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Family Physician
Family Physician, Board Certified MRO
Category: Drug Testing
Satisfied Customers: 12816
Experience:  Medical Review Officer - Physician Trained and certified in drug test interpretation
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My company gives random UA's cause we have Class A licenses

Customer Question

My company gives random UA's cause we have Class A licenses to drive a CMV. I recently had to take one and tested positive for a prescribed amphetamine. Got a call from a MRO and was asked what prescription medication was I taking and by slip of tongue I told the MRO I was also taking a prescription for Hydrocodone. I was told that there was not a positive for that. But for mentioning it, the MRO now is stating that I have to give a doctor's note to explain about the Hydrocodone use to my company because they disclosed that information to them. And for the note to say it won't affect my abilities to drive a CMV. By reading the language in FMCSA link you posted, it states that a MRO can not report a positive on a drug that was not found to be positive in their findings. Just only what came out positive. Is a MRO allowed to disclose this information to the company with no positive result? My doc that prescribed the amphetamine gave me note that says it's ok to drive, but I having problem w/ my back doctor give me due to "liability issues".
Submitted: 10 months ago.
Category: Drug Testing
Customer: replied 10 months ago.
Few notes.....I've been driving for this parcel service in their package box trucks for 8 yrs and now as a CMV truck driver for 2 yrs. The random was due to having a CDL, but always had to reapply for my DOT Physical every two years and never had an issue. I'm not worried about the amphetamine cause of the doc's note, it's about the Hydrocodone. I've been taking Hydro for over 6 yrs and never had an issue w/ driving. No accidents. I know having to release this information about taking prescribed Hydrocodone to the doctor performing my DOT Physical, he'll most likely disqualify me. I know I'm taking my chance, but if the drug test preformed doesn't show a positive for that type of opiate, It's a chance I'll have to take. My main concern is if that MRO on the phone is allowed to tell my company about what I disclosed about the prescription or are they just to report the result of the test only?
Expert:  Family Physician replied 10 months ago.

Thank you for your question:

The DOT rules reference reporting a test as NEGATIVE WITH SAFETY CONCERN if medical information provided during the interview reveals some medical condition (in your case use of an opioid medication that MIGHT influence your ability to safely drive a truck) as a "safety concern" even though the test is negative. This is NOT the same as a positive test - but you do need to address this issue with your physician to get documentation that the medication does not impact your ability to drive.

https://www.transportation.gov/odapc/part40/40_135

Customer: replied 10 months ago.
I believe the "Negative with a Safety Concern" was a result for the Amphetamine that tested positive. They ask my information for my pharmacy to validate the prescription which I believe by the rules as the outcome of that to be "Negative but with a Safety Concern". On the Hydrocodone, they told be I didn't test positive for it. With it not being tested positive, even though I mentioned that I took it, are they allowed to release that information to the company? Where I'm confused is, with a positive test for a prescribed amphetamine plus conformation that it's prescribed, from the pharmacy, does that result always come back as "Negative with a Safety Concern"?
My main concern is if that isn't the case, did the MRO put "Negative with Safety Concern" for the Hydrocodone just cause I mentioned taking it even though there was a no positive result? Where I'm also confused is that I gave them a wrong number to the pharmacy to confirm my prescription for Hydrocodone and in calling them back, they told me that they didn't have to call the pharmacy because the result for the Hydrocodone came out negative. They were only going to call for the amphetamine cause that's the only thing that came out positive. Do they have a right to inform my employer of anything that doesn't come out positive just cause I slipped up and mentioned it? By looking at the FMCSA language and their example given, I reads as they're not supposed to??
Expert:  Family Physician replied 10 months ago.

ANY information that is provided during a MRO interview may lead to reporting a "safety concern". For example: Under current DOT rules, someone taking insulin for diabetes can legally drive. If during a MRO interview, the driver mentions that he/she is taking insulin - this needs to be reported. Another example would be methadone. If the driver mentions methadone (not included in the DOT test panel), it would need to be reported as a "safety concern"

Hydrocodone is not actually included in the DOT testing protocol. It is an opioid medication ("opiate like") but not included in the DOT opiate panel. The only drugs that are tested under opiate are morphine, codeine and 6-AM (a metabolite seen after taking heroin). The other semi-synthetic opioids like hydrocodone, oxycodone etc are not tested. The can theoretically cause safety concerns.