DOT updates drug testing panel to include opioids

Beginning in 2018, new federal testing standards took effect. Here we informally summarize a number of critical provisions as well as our drug testing and system updates that make complying easy for you.

The U.S. Department of Transportation (DOT) has amended its drug testing panel regulations to:

  • Add hydrocodone, hydromorphone, oxymorphone, and oxycodone, four commonly-abused opioids;
  • Add methylenedioxyamphetamine as an initial test analyte; and
  • Remove methylenedioxyethylamphetamine as a confirmatory test analyte.

 

These changes align DOT regulations with Health and Human Services guidelines published earlier in 2017.  The new testing standards went into effect on January 1, 2018. Read the final rule.

Potential pricing increase

The updated panel changes are expected to impact pricing. The DOT’s initial analysis projected this change will increase the cost of MRO services by 3% and laboratory testing by 10%.  Laboratories are expected to increase their pricing related to these changes as incremental cost data becomes available.

We anticipate a price increase during 2018 to cover the higher combined costs from our laboratory vendors and the related impact on the Medical Review Officer (MRO) department.  We’ll continue to communicate with our vendors as potential pricing information from laboratories on the amount and timing of the changes becomes available.

System updated

As of Jan. 1, 2018, our system was updated and ready to receive results from the new DOT panel. Automatic updates were also made to all existing DOT client accounts along with the specific test and panel code.

If your clients choose a DOT look-a-like test panel, those accounts can be similarly addressed but will require you to contact us first and will be subject to any price increase.

Summary of Changes in Final Rule

Blind Specimens

Testing of blind specimens is no longer required.

MRO Practice Issues

The term ‘prescription’ has been clarified to mean ‘‘a legally valid prescription consistent with the Controlled Substances Act [CSA].’’ MROs have the authority to request D&L stereoisomer and THC-V testing if doing so is necessary to verify a test result.  Additionally the timing for the MRO to report a safety risk concern has been modified to allow the employee 5 days to have his/her prescribing physician contact the MRO regarding the use of the prescription prior to the MRO reporting the safety concern.

Fatal Flaws and Questionable Specimens

Three additional fatal flaws have been added to the laboratory reporting list: (1) There is no CCF; (2) In cases where a specimen has been collected, there is no specimen submitted to the laboratory with the CCF; and (3) Two separate collections are performed using one CCF. Additionally, the collection procedure has been clarified in the case where an employee does not provide a sufficient specimen by the end of the three hour wait period.

Additional Changes Include:

  • Collectors, alcohol testing technicians, MROs, and Substance Abuse Professionals will be required to subscribe to ODAPC’s list-serve at ODAPC Updates by Email.
  • Unauthorized use of DOT-branded items (such as logos or emblems) on a service agent’s website, publications, etc., could be a basis for the DOT to initiate a Public Interest Exclusion proceeding.

 

Frequently Asked Questions in DOT Summary of Changes

When did the final rule become effective?

CFR Part 40, Procedures for Transportation Workplace Drug and Alcohol Testing Programs: Addition of Certain Schedule II Drugs to the Department of Transportation’s Drug-Testing Panel and Certain Minor Amendments, was published in the Federal Register on Nov. 13, 2017. The final rule became effective January 1, 2018.

What does this mean for employees?

You will also be tested for four 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®.  In addition, you will no longer be tested for MDEA.

What does this mean for employers and Consortium/Third Party Administrators (C/TPA)?

As an employer or C/TPA, you will no longer be required to submit blind specimens to laboratories.

What does this mean for urine collectors?

The shy bladder process has been modified so that the collector will discard any specimen provided during the collection event when the employee does not provide a sufficient specimen by the end of the three hour wait period.

What does this mean for laboratories?

As an HHS-certified laboratory you will:

  • Add four semi-synthetic opioids: hydrocodone, oxycodone, hydromorphone; oxymorphone to your DOT testing panel;
  • Add MDA as an initial test analyte;
  • Remove testing for MDEA;
  • Add three more fatal flaws to the list of reasons when a laboratory would report a ‘rejected for testing’ specimen; and
  • Need to modify the reports [in Appendix B & C] you provide to employers and the DOT.

 

What does this mean for Medical Review Officers (MRO)?

Several of your MRO drug test review processes have been modified.  For example:

  • The term ‘prescription’ has been clarified;
  • You have authority to conduct D,L stereoisomer and THC-V testing; and
  • The timing when you communicate a significant safety risk has been modified.

 

What does this mean for alcohol technicians?

The list of NHTSA-approved Alcohol Screening Devices and Evidential Breath Testing Devices will appear on ODAPC’s website.

What does this mean for service agents?

  • Collectors, alcohol testing technicians, MROs, and Substance Abuse Professionals will be required to subscribe to ODAPC’s list-serve at:  https://www.transportation.gov/odapc/ListServe_Notices.
  • Unauthorized use of DOT-branded items (such as logos or emblems) on a service agent’s website, publications, etc., could be a basis for the DOT to initiate a Public Interest Exclusion proceeding.

 

What are some of the other changes to Part 40?

  • The DOT added a new section reiterating that, in the DOT testing program, only urine specimens can be collected and analyzed at HHS-certified laboratories.
  • The DOT added language further emphasizing the existing DOT prohibition on the use of DNA testing on DOT drug-testing specimens.
  • The final rule made minor modifications to certain section headings.
  • The final rule moved the list of Substance Abuse Professional certification organizations from the rule text to ODAPC’s website.
  • The final rule moved the MIS instructions from Appendix H to ODAPC’s website.
  • Outdated compliance dates were removed and links were updated.
  • Appendices B, C, D, and H were updated.

 

Where can I find a copy of the final rule?

Read the final rule on ODAPC’s web site www.transportation.gov/odapc/frpubs.

©2018. This informal Q&A summarizes important rule changes but is not a substitute for the rule and should not be relied upon to determine legal compliance with the rule.  ODAPC encourages affected entities, including employers and service agents, to review the final rule.