YSK that in the US, it is illegal for medical staff to share any part of your medical record with law enforcement unless it is subpoenaed or you are under arrest.

If you go to the hospital, ER or urgent care (or even just to your regular family doctor) and they ask for a urine sample, don't freak out. The doctor just wants to treat you for whatever you're there for. If you're complaining of shortness of breath or fast heartbeat or you passed out, they want to know why. Yes, they may order a drug screen. But they want to know what caused the issue and how to treat it.

So if you did actually take some drugs, that's fine because they absolutely are not going to turn around and call the cops on you simply because your drug screen was positive. The drugs may have been what caused you to black out, etc and knowing what you took could be the difference between you living or dying.

The only time law enforcement has a right to your record is if it is subpoenaed by a court or you are involved in a crime in which you were brought to the ER as a result of injury and are currently under arrest and they have a warrant (and even then a lot of red tape is involved).

So basically, don't try to cheat the test by filling the cup up with water. There are ways we, in the lab, can test that it's water. All this is doing is delaying your treatment for no reason other than your paranoia.

Source: I am a medical professional. I currently work as a medical lab tech (yep, I do all the testing) but am also studying to work in medical billing and coding so had to retake all the HIPAA and legal compliance courses again.

*Edited to add some information