEC asks, "Have your ever used drugs?"

And the client answers "Yes"

And SLMCEC asks "When and for how long?"

And the client answers something like "When I was 15, first year college. I was at a party and there were some who were smoking cigarette that smelled funny. I was curious and asked what it was. I tried it. That was the only time I tried/used marijuana." A crigarett that smelled funny and you was curious, you ask what it was, but after you was told it was pot you tryed it! And Clinton never inhaled, right?

And SLMCEC doesn't write Substance Abuse in the client's record...

That's sensible and logical.

If SLMCEC asks, "Have your ever used drugs?"

And the client answers "Yes"

And SLMCEC asks "When and for how long?"

And the client answers something like "When I was 15, first year college. I was at a party and there were some who were smoking cigarette that smelled funny. I was curious and asked what it was. I tried it. That was the only time I tried/used marijuana."

And SLMCEC writes Substance Abuse in the client's record...

That is an awful, illogical practice. The SLMCEC physician should go back to grade school and learn the meaning of the word "abuse" or be terminated for not understanding its meaning and writing false information on the report.

Now, an SLMCEC employee can be specifically awful when, by his demeanor and tone, he/she comes across as more of an interrogator rather than a medical specialist - wanting to trip up clients by asking questions without clearly explaining the context and meaning of the question.

If SLMCEC is going to use the phrase "substance abuse" in their reports, then the question shouldn't simply be "Have you ever used drugs?" There is a time and/or dosage element when you use the word "abuse."

[sjr09 155]

I agree that St. Lukes is only doing their job. However, I don't consider a person who (experimented with pot) in their youth to be a "bad seed."

I agree

[Tahoma 2,291]

Using drugs even once is substance abuse. You might not agree with it but it doesn't make it "illogical".

Experimenting with pot once is not "substance abuse." Where did you get that crazy idea from?

The panel physicians are given specific instructions. ANY drug use is bad.. whether just a "taste" or whatever and by USCIS standards is considered "substance abuse" unless proven otherwise..

Regardless of the "instructions" or "standards," it defies common sense that youthful experimentation with pot should be considered "substance abuse" and used as grounds to deny a visa.

She would need to speak to a psychologist about it who would then determine whether the use is bad enough to be excluded for. If it's' just "a taste" you wouldn't usually have any issue.

Please stop giving out incorrect information. Beneficiaries in Manila who admit to any type of drug use, no matter how minor, do not speak to a psychologist, nor anyone else at St. Lukes for that matter. They are simply denied a visa at their interview.

Look, whether you agree with it or no, drug use is bad. USCIS can exclude people for it. Let's hope she got lucky

No, I don't agree that experimenting with pot is "bad." Perhaps you would care to explain how it is.