The U.S. Department of Transportation announced in a rule published in the Federal Register on November 13, 2017, that, among other revisions to its drug and alcohol testing regulations, it will expand its drug testing panel to include four “semi-synthetic” opioid drugs: hydrocodone, hydromorphone, oxycodone and oxymorphone. These changes are being made to harmonize DOT’s drug testing regulations with recent revisions to the U.S. Department of Health and Human Services’ Mandatory Guidelines for Federal Workplace Drug Testing Programs that took effect on October 1, 2017. The changes to DOT’s rules take effect on January 1, 2018.
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.
Prescription Painkiller Epidemic
The addition of the semi-synthetic opioid drugs is intended to address the nationwide epidemic of prescription painkiller abuse. 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. DOT still refers to its drug testing panel as a 5-panel, but the term “opiates” is being changed to “opioids” and now will include these four synthetic substances in addition to heroin, morphine and codeine. 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.
In addition, DOT will add methylenedioxyamphetamine (MDA) as an initial test analyte, and remove methylenedioxyethylamphetamine (MDEA) as a confirmatory test analyte.
Drug Panel and Cut-off Concentrations
As of January 1, 2018, all DOT-regulated employers must utilize the following 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
Amphetamines 500 ng/ml 250 ng/ml
(includes Methamphetamines, MDMA, MDA)
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
DOT’s new rules also make certain technical amendments, clarify certain definitions and remove the requirement for employers and Consortium/Third Party Administrators to submit blind specimens. Among other things, the definition of “drugs” has been revised to include “opioids” instead of “opiates”, and the definitions of “evidential breath testing device” and “alcohol screening device” have been revised.
The regulation addressing direct observation collections is being revised to require service agents who learn that a direct observation collection should have been collected but was not, to inform the employer to direct the employee to have an immediate recollection under direct observation. (Previously this requirement applied only to collectors).
The regulation addressing MRO verification of valid prescription medication use also is being revised as follows:
You [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 consistent with the Controlled Substances Act, you will allow 5 business days from the date you report the verified negative result for the employee to have the prescribing physician contact you to determine if the medication can be changed to one that does not made the employee medically unqualified or does not pose a significant safety risk. If, in your reasonable medical judgment, a medical qualification issue or a significant safety risk remains after you communicate with the employee’s prescribing physician or after 5 business days, whichever is shorter, you must follow §40.327. If, as the MRO, you receive information that eliminates the medical qualification issue or significant safety risk you must transmit this information to any third party to whom you previously provided information under §40.327.
DOT will require Medical Review Officers, Substance Abuse Professionals, Breath Alcohol Technicians and Screening Test Technicians to subscribe to the Office of Drug & Alcohol Policy & Compliance’s list-serve to receive ODAPC e-mail updates.
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.
DOT-regulated employers should revise their drug and alcohol testing policies to conform to the regulations that are effective on January 1, 2018.