Department of Transportations Recent Changes to Federal Drug Testing Regulations

As you may or may not know, the Department of Transportation recently announced changes to the federal drug testing regulations. These changes are effective as of January 1, 2018 and are applicable to all DOT testing authorities. We suggest that you familiarize yourself with these changes. A link to the Dot website is provided below.

People that are performing jobs that are deemed to be safety sensitive will be tested for four additional  semi-synthetic opioids (i.e., hydrocodone, oxycodone, hydromorphone, oxymorphone). Some common names for these semi-synthetic opioids include OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, Exalgo®. Inclusion of these four semi-synthetic opioids is intended to help address the nationwide epidemic of opioid abuse.

The new DOT panel is as follows:

1)   Marijuana
2)   Cocaine
3)   Phencyclidine (PCP)
4)   Amphetamines (includes Methamphetamines, MDMA, MDA)
5)   Opioids
a.   Codeine/Morphine
b.   6-AM (heroin)
c.   Hydrocodone/Hydromorphone
d.   Oxycodone/Oxymorphone
The new panel removes methylenedioxyethylamphetamine (MDEA).

In addition, the employee now has 5 days to provide a valid prescription to the Medical Review Officer. A valid prescription will in most cases result in a negative drug test result.  

HOWEVER, if the Medical Review Officer (MRO) notices an unnatural amount of the drug, the MRO will likely want to ask more questions and it could result in a positive drug test. It may also result in a negative test with a Safety Sensitive Notification letter from the MRO. The impact of these prescription medications will likely increase the frequency you may receive “Safety Sensitive Notifications” from the Medical Review Officer. If employees have valid prescriptions for medications that trigger a positive, the MRO will reverse and report valid prescriptions as negative. However, if the medication raises a safety concern you will be informed. Prudent action on your part will be securing documentation from the prescribing physician. You will want to confirm the medical practitioner’s knowledge of the employee’s essential job functions and that there is no risk associated with the performance of the functions while taking this medication. 

These changes will increase the workload for the MROs because far more prescriptions will need to be verified. Also, the laboratories will have to analyze specimen for these additional substances. As a result, we expect that there will be a price increase from the labs and Medical Review Officers. As we move forward into next year we may need to pass along these increases to you.  

In addition, the DOT will also be issuing a new version of the Federal Custody and Control Form. These forms will be for use after January 1, 2018. The current forms may be used up until June 30, 2018. The changes to the forms will have very little impact on you or on your employees but everyone must conform to the new regulations and have the new forms in use by June 30, 2018.
  
Please use this link to the DOT website for more information.

So what should you be thinking about?

1)     How and when do I talk to my employees about the changes to the drug testing panel?
 
We suggest that you speak with your employees as soon as possible and make them aware of these changes. Information up front may avoid some issues going into the future. 
 
2)     How do I handle positive results for the new substances? What if my employee has a valid prescription for one of the drugs which will now be included in the testing? How do I handle Safety Sensitive notifications?
 
If Mass MDT provides your laboratory and MRO services, please give us a call or send us an email with your questions. We have a draft letter which may help. If we do not provide these services, you should contact your service provider.

3)     How/when do I get the new testing forms?
 
If Mass MDT provides your DOT testing forms we will take care of your testing forms. We will make sure that we issue new forms to you well before the June 30, 2018 deadline. If Mass MDT does not provide your forms, contact your provider for new forms.
 

4)     If my non-dot testing program mirrors the DOT panel should I change it to include the new substances?
 
If your current NON-DOT panel mirrors the DOT panel, we will automatically update your NON-DOT panel to match the new DOT panel. Given the severity of the opioids crisis in Massachusetts it is certainly recommended that you use the new panel but it is not required. If you do not want your NON-DOT lookalike panel changed you must contact us before January 1st.
 
5)     Do I need to update my DOT FMCSA Testing Policy?

Yes, your policy needs to be updated. If Mass MDT wrote your policy please call or send us an e-mail and we will send you the update. If Mass MDT did not write your policy, contact your provider.

