Back

Idealease Safety Bulletin - Prescription Drugs and Commercial Motor Vehicle Operation do not always mix

Feb. 26 2021 Miscellaneous By McCandless Idealease

Share

The February 26th Idealease Safety Bulletin is here and it brings us some important reminders about your drivers and prescription drugs. 

Read, view, or share the entire bulletin online or download a PDF version through the image below.  Remember, you can always sign up to receive the newest bulletins automatically to your inbox each and every week! 

CLICK HERE TO ACCESS ALL PAST SAFETY BULLETINS

Important Resources:

FMCSA Controlled Substance Testing Program

Information about medications and side effects

It is important for motor carriers to be aware of the medications their drivers are taking, as they can have a direct effect on driving skills as well as the overall operation of a commercial motor vehicle.

Prescription medications have increased substantially over the past several years.  

What can you do to help guard against prescription drug use in your vehicles:

  • Be aware of your driver's physical condition and communicate with them regularly. If you know a driver has been injured, talk with the driver to understand whether medications have been prescribed. 
  • Make sure examining physicians are aware that the employee operates a CMV in any work-related injuries.  Visit the physician's office with your employee. 
  • Work with the Medical Review Officer for your drug and alcohol testing program for assistance in reviewing any prescription medications
  • Develop relationships with medical care providers to ensure they understand the job requirements of your employees

In the right amount, the following list of legal medications can impair one's ability to drive and operate a CMV:

  • Anti-anxiety medication
  • Amphetamines
  • Barbiturates
  • Stimulants
  • Narcotic pain medications
  • Allergy medicines
  • Blood sugar medicines
  • Antidepressants
  • Tranquilizers
  • Blood pressure medicines
  • Motion sickness medication
  • Ulcer medication
  • Antibiotics
  • Anti-seizure medicines
  • Paregoric
  • Anti-nausea medicine
  • Sedatives
  • Cough syrups
  • Alcohol-containing medicines
  • Caffeine-containing medicines
  • Decongestants 

As a driver, it is recommended to partner with both your physician and pharmacist to better understand any medication's potential side effects and what drugs are generally safe to combine, especially behind the wheel. Be sure to never take more than the prescribed dosage and ask for non-sedating forms of your prescriptions if you are operating a CMV.  Give your body time to adjust to any new medications before you get behind the wheel! It is your responsibility! 

FMCSA FAQs:

Medications that disqualify a CMV driver: https://www.fmcsa.dot.gov/faq/what-medications-disqualify-cmv-driver

Can a CMV driver be disqualified for using a legally prescribed drug? https://www.fmcsa.dot.gov/faq/can-cmv-driver-be-disqualified-using-legally-prescribed-drug

21 CFR 1308.11 Controlled Substance Schedule 1: https://www.ecfr.gov/cgi-bin/text-idx?SID=fb0b4afcff84aef52755d6dff7b8880d&node=se21.9.1308_111&rgn=div8

For further assistance, please contact the FMCSA's Physical Qualifications Division at fmcsamedical@fmcsa.dot.gov or (202) 366-4001. 

Medical Review Officers (MROs) may sound the alarm even if a DOT drug test is NEGATIVE:

The addition of four commonly prescribed opioids to the DOT drug testing panel effective January 1, 2018, has left some drivers and carriers with unanswered questions, especially when the Medical Review Officer (MRO) calls into question a driver's fitness for duty.

What drugs are prohibited?

Sections 382.213, 392.4, and 391.41(b)(12) state that any drug, including over-the-counter medications, that affects a driver's ability to safely operate a commercial motor vehicle (CMV) is strictly prohibited.

Schedule I drugs, such as marijuana, are strictly prohibited - even if permissible under state laws.

On the other hand, the regulations allow for the use of a non-Schedule I controlled substance, providing:

  • It was legally prescribed to the driver, and
  • The prescribing medical practitioner:
    • is aware of the driver's job duties, and
    • has indicated it will not interfere with the driver's ability to safely operate a commercial motor vehicle.

CDL driver's opioid prescription

Hydrocodone, hydromorphone, oxymorphone, and oxycodone (all on Schedule II of Controlled Substances) were recently added to the DOT testing panel for safety-sensitive positions, including CDL positions.

  • If a DOT urine collection reveals one of these four controlled substances:
    • The MRO will verify that the prescription meets the exception in Section 382.213 by contacting the medical practitioner who wrote the script. 
    • The test is reported to the motor carrier as a negative. 

Recent changes to 49 CFR Part 40 now offer procedures for MROs who see continued use of the prescription as a safety risk. 

In such instances:

  • The MRO will notify the driver that he or she has five days to arrange an alternative to the current medication. 
  • If the driver fails to act on this request and/or the prescribing physician is unable to offer a suitable replacement, the MRO has been given the discretion to call the medication into question. 
  • He or she may contact the motor carrier, certified medical examiner (ME) that qualified the driver under the Federal Motor Carrier Safety Regulations, a Substance Abuse Professional evaluating the employee as part of the return-to-duty process, a DOT agency, or the National Transportation Safety Board in the course of an accident investigation.

What are an employer's options?

When a motor carrier is contacted by the MRO about the driver's prescription drug use, the motor carrier has not been given instructions on how to proceed.

  • The motor carrier has the option of sending the driver for a new DOT physical anytime his or her qualifications come into question. 
    • This is in accordance with Section 391.45(c). 
    • The driver must be honest about his or her prescription drug use on the health history portion of the exam form.
    •  The medical examiner makes the final determination.

The Medical Examiner could:

  • Use the exception and fully qualify the driver,
  • Request another medication and withhold certification until it is rectified, or
  • Medically disqualify the driver.

Since the test is negative (and the driver has a current medical card), the company, in theory, could opt to do nothing. 

However, the Medical Review Officer may wind up contacting the company each time the driver has a drug screen since the safety risk, in the MRO's opinion, has not been resolved.

And, if this driver is in a serious crash, it could dredge up claims of negative entrustment since the motor carrier has knowledge of a potential safety risk.



*The Idealease Safety Bulletin is provided for Idealease locations and their customers and is not to be construed as a complete or exhaustive source of compliance or safety information. The Idealease Safety Bulletin is advisory in nature and does not warrant, guarantee, or otherwise certify compliance with laws, regulations, requirements, or guidelines of any local, state, or Federal agency and/or governing body, or industry standards.