Positive Drug Test Results: What You Need to Know

What does a positive drug test mean for you and your employee?

Things can get complicated if a non-negative drug test result comes from any of your employees – especially for companies regulated by the Department of Transportation (DOT). The DOT has strict regulations regarding the steps you need to take after this occurs.

If the positive result comes from a pre-employment drug test, you cannot allow the employee to operate a commercial motor vehicle (CMV) for your company. You must have a negative drug test result in the driver qualification file for every employee in order to operate compliantly and meet DOT recordkeeping requirements.

So, what does a positive drug test mean and what happens next? Let’s go over a few scenarios that may apply to your employee’s specific situation, such as...

• They say the result is a false positive
• They admit to using drugs
• They refuse to take a drug test
• They take prescription medication and are afraid to take a test
• They need to go through the return-to-duty process

What if I received a positive drug test result, but the employee says it’s a mistake?

This is a common claim that employers encounter after receiving a non-negative drug test 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 sample is split into two separate vials – vials A and B – which are shipped to a laboratory.
• The laboratory tests vial A. If drugs are detected, the specimen goes under 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 contact the employee in order to conduct an interview.

2. During the interview, the MRO will determine if there is a valid medical explanation as to why the specimen may have tested positive (such as prescribed medications).

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 there were no errors made.

• After the medical review process is complete, the 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 three contact attempts have been made, the result will report to the employer as a “non-contact positive.”

What happens if the employee agrees to split-specimen testing?

The employee must make the split-specimen test 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.

What if my FMCSA-regulated driver admitted to me that they use drugs?

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

If you are regulated by a DOT agency other than the FMCSA, such as the Federal Aviation Administration (FAA), Pipeline and Hazardous Materials Safety Administration (PHMSA), Federal Railroad Administration (FRA), Federal Transit Administration (FTA), or Maritime Administration (MARAD), please call Foley at 800-253-5506 for assistance.

One of my employees refused to take a required drug test. Now what?

This is known as “Refusal to Submit.” It involves the same consequences as a positive result.

What if I have an employee who is on prescribed medication and doesn’t want to test for fear of the result being positive?

This is another common scenario, but thanks to the medical review process, it shouldn’t be a concern. If during the MRO interview the employee states that they are taking prescribed medication, they 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 result will be reported as a verified negative to the employer.

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

What if I have an employee that needs to go through 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 not usually a quick one. This process consists of the following steps:

1. 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.
2. Education/Treatment – The employee must comply with the SAP’s recommendations. This could be anything from attending several group meetings to in-house rehabilitation.
3. 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.
4. 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 collection process.
5. DOT Follow-Up Testing – The SAP will provide the employer with a schedule of follow-up tests, in which a minimum of six unannounced tests conducted under direct observation are to be scheduled over at least a 12-month period. This process may continue for up to five years.

A non-negative drug test result can be a stressful experience for both the employee and you, the employer. Following these steps will ensure you meet DOT regulations while keeping the safety of your company at the top of your list of priorities.

Trust Foley for DOT Drug Testing Done Right

If you need additional support throughout the drug testing process, turn to a trusted third-party administrator (TPA) like Foley for a DOT-compliant drug and alcohol testing program. We’ll take care of pre-employment, random, post-accident, return-to-duty, and reasonable suspicion drug tests. Foley also manages all the DOT recordkeeping requirements that go along with these tests.

Our nationwide network of collection sites makes it easy for your drivers to find a convenient location along their routes.

Ready to make drug testing drivers easier for yourself? Get a FREE demo of Foley’s drug and alcohol testing software today by filling out the form below.