DOT Update: New Drug Testing Panel Addresses Nationwide Epidemic of Painkiller Abuse

DOT Update: New Drug Testing Panel Addresses Nationwide Epidemic of Painkiller Abuse

On 27 Dec 2017, in

In a long-anticipated move, the Department of Transportation (DOT) has expanded its drug testing panel to include prescription pain medications that are most frequently used without medical authorization. Effective January 1, 2018, the DOT 5-panel test will include the following semi-synthetic opioid drugs:


  • Hydrocodone
  • Hydromorphone
  • Oxycodone
  • Oxymorphone

“The synthetic opioids are more commonly known as Vicodin, OxyContin, Lortab, Norco, Percocet and Dilaudid, among other names,” says Tom Kibby, BarnesCare’s chief medical officer. “They are being added to the standard opioid panel which already includes heroin, morphine and codeine.”

DOT’s decision to add the four semi-synthetic opioids is intended to address the nationwide epidemic of prescription painkiller abuse and match U.S. Department of Health and Human Services (HHS) Mandatory Guidelines for Federal Workplace Drug Testing Programs.

DOT-Covered Employers

Employers regulated by the following DOT agencies should revise their drug and alcohol testing policies to conform to the new rule:

  • Federal Motor Carrier safety Administration (FMCSA)
  • Federal Aviation Administrations (FAA)
  • Federal Railroad Administrations (FRA)
  • Federal Transit Administration (FTA)
  • Pipeline and Hazardous Materials Safety Administration (PHMSA)
  • United States Coast Guard (USCG)

New Drug Panel

As of January 1, 2018, all DOT-regulated drug tests at BarnesCare will reflect the following updated 5-panel test and cutoff levels:









50 ng/ml


15 ng/ml




150 ng/ml


100 ng/ml


Phencyclidine (PCP)


25 ng/ml


250 ng/ml


Amphetamines (includes Methamphetamines, MDMA, MDA



500 ng/ml



250 ng/ml




6-AM (Heroin)







2000 ng/ml


10 ng/ml


300 ng/ml


100 ng/ml


2000 ng/ml


10 ng/ml


300 ng/ml


100 ng/ml





MRO Reporting of Medication-Related Safety Concerns

According to Kibby, adding the synthetic opioids will likely lead to more laboratory-positive results for MRO review. Under the new rules, DOT is directing MROs to report test results promptly, but to pause up to five days (or until contacted by the prescriber, whichever happens first) before reporting medication-related qualification and safety risks for a legally valid prescription. “The five-day pause is to allow donors to have the prescriber of the medication contact the MRO to discuss changing the medication to eliminate the MRO’s concern," says Kibby. "DOT hopes that the pause allows many of the concerns to be reconciled before they are reported to employers.”

BarnesCare encourages employers to review the new rule here.

If you have any questions regarding the new DOT rule, contact the BarnesCare MRO office at 314.747.6050.

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