There is a lot of new information for you to consider. If you have any concerns or questions, please feel free to contact us at the email or phone number below.

Will Passive Inhalation of Marijuana Cause a False Positive?

I was just asked this question last week. The donor was at a party and other people were smoking marijuana, not the donor. The donor was afraid that they may have inhaled some of the smoke. It is very unlikely that an individual could inhale enough marijuana smoke to produce a positive drug test at the cut off levels currently observed by most drug testing laboratories. The Donor may have some trace of the drug in their system but not enough to register a positive at a cutoff level of 50ng/ml.
The National Institutes of Health conducted passive inhalation experiments in which subjects were exposed to the smoke from 16 marijuana cigarettes for one hour a day for nearly a week. Further the subjects were in unventilated rooms with the smoke blowing directly in their faces, so much so they supposedly required googles to protect their eyes. Only after this kind of extreme exposure did anyone produce a positive drug test equivalent to that of someone who had smoked just one marijuana cigarettes. In studies conducted under less extreme conditions no drug test were positive for more than a few hours after exposure and the measured cannabinoid levels were low.

Can You Cheat a Drug Test?

The answer, generally speaking, is no. The Internet is swarming with popular ways to cheat a drug test, ranging from sample switching to sample alteration to making up clever excuses. Although some of these methods can work some of the time, none of them can reliably guarantee a negative test.
Sample Switching
One of the most common ways people try to beat a drug test is by switching their drug-laden urine sample with a clean sample. This may be synthetic or real urine bought off the Internet or provided by a friend. Sample switching is an ineffective method for two reasons. First, most tests involve measures designed to make switching difficult or impossible. Some testing companies ask the person being tested to urinate in front of a witness, while others require changing into a hospital gown to make smuggling items into the testing area difficult. Second, the test itself is sensitive enough to detect an old or synthetic sample, meaning that at the very best, switched samples are flagged for more testing.
Adulteration 
Various theories on cheating drug tests advise adding bleach, Visine, Drano or one of several other chemicals to the sample. Supposedly, this will clean out the THC and cause a negative test. Beyond the challenge of smuggling these chemicals into the testing area, they are ineffective when used. What these chemicals actually do is alter the pH level of the sample far outside normal human levels. Testing companies immediately know when samples have been altered, and will perform additional tests on the suspicious sample. Some people try to alter their urine by drinking vinegar or pickle juice, which is not only unhelpful but also causes violent diarrhea.
Dilution
In order to test positive, a urine sample must have a THC level above a certain threshold. The theory behind dilution is that drinking large amounts of water or juice will add more fluid to the urine, thus reducing the THC concentration. Dilution really does lower the amount of THC in a urine sample, but it also dilutes other chemicals typically found in urine. The testing company knows this and carefully screens each sample for signs of deliberate dilution. A particularly dilute sample may be subject to more intensive testing, or the person who provided the sample may be called in for another test with little time to prepare.
Excuses
Some people try to explain away a positive test by claiming to be passive users. Perhaps they accidentally inhaled some marijuana at a party or rock concert. Others try to get out of the test by eating poppy seed muffins, which contain trace amounts of opiates. Modern drug tests, though, set a threshold for a positive test that is far above what could appear in a casual or accidental user’s urine. Anyone who deliberately uses drugs will test positive, and these excuses will not be seen as valid explanations. Conversely, people who really are passive or accidental users have nothing to worry about, since their THC levels are below the minimum threshold for a positive test.
People have tried all of these methods and more to cheat on drug tests for years, and testing companies know every trick in the proverbial book. They have devised drug tests sensitive and secure enough to beat every one of these methods time and again. Although it is remotely possible to beat the test on occasion, no method of cheating can guarantee a negative test. Anyone who continues to use drugs and continues to be tested will get caught, sooner rather than later. The only one hundred percent effective way to guarantee a negative drug test is to stop using drugs