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I'm a 4th year male PhD student coming to grips with the fact that I may not get an academic job. Alternatively, I'm looking to industry/government, but I have a significant hurdle in landing a job here: the drug test. I have never done drugs, nor do I ever intend to, but I have a condition called paruresis, more commonly known as "shy bladder syndrome" or "pyschogenic urinary retention." I have never been medically diagnosed, but when you have this condition it's blatantly obvious.

I know that not all companies/agencies conduct drug tests, but many do. While my condition has improved somewhat over the past few years, frankly, I do not think it's possible for me to urinate with someone explicitly watching me. Obviously it sounds horribly incriminating when a person says, "No I cannot take a drug test." I'm sure that drug users have tried every excuse imaginable - including "I have shy bladder syndrome" - in order to avoid them. How can I handle this if I'm required to take a drug test? Would it be possible for me to take a blood test instead? I know that blood tests probably aren't used because of the expense, but can I pay for a drug test by blood out of pocket instead? Even periodically? I would be more than willing to do this if it landed me a job, and I'd assume these are no less accurate.

Notes: solutions such as "getting over it" are not constructive here. Please assume (if for nothing other than the sake of the question) that I cannot possibly urinate with someone watching me. Also, this condition does not affect me in other ways, and almost no one knows that I have this problem. For practical purposes of everyday life, this condition is not debilitating and would not affect my work/productivity. Even when traveling with my department/colleagues or going to crowded places, I can creatively avoid difficult situations by using a stall, visiting the restroom at carefully selected times, etc.

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    Do you know for sure that this drug test requires somebody physically watching you? All of the drug tests I've taken just have you in a sealed bathroom with a few non-obtrusive security precautions. – GGMG-he-him Aug 22 '17 at 2:38
  • @GGMG Interesting. I've never heard of that before. I don't know for sure what the drug test will be like. I was just speaking in generalities, basing this off of the worst case scenario and what I thought was common. I know that drug testing in the military, NCAA, and a government-contracted company that my friend works for that this is standard operating procedure. – J. Doe Aug 22 '17 at 2:42
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    At the time you would take a drug test you should be with medical people that should understand and just tell them. – paparazzo Aug 22 '17 at 6:21
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    Having urinal "stage-fright" isn't rare at all (I personally would avoid urinals even if there's not one else at the rack). For a routine test, you'll most probably be given a pot and a privacy cubicle. It doesn't seem like a high risk, so I don't think there's a need for someone to watch. Obviously, drinking lots of water beforehand will help. – user44108 Aug 22 '17 at 8:02
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    This seems like something many people will having trouble with. I never even thought about it being a medical condition but more like common sense that someone (myself included) cannot urinate while being observed. My expectation would be that they are absolutely aware of this issue and will either provide a "secure" environment or a different kind of test (hair, blood, etc.). – Chris Aug 22 '17 at 8:41
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As GGMG said, most drug tests are taken in private. If a urine test is not possible, there is always a hair follicle test, or a blood test.

  • "Most [but not all] drug tests are taken in private", but how do you know whether any given test would be in private or not? Would they tell you this beforehand? Asking, if not done carefully and at the right time, would arouse suspicion and, in the worst case, cost one the opportunity. – Dukeling Aug 22 '17 at 4:56
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    The fact is, most non-DoD jobs I have had say they require a test, but do not actually administer one. DoD or any job that includes driving likely will though. I have never needed to be viewed, only monitored. Most companies do not give the test until after they are ready to offer, and then they opt for the cheap urine tests. They don't like to give them to every candidate and waste the money, so may be reluctant to pay the difference for blood/follicle. You may need to be prepared to say you are willing to pay the difference which may be enough to either satisfy them or get them to pay.. – dlb Aug 22 '17 at 13:43
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    In my experience the security measures are really unobtrusive. The last drug test I took was in a sealed bathroom with a locked door, water shut off and toilet water dyed blue. I also believe that they measured the temperature of the sample immediately. – Myles Aug 22 '17 at 13:57
  • @Myles that has been my experience in the past as well, and you always have the option of a blood test. – Richard Says Reinstate Monica Aug 22 '17 at 13:59
  • For what it's worth, this is germany but still, when a state government agency I worked at once drug tested me, they had the option to do a blood test or give some hairs instead too if you didn't want to do the urine test. Also the urine test was in a normal unmonitored bathroom with only dyed toilet water. – Magisch Aug 24 '17 at 11:38
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As a probation officer by trade, our department dealt with a handful of offenders with shy bladder (and, yes, it is a very real condition). We offered those select few a "lollipop" test. It's an oral swab that you suck on for about fifteen minutes. That's it! These tests are highly reliable and are similar to buccal swabs. I would suggest:

  • Google "drug test" and your town's name
  • Find an agency that does oral swabs
  • Speak to the agency; explain your problem; ask them how you might arrange for an oral swab (Just so you know what the expectations are, what their hours are, how much it will cost, etc.)
  • Should you be offered a job that requires a pre-employment drug test you're going to have to tell your potential employer that you have shy bladder.
  • Tell them. "I have no problem completing a drug test. Unfortunately, my bladder's quite shy! I've found an agency which conducts oral drug tests -- here's some information on oral swabs and the agency for you to look over. If you're comfortable with it, I'll complete the test tomorrow."
  • Make sure you obtain the fax number or email address you want the results sent to.

Hopefully this will be useful to you!

  • This is a good answer. Sometimes, the only reason you're denied a reasonable request is that no one has done the footwork researching a particular solution. But by having done those phone calls yourself and figured out the details, then you can leap frog of that issue should it ever come up. – Stephan Branczyk Aug 24 '17 at 5:00
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Since Richard nicely covered that this likely won't be an issue, this answer will just assume it may be.

https://www.drugs.com/article/drug-testing.html states that:

Certain laboratory procedures may require direct visual observation while the specimen is being voided.

To your question:

How can I handle this if I'm required to take a drug test?

Certainly not by saying:

"No I cannot take a drug test."

Explain, only when it's necessary (i.e. AT the test if a tester has informed you that they need to watch you), about your condition. It may help to go get diagnosed, because it's a medical condition and (depends on location) most places cannot discriminate.

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    Getting an actual diagnosis from a medical professional would likely help (and they might be able to help improve the condition as well). – Jon Custer Aug 22 '17 at 12:04
  • As someone taken numerous tests like this, I can confirm, they do not literally watch you. There is no door to the stall you use, so your back would be turned at worst, but the procedure differs with the military. They are not going to be close enough to laugh and point. – Donald Aug 23 '17 at 0:01
  • What does "AT the test" mean? – hiergiltdiestfu Aug 24 '17 at 7:09
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Unless there are significant legal (DUI, criminal investigation, insurance fraud) or regulatory issues surrounding the test, no one will be watching you ;)

Being alone in the contribution room (bathroom) is usually enough for a regular employment drug screening. If you've given a sample to you doctor, it's pretty much the same thing.

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