Will Prescription Drugs Cause Me to Fail A DOT Drug Test?

The Department of Transportation prohibits the use of controlled substances at work, but what happens if you have a prescription for it? For instance, if you have pain medication following an injury, will you fail a DOT drug test for prescription drugs? 

What Drugs Are Included in DOT Drug Tests?

DOT drug tests look for evidence of the following substances: 

  • Opioids, including morphine, hydrocodone, codeine, oxycodone, heroin (6-AM), oxymorphone, and hydromorphone
  • Marijuana metabolites
  • Cocaine metabolites
  • Amphetamines, including methamphetamine and MDMA (ecstasy/molly) 
  • Phencyclidine (PCP)

The most common prescription drugs to show on a DOT drug test are hydrocodone (Lortab, Norco, Vicodin), oxycodone (Percocet, Oxycet, Roxicet) and codeine (used in many prescription cough syrups). You should inform your medical provider of your obligations and job functions. If you are subject to DOT-regulated medical standards (truck/bus driver, airline pilot, mariner), the DOT agency may require you to report your prescribed medications to those who approved your medical qualifications. Your employer may have a policy that requires you to report your prescribed medications to them.

Will I Fail a DOT Drug Test If I Have a Prescription?

A positive drug test isn’t necessarily a failed drug test. Following a positive test, the Medical Review Officer (MRO) will conduct an interview with you to determine if there is a legitimate medical explanation for the result. If you provide a medical explanation for the test results, the MRO could report the test as negative to your employer. However, if the MRO determines the prescription poses a risk to you performing safety-sensitive duties, the MRO may report your medication use/medical information to a third party (e.g. your employer, health care provider responsible for your medical qualifications, etc.).

It is possible to fail a DOT drug test for marijuana or any of the substances tested, even if you have a prescription for it. Even over the counter cannabidiol oil products can yield a positive drug test. Learn more: Will CBD Oil Make You Fail a Drug Test?

What Happens If I Don’t Have a Prescription and Test Positive?

If you do not have a prescription and have positive drug test results, you will be removed from safety-sensitive job duties. You will have to complete the Return-to-Duty process before returning to work. If there was an accident preceding the drug test, you may also be subject to investigation. 

How to Return to Work after a Positive DOT Drug Test

If you have a prescription that is a sufficient medical explanation for the positive drug test, you should be able to return to work immediately. The exception for this may be an investigation, such as a post-accident investigation from the insurance company or law enforcement. Without those hurdles though, you can go back to work as normal.

If you fail a DOT drug test for controlled substances without a prescription, you will need to complete the return to duty process before you can return to work. This process involves getting matched with a Substance Abuse Professional and completing treatment, counseling, or education hand-selected for your circumstances. You must go through two in-person evaluations, one at the beginning of the program and once at the end. After successful completion of the SAP program, you can re-apply for work or resume your previous job duties. The state of your employment is up to your employer, not the SAP. 

Note that there will be a minimum of six unannounced drug tests after your SAP program. This unannounced drug testing may occur for up to five years. 

Get Matched with a DOT-Qualified SAP near You

If you fail a DOT drug test and need a Substance Abuse Professional, ASAP has over 5,000 SAPs throughout the country. 

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