As of 1/1/18, the DOT drug panel looks a bit different. It now includes what we normally refer to as Expanded Opiates, or Extended Opiates. Still referred to as a 5 panel test, it include much more than the conventional 5 panel test.

As per DOT regulations 49 CFR Part 40 the DOT panel now looks like this:

  • Marijuana metabolites
  • Cocaine metabolites
  • Phencyclidine (PCP)
  • Opioids  (codeine, heroin, morphine, oxycodone, oxymorphone, hydrocodonea and hydromorphone)
  • Amphetamines  (amphetamine, methamphetamine, MDMA & MDA)

Some common names for the new semi-synthetic opioids include OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, and Exalgo®.

The chart below lists the five panel DOT drug test with cutoff levels. A cutoff level is a threshold. If the detected level of a substance is below the cutoff it is not detected at all.

Initial Test Analyte Initial Test Cutoff Concentration Confirmatory Test Analyte Confirmatory Test Cutoff Concentration
Marijuana metabolites (THCA) 50 ng/ml THCA 15 ng/ml
Cocaine Metabolites (Benzoylecgonine) 150 ng/mL Benzoylecgonine 100 ng/mL
Phencyclidine (PCP) 25 ng/mL Phencyclidine (PCP) 25 ng/mL
Amphetamine 500 ng/mL Amphetamine 250 ng/mL
Methamphetamine 500 ng/mL Methamphetamine 250 ng/mL
MDMA/MDA 500 ng/mL MDMA/MDA 250 ng/mL
Codeine/Morphine 2000 ng/mL Codeine/Morphine 2000 ng/mL
6-Acetylmorphine (6AM or Heroin) 10 ng/mL 6-Acetylmorphine (6AM or Heroin) 10 ng/mL
Hydrocodone 300 ng/mL Hydrocodone 100 ng/mL
Hydromorphone 300 ng/mL Oxymorphone 100 ng/mL
Oxymorphone 100 ng/mL Oxymorphone 100 ng/mL
Oxycodone 100 ng/mL Oxycodone 100 ng/mL

There have been a lot of questions about the new panel and how the MRO is supposed to handle prescribe opioids.

Our MRO has told me that he will always attach a safety concern to a regulated employee who is prescribe opioids.

Do I need to tell anyone about my prescribed medications?

      Your employer may have a policy that requires you to report your prescribed medications to them, so check with your employer.  If your job function has DOT-regulated medical standards (truck/bus driver, airline pilot, mariner), the DOT agency regulation may require you to report your prescribed medications to those who approved your medical qualifications.

What should I tell my prescribing physician?

      If you are taking any prescription medications, consider this to be a reminder to have a conversation with your prescribing physician to discuss your safety-sensitive work.  Be proactive in ensuring that your prescribing physician knows what type of transportation-related safety-sensitive work you currently perform.  For example, don’t just provide a job title but describe your exact job function(s) or ask your employer for a detailed description of your job function that you can give to your prescribing physician.  This is important information for your prescribing physician to consider when deciding whether and what medication to prescribe for you.  It is important for you to know whether your medications could impact your ability to safely perform your transportation-related work.         

Will the MRO report my prescribed medication use/medical information to a third party?

     Historically, the DOT’s regulation required the MRO to report your medication use/medical information to a third party (e.g. your employer, health care provider responsible for your medical qualifications, etc.), if the MRO determines in his/her reasonable medical judgement that you may be medically unqualified according to DOT Agency regulations, or if your continued performance is likely to pose a significant safety risk.  The MRO may report this information even if the MRO verifies your drug test result as negative.

     As of January 1, 2018, prior to the MRO reporting your information to a third party you will have up to five days to have your prescribing physician contact the MRO.  You are responsible for facilitating the contact between the MRO and your prescribing physician.  Your prescribing physician should be willing to state to the MRO that you can safely perform your safety-sensitive functions while taking the medication(s), or consider changing your medication to one that does not make you medically unqualified or does not pose a significant safety risk.