Volume 63, Number 1
February / March / April 2018

DOT responds to opioid crisis with increased monitoring

The U.S. Department of Transportation (DOT) announced on November, 13 2017 the expansion of its drug testing panel to include four “semi-synthetic” opioid drugs: hydrocodone (Vicodin, Lortab, Norco), hydromorphone (Dilaudid), oxycodone (Percocet & OxyContin) and oxymorphone (Opana). The changes took effect on January 1, 2018 and were made to assure that DOT’s drug testing regulations are consistent with the Mandatory Guidelines for Federal Workplace Drug Testing Programs issued by U.S. Department of Health and Human Services that took effect on October 1, 2017.

DOT-regulated employers include those regulated by the Federal Motor Carrier Safety Administration, Federal Aviation Administration, Federal Railroad Administration, Federal Transit Administration, Pipeline and Hazardous Materials Safety Administration, and the United States Coast Guard. All commercial drivers are subject to the new rules.

The addition of the semi-synthetic opioid drugs is intended to address the nationwide epidemic of prescription painkiller abuse. Since 1999, opioid prescriptions and deaths from accidental overdose have almost quadrupled. Fatal drug poisonings, which are largely due to opioid painkillers, now account for more preventable deaths annually than automobile accidents among adults.

Hydrocodone, hydromorphone, oxycodone and oxymorphone are Schedule II controlled substances and are more commonly known as Vicodin, OxyContin, Lortab, Norco, Percocet and Dilaudid, among others. All of the drugs added to the testing panel are available by prescription.

DOT still refers to its drug testing panel as a 5-panel, but the term “opiates” which formerly only included heroin, morphine and codeine, is being changed to “opioids” and now will include these four synthetic substances. The Department of Health and Human Services explained that the four prescription pain medications were added to the standard testing panel because data indicates that although they are prescribed, they are the prescription pain medications that are most frequently used without medical authorization.

DOT regulations still permit the employee to produce a legitimate medical explanation for the presence of drugs in his/her system, but the Medical Review Officer is not permitted to question whether the prescribing physician should have prescribed the substance.

The regulation addressing MRO verification of valid prescription medication use provides the following guidance:

The MRO must also advise the employee that, before informing any third party about any medication the employee is using pursuant to a legally valid prescription, the MRO will allow 5 business days from the date the MRO reports the result as negative for the employee to have the prescribing physician contact the MRO to determine if the medication can be changed to one that does not make the employee medically unqualified or does not pose a significant safety risk.

If, in the MRO’s reasonable medical judgment, a medical qualification issue or a significant safety risk remains after the MRO communicates with the employee’s prescribing physician or after 5 business days, whichever is shorter, the MRO must report the information to a third party which may include the employer.

If the MRO receives information that eliminates the medical qualification issue or significant safety risk, the MRO must transmit this information to any third party to whom the MRO previously provided information under §40.327.

DOT’s new regulations also confirm that no specimens, other than urine, may be tested for drugs. Only urine specimens screened and confirmed at HHS-certified laboratories are permitted; point-of-collection testing, or instant tests, are not authorized.

What these rules mean for Teamster commercial drivers is that every CDL holder should be certain that he or she is taking prescribed opioid medications in the amounts the doctor wrote on the prescription. The prescribing physician should be aware of the CDL holder’s job requirements, so drivers should tell their doctors what they do for a living. Under no circumstances should a CDL holder take a different painkiller medication for which he or she does not have a valid prescription. It is unwise to take old medications that might be in one’s bathroom cabinet even though they were prescribed in the CDL holder’s name. For example, an old prescription for vicodin written by a dentist for a procedure done four years ago may not be verified by that dentist when the MRO calls to ask if the driver should be taking that medication four years later.

If you are one of the many million Americans taking a prescription opioid daily and would like to consider an alternative, contact your physician about your options. If you want to stop using opioids completely because you fear you have crossed into drug abuse or addiction, please contact TAP at 800-253- 8326 or TARP at 800-522-8277 for information or a confidential assessment.

Current drug test panel and cut-off concentrations
Drug Initial Confirmatory
Marijuana 50 ng/ml 15 ng/ml
Cocaine 150 ng/ml 100 ng/ml
Phencyclidine (PCP) 25 ng/ml 25 ng/ml
(includes Methamphetamines, MDMA, MDA)
500 ng/ml 250 ng/ml
Codeine/Morphine 2000 ng/ml 2000 ng/ml
6-AM (Heroin) 10 ng/ml 10 ng/ml
Hydrocodone/Hydromorphone 300 ng/ml 300 ng/ml
Oxycodone/Oxymorphone 100 ng/ml 100 ng/ml

For more information, please call TARP at 1-800-522-8277 or TAP at 1-800-253-8326.

Call TARP (Teamsters Alcohol/Drug Rehabilitation Program) at (800) 522-8277 or TAP (Teamsters Assistance Program) at (800) 253-8326 if you or a loved one would like more information on this subject or our services.