A recent expansion of U.S. Department of Transportation (DOT) drug screening guidelines applies to more than 225,000 mariners employed on oceangoing and inland vessels. As of Jan. 1, DOT drug testing for transportation workers nationwide includes four semi-synthetic opioids: hydrocodone, hydromorphone, oxymorphone and oxycodone.
The change to the Code of Federal Regulations, found in 49 CFR Part 40, requires that all mariners in safety-sensitive positions pass a test for these opioids, in addition to other drugs previously tested for such as marijuana, cocaine, amphetamines and heroin.
“A safety-sensitive employee is best understood as a mariner having a responsibility to operate the vessel or its equipment,” said Patrick Mannion, drug and alcohol program manager for the U.S. Coast Guard. “Most mariners sailing aboard a vessel are considered safety-sensitive employees.”
The societal opioid crisis has prompted some transportation companies to test for semi-synthetics in their own non-DOT screening programs.
“We haven’t seen any evidence of this being a problem with our members. But in society overall it’s affecting other transportation modes,” said Klaus Luhta, a vice president for the International Organization of Masters, Mates & Pilots (MM&P).
Common trade names for the four opioids include Oxycontin, Percodan, Percocet and Vicodin.
Mariners have undergone drug screening since Congress passed the Omnibus Transportation Employee Testing Act (OTETA) in 1991. Since then, DOT’s Office of Drug and Alcohol Policy and Compliance has been responsible for maintaining drug screening guidelines.
“I think this is the most dramatic change we’ve seen in a long time. I can’t remember when there’s been a change like this,” Luhta said.
Beyond the addition of new drugs to the testing regimen, employers no longer need to submit blind specimens to labs, according to Dr. Anne-Marie Puricelli, director of medical operations at Concentra, a DOT-qualified specimen collector.
“Labs have improved in their quality control measures. (The DOT is) not concerned anymore that there’s going to be a test reported as positive that wasn’t positive,” she said.
Prescriptions, however, will be subject to further scrutiny. Medical review officers (MROs) now have the option to report a mariner to an employer if they’re concerned about a prescription. But first, the MRO must give the employee five days to contact their physician and have the prescription changed to a safer drug, such as a non-opioid pain medication.
The DOT also has given MROs the authority to test for tetrahydrocannabivarin (THCV), a compound found in marijuana. THCV does not exist in Marinol, a synthetic form of marijuana initially approved by the Food and Drug Administration to help cancer patients cope with nausea caused by chemotherapy. The test will help “differentiate those individuals who are truly just taking Marinol from those who may be using Marinol as a front,” Puricelli said.
The changes to 49 CFR Part 40 did not come as a surprise. DOT guidelines often mirror the Department of Health and Human Services (HHS), which determines what drugs should be the focus of federal screening. HHS implemented workplace drug testing for the same four semi-synthetic opioids on Oct. 1.