Should Employers Test for Opioids and Prescription Painkillers?

The opioid epidemic is a hot topic these days and is a serious issue due to the growing problem of individuals abusing prescription painkillers. Many employers are now adding drug testing or expanding their existing testing to include opioids and other prescription pain killers in their drug-free workplace and safety programs. This is both legal and a best practice for many industries, drug testing experts say, as long as certain procedures and laws are followed.

Effective Jan. 1, “the U.S. Department of Transportation (DOT) requires employers regulated by the department to include opioid testing in the 5 panel Federal testing panel”, said Tom Fulmer, Vice President of Business Development with National Drug Screening, Inc. based in Melbourne, Florida. The rule applies to commercial motor vehicle drivers (FMCSA), flight crew and other aviation-related workers (FAA), railroad employees and maintenance of way workers (FRA), transit workers (FTA), certain pipeline employees (PHMSA) , and marine employees regulated by the U.S. Coast Guard.

While not required for nonDOT testing, opioid testing among employers has become more common over the last several years due to the increase in abuse of or addiction to prescription painkillers.

For companies with employees in safety-sensitive positions that are not covered by the DOT regulations, testing for opioids or other prescription painkillers is helpful in limiting a company’s risks and liabilities. Safety-sensitive jobs are defined by each employer and may include construction workers, equipment operators, warehouse employees, or other employees who operate in a job where a momentary lapse in concentration can lead to injury or death, or serious environmental consequences.

“Employees who abuse opioids or other impairing effect medications may injure themselves or others on the job, damage property, be late or absent more often, or even steal from employers or customers or create morale problems”, stated Joe Reilly, President of National Drug Screening.

It is important to remember that even employers not regulated by DOT should follow best practices as well as maintain compliance with State drug testing laws which can vary greatly from state to state.

One key part of any drug testing program is having a medical review officer (MRO) who reviews positive test results to ensure that an employer is informed only of the use of a prescription drug that is being used illegally, meaning without a valid prescription. The MRO can also notify employers in the event of a safety concern over a legal drug that a person is taking. Drug-free workplace policies clarify which substances are prohibited and good job descriptions will assist in determining which employees are safety sensitive. This allows the MRO and the employer to make the best decisions when a test yields a positive result.

By testing for illegal or illicit drug use including opioids, employers are protecting their employees, their companies, and the public. This also helps to identify employees that can benefit from assistance through an employee assistance program or EAP or through referral to a substance abuse professional (SAP) so they can get the help they may need.

Many employers offer employee assistance programs for employees to get help prior to a positive drug test or provide last-chance agreements for workers who do test positive for drug use.

While the Americans with Disabilities Act prohibits employers from discriminating against anyone who takes a legally prescribed medication, employers are not required to accommodate illegal or illicit drug use.

With the Change to the DOT test panel which has been a standard for many years for nonDOT testing plus the opioid epidemic, it is very likely there will be an increase in expanded panel testing among employers not covered by DOT regulations.

Employers who are not covered by the DOT rule should still follow DOT best practices and should always use a medical officer to review all positive drug test results for potential legal use. The MRO is a licensed physician with expertise in analyzing drug test results and will review positive results to determine if the employee has a legal prescription.

The MRO gives the employee the opportunity to confidentially explain whether there is a valid prescription or explanation for a positive drug result before the results is reported to the employer. The medical review officer has the option of reporting the use of prescription medication to the employer, even if there is a valid prescription, if the MRO determines that the employee’s continued use of the medication is likely to pose a significant safety risk.

With the increasing abuse or prescriptions and an increase in the use of illegal drugs, many employers are revising or adding drug testing or safety programs into their company policies. For those that are regulated by DOT, there are clear guidelines defining what you can and cannot do and what substances you must test for but for non-regulated companies, it is no so clear. DOT testing is done under Federal authority, while nonDOT testing is subject to both federal, state, and possibly even local laws. It is critical to make informed choices in what drugs you test for, what specimen type you test (Urine, Hair, Saliva, etc.), and what procedures you follow.

You can find more information on DOT testing, the opioid epidemic, and specific state laws and requirements at or contact Tom Fulmer  or Joe Reilly at 866-843-4545.

Woman looking into a medicine cabinet
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