What drugs are tested for in a random (DOT) urine screen?
Five major groups of drugs are screened for in a DOT 49 CFR Part 40 random urine drug test. These are marijuana metabolites, cocaine metabolites, opiate metabolites (heroin, morphine, codeine, etc.), phencyclidine (PCP, angel dust), and amphetamines. This does not mean that other drugs will not be tested for in a "for cause" or "post accident" testing situation by the NTSB. You are cautioned, as always, to be sure any medication prescribed or purchased over-the-counter is cleared for use while on flight duties. The DOT testing for drugs is for the presence of illegal substances, whereas for alcohol, it is for impairing levels of legal substances.
What are the procedures for drug testing?
A complete description of drug testing procedures is beyond the scope of this page. Briefly, DOT drug tests are administered randomly to 25% of safety sensitive employees in DOT regulated commercial operations. Drug testing is by urine sample. Persons giving a sample will have a "split" specimen for independent testing if the initial test is positive. Samples must have at least 45 ml (1 1/2 ounces) of urine for testing. The drug testing monitor will test the urine for temperature and observe for color to screen for obvious adulterants (contaminants). Both the observer and the testee will initial sealed containers of the urine attesting to the identifying information and the specimen. Several copies of paperwork will also be signed by each individual and one copy of the form will be given to the testee. A chain of custody must be maintained for valid testing results to be reported.
Which laboratories conduct drug testing?
Drug testing laboratories conducting analyses for DOT-mandated testing programs must be certified by the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the Department of Health and Human Services. There are currently about 70 approved laboratories (although with industry consolidation, that number is getting smaller). They must demonstrate technical and administrative ability to process specimens in according to federal regulations.
How do laboratories test for illegal drugs?
Testing is basically a three step process. First, the specimen is tested for any adulterants or substances added to the urine to obscure possibly positive results. If any adulterants are found, this information is reported to the employer. The FAA views the presence of adulterants in urine very harshly, as do most employers.
Next, a screening test for each illegal substance is performed for each of the five metabolites. Screening levels of each metabolite are relatively high values that protect the testee from false positive results. If the screening test is negative, no further testing is conducted and the result is reported as a negative test.
Finally, if a screening test is positive, confirmatory testing for the specific substance is done by a very sensitive method called Gas Chromatography/ Mass Spectrophotometry (GC/MS). The levels considered positive in confirmatory testing with GC/MS are significantly lower than the screening levels required in the screening test. If the GC/MS confirms the presence of an illegal substance or its metabolites, the test is reported as a positive to the designated Medical Review Officer.
What is a Medical Review Officer (MRO)?
An MRO is a physician designated to interpret the results of drug testing. The MRO can be an employee of the testee's employer, but more often is an independent contractor that offers MRO services to a variety of companies. MRO's must be certified every 5 years by one of two organizations, the American Association of Medical Review Officers or the American College of Occupational and Preventive Medicine. Certification requires at least 16 hours of additional training and passing a standardized test. There are no specialty requirements for MRO's, only a current valid medical license to take the course. MRO's validate positive testing results and interview or examine individuals with positive test results for possible legitimate explanations for the results. If a legitimate reason exists, the MRO may report the test as a non-test and the individual is returned to the random pool.
What are my rights with a positive test result?
An individual notified by an MRO that test results are positive may request within 72 hours testing of the split sample by a different laboratory. The original laboratory is responsible for sending the sample to the designated laboratory while maintaining the chain of custody. The split sample is tested for by GC/MS using the stricter confirmatory levels for the specific metabolite. Compounds that were not screened and confirmed positive are not tested for by the second laboratory. Both the individual and the company are notified of the split sample test results.
Will poppy seeds or other compound give a false positive?
No. The GC/MS is very specific for the illegal compounds prohibited for use under DOT regulations. Poppy seeds can cause elevated levels of opiate metabolites, but additional analysis of metabolite ratios and physical examination by the MRO will prevent test results from being reported as positive.
The majority of Americans are reported to use some type of vitamins or nutritional supplements for health benefits. Hemp oil is touted as beneficial for a variety of conditions. Hemp is also the source of marijuana. Hemp oil products used as dietary supplements may cause a positive drug test on DOT testing. Use of hemp oil in any form is a PROHIBITED USE according to the DOT and FAA. A confirmed positive drug test will result loss of a pilot medical certificate and possible suspension/revocation of all pilot certificates and ratings. VFS strongly discourages pilots from using hemp oil in any form for any purpose.
What should I do if I have a positive drug test?
The implications of a positive drug test are far ranging. A positive drug test result jeopardizes your FAA medical certificate and your position of employment. Legal and qualified aeromedical assistance is essential for those who hope to fly in the future. The FAA will allow an individual who has had a positive drug test to regain a medical certificate after appropriate treatment, aftercare and monitoring. Coordination of resources required to report the pilot's progress to the FAA is a complex process. The physicians of VFS are qualified MRO's and have considerable experience in assisting pilots with positive drug tests. Contact us for specific advice.
See our article on Drug and Alcohol Treatment and Abatement Programs for corporate aviation flight departments and professional pilots. Also see Aviation International News article Feb 04 on VFS Substance Abuse Prevention Program in the Press Release section under the VFS News section of our website.