ACT NOW: Important Drug Testing Changes

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ACT NOW: Important drug testing changes

Changes to the U.S. Department of Transportation (DOT) drug-testing regulations took effect January 1, 2018 and already we are seeing a major impact. The percentage of laboratory positive tests has doubled and the number of safety warnings issued by the MRO has gone up even more. If you act now, there are ways to keep your workplace safer, avoid positive tests and prevent employees from being removed due to safety letters.


What happened?

Four New Opioids, a Change from “Opiates” to “Opioids” and a delay in safety warnings

Effective January 1, 2018, the Final Rule added four semi-synthetic opioids to DOT’s standard 5-panel drug testing: hydrocodone; hydromorphone; oxymorphone; and oxycodone. In addition, the regulations rename the category or class of drugs currently referred to as “opiates” to “opioids.”


Medical Review Officers (MRO’s) always issued safety warnings to employers when the MRO learned of information during the post-drug test interview with the employee/urine donor that would likely lead to the employee being medically disqualified. What is new is the “5 day pause.” The employee has 5 business days to have his or her physician contact the MRO to discuss the safety issue. For example, if an employee tests positive for oxycodone and presents a prescription to the MRO, the MRO would tell the employee that there is a potential safety issue and that the employee has 5 business days to have the prescribing physician contact the MRO to discuss. After 5 days or after the discussion takes place, whichever comes first, the MRO will then report the safety issue to the employer if the issue cannot be resolved.



  1. We are seeing a high number of lab reports positive for these opioids, most by prescription but some not. In some cases, drivers have been on potent opioids for years but never mentioned it on their DOT physical.
  2. We are sending out more safety letters. Most opioid positive tests are caused by legal prescriptions. Therefore, the test is reported to the employer as “negative,” however a safety notice may be issued.
  3. It is taking longer to verify and report certain drug tests.
  4. Sometimes, an employer will receive a negative test report, but a week later get a letter that the employee has a safety issue and needs to be removed from DOT work. This process is problematic, but it is how DOT wants it. We are trying hard to perform the prescription verification and the safety discussion with prescribing physician simultaneously so there won’t be a “5 day pause,” but it is not always possible.


What can you do about it?

  1. Notify employees today that they are now going to be tested for synthetic opioids found in prescription pain medicines such as Percocet, Oxycontin, Norco, Lortab, etc.
  2. Remind employees if your company policy requires them to notify you of the use of controlled substances.
  3. Even if your company policy doesn’t require notification, remind employees that they are forbidden from using impairing substances when performing safety-sensitive work. Tell them to speak to their prescribing providers about alternative treatments other than controlled substances.
  4. Review your current policy with your lawyer to make sure it is compatible with the new Part 40 drug testing regulations.

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