Effective January 1, 2018: DOT Drug Screening Expands to Include Semi-Synthetic Opioids

Drug screen

The Department of Transportation (DOT) has ruled to adopt drug screening panels set by the Department of Health and Human Services earlier this year, with changes in effect January 1, 2018.

What changes are being made to the panel?

The DOT has opted to expand the required panel to include the following Schedule II semi-synthetic opioids: hydrocodone, hydromorphone, oxycodone, and oxymorphone. Technically, the DOT panel is still considered a 5-panel drug screen. The difference is in the expanded opioid coverage that will now be part of federal drug screening programs for urine testing. Many might be more familiar with these opioids from their pharmaceutical brand names: OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, and Exalgo®.

Additionally, Methylenedioxyamphetamine (MDA) has been added as an initial test analyte, replacing methylenedioxy-N-ethylamphetamine (MDEA).

Why were these changes made?

Prescription drugs have become one of the most widely used, misused, and abused drugs in history. They are highly addictive and often prescribed as pain management for everything from minor procedures and broken bones to chronic conditions. In 2015, opioid misuse and overdose culminated in over 33,000 deaths for the year. In 2017, the current administration declared the opioid epidemic a public health emergency.

The inclusion of these semi-synthetic opioids is the DOT’s response to this epidemic and an attempt to remove these drugs from the federal workplace environment.

What does this mean for employers? What is the impact to existing screening programs?

While employers are assured their employee pools are being tested for a commonly abused class of drugs not previously tested under the DOT panel, these changes will have some impact:

  1. There may be instances where employees who have not previously tested positive on their drug screens will now be showing positive on their results.
  2. Diligent reporting by the Medical Review Officer (MRO) may increasingly raise safety concerns or report an employee unqualified as part of a reasonable medical judgement.
  3. And, finally, a potential increase in drug screening price.

A little more about safety concerns raised by the MRO.

If the MRO believes there is a significant safety risk with the employee’s continued use of an opioid drug, then the MRO will now instruct the employee to have his/her prescribing health care provider (HCP) contact the MRO to discuss possible changes or discontinuance of the medication.

There are three outcomes for this process:

  1. If the prescribing HCP does not contact MRO within 5 days, the MRO will report a safety concern to the employer.
  2. If the prescribing HCP discontinues the medication or changes the medication to one that does not present a significant safety risk, the MRO will not report a safety concern to the employer.
  3. If the prescribing HCP contacts the MRO and states that the medication is not being changed or discontinued, the MRO will report a safety concern and recommend a fitness for duty evaluation of the employee.

The usual Federal Chain of Custody and Control forms (CCF) that we have now can still be utilized after Jan. 1, 2018 without issue until June 30, 2018 at all laboratories. After that, we will be required to use the newly updated CCFs for any federal drug screening.

How can I make sure that I am ready for the upcoming changes?

A-Check Global is your trusted partner during this change. If you have any questions surrounding your federal workplace program or changes to the DOT protocol, A-Check Global’s team of dedicated professionals are available to help, and can provide friendly, accurate guidance.

Give us a call today at 877-345-2021, or email support@acheckglobal.com.

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