Nurse Who Denies Using Meth Keeps License After Positive Drug Test—Here’s What Happened

Disclaimer: This article addresses topics related to substance use, which may be distressing for some readers. Reader discretion is advised. If you are in crisis or need support, please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline at 1-800-662-HELP (4357)—available 24/7 for free, confidential assistance.

An Iowa nurse who tested positive for methamphetamine while working at a nursing home will keep her license but face a year of probation and mandatory drug screening, according to a recent Iowa Board of Nursing decision.

Lacy Dencklau, 45, was working at Friendship Haven in Fort Dodge when she tested positive for methamphetamine in January 2024. Following the positive test, she was terminated from her position. Six months later, in July 2024, the Iowa Board of Nursing charged her with "unethical conduct or a practice harmful to the public" specifically related to methamphetamine use. The board ultimately resolved the case in April 2025 by placing her license on probation rather than revoking it.

"I don't know how the drug got into my system because I have never used drugs," Dencklau stated when contacted about the case, maintaining her innocence despite the positive test results.

Substance Abuse Allegations

This case highlights the complex challenges nursing boards face when addressing substance use among licensed professionals. According to research on nurse substance abuse, approximately 10% of nurses—one in every ten—abuse prescription medications, with higher rates observed among those working in home health and nursing home settings compared to other practice areas.

What makes Dencklau's case particularly interesting is that after being fired from Friendship Haven, she was able to secure employment at another healthcare facility while her case was pending before the nursing board.

The Iowa Board of Nursing's decision to place Dencklau on probation rather than revoke her license reflects a common approach among state nursing boards that often prioritize rehabilitation over permanent license removal. This approach recognizes substance use disorders as medical conditions that can be treated, while still implementing monitoring systems to protect patients.

However, critics argue that allowing nurses with positive drug tests to maintain active licenses—even with probationary status—could potentially put vulnerable patients at risk, especially in settings like nursing homes where residents often require complex care and medication management.

The Iowa case mirrors similar situations in other states.

• In February 2025, Iowa nurse Kristine Brammer kept her license despite drug theft allegations that resulted in her Nebraska nursing license being revoked. 

These cases raise questions about consistency in nursing regulation across state lines and the effectiveness of current monitoring systems.

Substance Use Disorder Support

For nurses struggling with substance use disorders, many states offer confidential monitoring and treatment programs that allow them to maintain their licenses while receiving support. These programs typically include random drug testing, therapy requirements, workplace monitoring, and other structured interventions designed to support recovery while ensuring patient safety.

If you are in crisis or need support, please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline at 1-800-662-HELP (4357)—available 24/7 for free, confidential assistance.

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