After a Positive DOT Drug Test - MRO Duties

After a positive DOT drug test, the MRO is required to contact the donor. But, what happens when a the MRO is unable to contact the donor to confirm the result?

All positive DOT drug test results are immediately sent to the Medical Review Officer (MRO) for confirmation. It is the role of the MRO to contact the donor by telephone to confirm that there is not a legitimate medical explanation for the positive test result.

The actions that the MRO takes are written into the regulations of 49CFR Part 40. Specifically, the MRO must make reasonable efforts to reach the employee at the day and evening telephone numbers listed on the CCF. Reasonable efforts include, as a minimum, three attempts, spaced reasonably over a 24-hour period, to reach the employee at the day and evening telephone numbers listed on the CCF. If the MRO or her staff cannot reach the employee directly after making these efforts, the MRO or her staff must take the following steps:
(1) Document the efforts you made to contact the employee, including dates and times.
(2) Contact the Designated Employer Representative, instructing the DER to contact the employee and instruct the employee to contact the MRO. If both phone numbers are incorrect (e.g., disconnected, wrong number), the MRO or her staff may contact the DER without waiting the full 24-hour period.

After the employer has been contacted and attempted to contact the employee, the MRO may verify the test result if the employer has reached the employee and instructed him or her to call the MRO, and 72 hours has passed. If neither the MRO nor the employer has been able to contact the employee, the MRO must wait 10 days before verifying the test.

DOT Follow-up Testing Requirements

After a driver who had a positive result on a drug or alcohol test has been evaluated by a Substance Abuse Professional (S.A.P.) and passed a return-to-duty test, he may be returned to work. The DOT requires that the driver have a series of substance abuse follow-up tests over the course of the next year or more.

The testing may be for alcohol, drugs or both as designated by the Substance Abuse Professional (S.A.P.).

As a reminder, the sequence is as follows:
(1) A driver tests positive for alcohol or drugs
(2) The employer decides to retain the driver.
(3) The driver is evaluated by a licensed S.A.P.
(4) The S.A.P. determines what treatment the driver should undergo.
(5) The driver has a negative return-to-duty test and returns to work.
(6) The driver is required to have follow-up testing for a period of no less than one year.

The number of tests and the length of the testing program are determined by the S.A.P. based on his or her evaluation of the driver’s particular substance abuse issues. The D.O.T. requires that the driver undergo no less than six follow-up tests in the next twelve months, but follow-up sequences can go on for years as necessary.

Prescription Drug Abuse - Beyond DOT drug tests

The Department of Transportation testing program includes tests for illegal drugs only; Marijuana, Opiates, Amphetamines, PCP, and Cocaine. However, there are many other drugs that people abuse; often prescribed by doctors!

Prescription drugs are prescribed by doctors to cure people, so how can they be harmful? Because everyone’s body chemistry and tolerance to drugs is different, taking someone else’s prescription drugs can be harmful, even fatal. When doctors prescribe drugs, they evaluate many different factors. Drugs should only be used to alleviate conditions that are painful or harmful to your body, because even taking safe medicines carry risks.

In today’s workplace, employees sometimes take prescription medications not to alleviate medical conditions, but to numb feelings and zone out. This behavior negatively impacts the work being performed and can lead to accidents. Also, even though prescription drugs are legal, employees who sell or use drugs obtained illegitimately are breaking the law.

The two most frequently encountered drugs on the illicit market are Xanax (alprazolam) and Valium (diazepam). These drugs are depressants. Their abuse causes amnesia, hostility, irritability, and eventual physical dependence. When combined with alcohol, they can be deadly.

Abuse of prescription drugs can be detected by using 10-panel drug testing. Also, a Medical Review Officer should review the results to confirm that a person using a prescription drug has a valid prescription.

Employer Page on the DOT Web Site is a Great Resource

The Department of Transportation’s Office of Drug & Alcohol Policy & Compliance has a web site destination specifically for companies that hire DOT drivers. Entitled the "Employer Page", they have posted links to the most important information for employers to know in one place.

The DOT recognizes that employers of safety-sensitive transportation employees play a vital role in ensuring the safety of their employees and the traveling public. Employers are responsible for developing and implementing successful DOT workplace drug and alcohol programs that have as their components clear policies, provisions for education and training, drug and alcohol testing, and when needed, referral for evaluation and treatment.

• Some of the articles and links on the Employer Page include:
• Best Practices for DOT Random Drug and Alcohol Testing
• Current list of HHS certified laboratories
• DOT Agency/USCG drug and alcohol program manager contact information
• DOT Agency/USCG drug and alcohol program facts
• Drug and Alcohol Record Keeping Requirements
• Drug and Alcohol Testing Data MIS Collection Form and Instructions
• Employer Responsibilities under Subpart B of 49 CFR Part 40
• ODAPC - Fact Sheet
• Random Testing Rates
• Release of Information Form 49 CFR Part 40 – Drug and Alcohol Testing (suggested format)

You can browse to the Employer Page by clicking here: DOT Employer Page