Industry News on Drug Testing

     On January 1, 2018, the DOT will be implementing a change in their drug testing regulations. They are adding four semi-syntheticopiate medications to the drugs that are tested as part of their random drug testing program. These medications are: hydrocodone, oxycodone, hydromorphone, and oxymorphone. Some common trade names for these medications are: Dilaudid, Lortab, Norco, Oxycontin, Percodan, Percocet and Vicodin.
These changes have been in process for several years. The Department of Health and Human Services (HHS) establishes the guidelines for federal workplace drug testing programs. They published their update on January 23, 2017, with an effective date of October 1, 2017. The DOT finally published their updated regulations on November 13, 2017.
     The DOT regulations have a very structured review process for random drug test results. Any tests that are found by the lab to be nonnegative are sent to a Medical Review Officer (MRO) for review. The MRO’s responsibility is to determine if there is a legitimate medical explanation for the result from the lab. In most cases, this means the medication was prescribed by a doctor. Because these new drugs are all prescription medications, the MRO will have to make a judgment call as to whether the medication was taken appropriately.The DOT has provided some guidance to MROs about this determination, but I expect it will be an evolving process over the next few years.
     If a medication has been prescribed by a doctor and has been taken appropriately, the MRO should report it as a negative test. However, the MRO also has the option of reporting a possible safety concern to the company regarding the medication, again using theirjudgement regarding the medication and underlying medical condition. Note that this is optional, but not a requirement in all circumstances. This type of report would most likely result in either a meeting with the chief pilot or possibly a fitness for duty evaluation. Therefore, the best approach is to try and avoid this situation in the first place.
     The FAA recommends considering both the medication and the underlying medical condition when determining your fitness for duty prior to a flight. They currently recommend a general guideline of waiting at least 5 half-lives after taking a disqualifying medication before returning to flight status. A half-life is basically the amount of time it takes your body to metabolize about half of the medication in your system. Based on this guidance, and with a little extra margin, allow at least 48 hours after taking most of the medications.For oxymorphone, 72 hours recommended. Of course, longer is better if it’s an option. Please call your AME if you want to discuss in more detail.

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