Drug tests are changing in 2018
Transportation Safety Management Today
The Department of Transportation (DOT) has announced that it will modify the list of drugs tested for during DOT drug tests starting January 1, 2018. Added to the laboratory testing are hydrocodone, hydromorphone, oxymorphone, and oxycodone. These drugs are “semi-synthetic” opioids and are commonly prescribed for pain control in serious cases. However, they are also commonly abused drugs that are at the center of the current opioid abuse crisis.
This change is a result of two separate, but related actions. First, the federal government, including the DOT, is trying to curb illegal opioid abuse and misuse. Second, the Department of Health and Human Services (HHS), which DOT relies on to establish the technical standards for laboratory testing, has added standards for the testing of these drugs to their urine testing panel.
Once the change is initiated, the “DOT five panel” will include checking for the metabolites from the following drugs:
Amphetamines: including methamphetamine and MDMA/MDA (ecstasy)
Opioids: including morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone, 6-Acetylmorphine
In all, the five-panel laboratory test will now look for 14 specific metabolites in the five families.
Process review (and changes)
It is important to understand how the overall process works, so you can understand how prescription drugs, including the semi-synthetic opioids, are dealt with in the process. Once the driver has completed the collection, the sample is securely transported to the laboratory. The laboratory then tests the sample for the targeted metabolites (the 14 metabolites in the five families).
The laboratory reports its findings to a medical review officer (MRO), who is a doctor that specializes in interpreting drug testing results. If the lab results are below the threshold for all of the metabolites and all paperwork is correct, the MRO verifies the test as negative and notifies the employer.
If the laboratory results are positive (over the threshold for one of the metabolites), the MRO must contact and interview the driver. During the interview, the MRO will attempt to determine if there was a legitimate reason for the positive results reported by the laboratory. The reason an MRO would accept is that the driver was using a legally prescribed drug that led to the specific metabolite being present.
In this case, the MRO would ask the driver to provide a copy of the prescription and verify that the prescription is authentic. If the MRO determines that the prescription was legitimate, the MRO will report the test as negative.
However, if the MRO believes that the underlying medical condition or the use of the prescription drug would impact the driver’s ability to operate safely or would make the driver unqualified, the MRO must follow up with the prescribing doctor. If, after following up with the prescribing doctor, the MRO believes the driver cannot operate safely while on the medication or that the driver is unqualified, the MRO has a duty to report this concern to the driver’s employer. The employer then has the responsibility of verifying that the driver is still medically qualified. This would involve sending the driver for another DOT medical exam under §391.45.
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