Positive Drug Test Results: What You Need to Know

Scott Mogensen

JUNE 21, 2017 – Circumstances can get pretty complicated in the event of a positive drug test result – especially for companies regulated by the Department of Transportation. The DOT has strict regulations regarding the steps that must be taken afterwards. So let’s get into it:  What happens if an employee tests positive?

Drug & Alcohol Testing Solutions

I received a positive drug test result, but the employee says it’s a mistake because he’s never used drugs

This is a fairly common claim that employers encounter after receiving a positive result, which is why it’s important to understand the measures the DOT has in place to address this argument:

  • After a drug test is taken, the urine specimen is split into two separate vials – Vial A and B – which are shipped to a laboratory.
  • The laboratory tests Vial A. If drugs are detected, the specimen goes into further testing to confirm the presence of drug metabolites, and is eventually reported to a DOT Medical Review Office (MRO) as positive for at least one controlled substance.
  • Once the MRO receives a positive laboratory result, a “medical review” takes place. This review consists of the following steps:

1.   A DOT qualified physician – the Medical Review Officer – attempts to make contact with the employee in order to conduct an interview.

2.  During the interview, the MRO will determine whether there is a valid medical explanation as to why the specimen may have tested positive.

3.  If the MRO determines there is no medical explanation, they will offer the employee the option to have Vial B tested (as described above) in order to verify that no error was made.

  • After the medical review process is complete, the final result is reported to the employer as a verified positive.
  • If the MRO is unable to reach the employee to conduct the interview after a minimum of 3 contact attempts have been made, the result will report to the employer as a “non-contact positive.

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Split-Specimen Testing

If the employee opts to have the split specimen tested, he or she must make the request to the MRO within 72 hours. At that time, Vial B will be shipped to a laboratory for testing. This cannot be the same laboratory used to analyze the first sample.

I have an employee who is on prescribed medication and doesn’t want to test for fear that the result will be positive

This is another fairly common scenario, but thanks to the medical review process, it should be of no concern. If during the MRO interview the employee states that he is taking prescribed medication, he will be given the opportunity to provide proof of the prescription to the MRO. Once a valid prescription is received, and it is determined that the employee is using the medication as prescribed, the final result will report out to the employer as a verified negative.

An employee who has been prescribed medication may be required to obtain a note from the prescribing physician that the medication will not affect their ability to perform safety-sensitive functions.

The DOT Return-to-Duty Process

As you might expect, if an employee does test positive, the process they must complete prior to resuming safety-sensitive functions is often not a quick one. This process consists of the following steps:

  • An initial Evaluation with a DOT-qualified Substance Abuse Professional (SAP) – This face-to-face interview will determine the course of action the employee must take.
  • Education/Treatment – The employee must comply with the SAP’s recommendations. This could be anything from attending several group meetings to in-house rehabilitation.
  • Follow-Up Evaluation – This must take place with the same SAP who conducted the initial evaluation and will determine whether the employee has satisfied the recommendations.
  • DOT Return-to-Duty Drug Test – When this test comes back negative, the individual may resume safety-sensitive functions. It must be completed under direct observation, meaning a person of the same sex must accompany him or her during the urination process.
  • DOT Follow-Up Testing – The SAP will provide the employer with a schedule of follow-up tests, in which a minimum of 6 unannounced tests conducted under direct observation are to be scheduled over at least a 12 month period. This process may continue for up to 5 years.

My FMCSA-regulated driver admitted to me that she uses drugs

This is what’s known as “Actual Knowledge” and it carries the same consequences as a positive result.

If you are regulated by a DOT agency other than the FMCSA, please call 800-253-5506 for assistance.

An employee refused to take a required test. Now what?

This is what’s known a “Refusal to Submit.” It carries the same consequences as a positive result.

Does a positive alcohol test carry the same consequences as a positive drug test?

Yes. Stay tuned for our next blog, which will focus specifically on alcohol testing.

164 thoughts on “Positive Drug Test Results: What You Need to Know”

  1. When you’ve been stent home from work due to a Rx failure on drug screen,then it proven by the Doctor your good to go .When your employer calls you for work return by voicemail,do you have a time frame to to return the call??InTexas

    1. Hi Steve,

      I don’t believe there’s a timeframe to return your employer’s call. I would try to get back to them as quickly as possible, however.

  2. Do all companies have to follow the dot guidelines? If something triggered a positive result, does the MRO HAVE to contact the employee before posting results? I’m worried the results have been submitted (not uploaded yet) but I haven’t been contacted yet.

