The when-they'll-drug-test matter will depend on that particular court and what its standard procedures are regarding when they require people to submit. The ones where we live tend to leave that up to the judges' preferences. No one can give you a guess on that one. As far as how serious the first show-cause matter is, it's generally relatively gentle at that step. You sound like you have a reason. It'll help you tremendously to have medical records and verifiable documentation of that reason at the ready to trot out if need be. They'll probably treat it like it's nothing and move on if you present your cause. That's what that proceeding is for.