    1. Hi Herman, Yes, the MRO would need to contact you about a positive result first. For motor carriers, only those who operate motor vehicles in excess of 26,000 pounds need to comply with federal drug and alcohol testing requirements.

  3. Hi Scott
    If an employee test positive on a DOT drug screen what protocols does DOT want used to verify.
    Full panel confirmation test
    Single test confirmation
    Only confirm drugs tested positive
    and do you have the reg number.
    thanks

    1. Hi Denise, Split testing is used only to test for the drug(s)/drug metabolite(s) detected in the primary specimen. The regulation for this information is 40.177

  4. An employee went for orientation 3 day process took unrine test the first day the next two days where paperwork a video follow by driver skill test by the end of the third day was sent home to prepare yourself for overroad training the 4th day and off the clock received a call from drug test facility saying there was a problem with the urine sample it cane back invalid couldn’t make it in to reset does this count as a refusal for a pre employment dot test

    1. Hi Clay, If the Designated Employee Representative (DER) for your company wants to deem it to refusal, it can be. If not, you’d have to go in for a recollection (under Direct Observation for DOT).

  5. I have a hair follicle test coming up in a week. I’m prescribed xanax to help with insomnia. There have been a few times in the past month that I have took more than the prescribed amount. Will this make me fail the hair foilicle test?

    1. Hi Peter, If the drug test includes benzodiazepines then it will be detected. The MRO will verify after the test that you have a valid prescription for the drug, but I’m not sure they can see whether you took more than the prescribed amount. As long as you have a valid prescription, you should be fine.

  6. The lab got my test on june 5 and they sent results back on june 6 does that mean that i passed my urine test

    1. Hi Shane, I can’t say definitively that’s what it means as turnaround time varies from lab to lab. If there’s a problem with your test, you would receive a call from the MRO before your results were released, however.

  7. Hello I took a urine test on Tuesday and here t is Friday 2 days later. I called the lab and they informed me my urine test was sent to my employer yesterday (2 days after taking the test) and they would not tell me whether I passed or not. Would they have called me if I got a positive? Or does it just depend?

    1. Hi Thomas, If there’s a problem with your test, the MRO will contact you before they mark the test positive and send out your results. This allows you the opportunity to provide a valid prescription for a drug you tested positive for.

  8. I passed the POCT urine test given by my employer and then failed the lab urine test. I dont do drugs and haven’t in over 6 years. What should I do? they are referring, but Im extremely upset. The company had yet to give me actual results of this test and my potential employer jusg a verbal.

    1. Hi Carlos, If you’re on any prescription medications, the MRO will ask for proof before returning a positive result. If you believe their was a testing error, however, you could ask for a confirmation test – that will provide you with a more accurate result.

  9. Hello:
    I have been employed with my company for over 15 years and have been drug tested numerous times. I have never used drugs. I recently took a hair follicle test and the results came back positive for cocaine. I was offered two options: to retest (which will take 2 weeks), or rehab for a week and return to work. Even though I want to return to work as soon as possible, I feel like I am admitting guilt by taking the rehab option. Again, never done a drug in my life. With that being said, will the second test look more closely at the hair sample to determine what caused the false reading? Or is it simply tested in the same way the first test was done? The only medication I had taken was Tylenol with codeine but I had a doctor’s note. Any suggestions would be appreciated. Thank you

  10. How long does the DOT have to return the result from vial B for a retest? It’s been 7 days since the order was placed for a retest, 5 of have been business days.

  11. I had a drug test come back positive for butalbital, which I have a script for. Is there a way I can prove that I took it when I wanst on the job(on my day off), or will the test automatically show how long ago I took it?

    1. Hi Aaron, As long as you have a valid prescription, you should be fine. The test identifies how much of the drug is in your system and will register positive if the amount is above the designated cutoff level. It can’t definitively tell when you last took it.

  12. I took a UDT at pain management in April 16/2018, Urine test result final report say the two in which I’m prescribe tested positive, but they said I tested positive for cocaine, I’m a 55yo Stroke patient may have touch something like that in 1989 but never since, on my next day final report its showing a negative for cocaine, but in the same office they had a batch record of 4/12/18 urine LC MS/MS Toxicology report with a funny looking lable on it, I think these ppl doing something crooked, please advise I can up load the reports one say negative ,normal creatinine normal pH everything negative and normal, something not right about this

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