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Q&A
Does the DOT physical include a drug test?
What drugs are tested for, if a DOT drug test is requested?
What if the DOT drug screen tests positive?
Why do I have to have a urine test for my DOT physical?
Is protein in the urine a disqualifier?
Is sugar in the urine a disqualifier?
Is blood in the urine a disqualifier?
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
What if I take insulin by injection and my diabetes is under control?
My doctor put me on Metformin. Can I still drive truck?
What medications disqualify me from getting a medical card?
Can I be qualified if I have a prescription for medical marijuana?
What if I take nitroglycerine for angina?
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
Can I still drive if I take a blood thinner?
Can I still drive while taking Provigil (Modafinil)?
Does the DOT physical include a drug test?
The DOT physical exam to get your medical card, does not include a drug test. This does not mean that any Company you want to work for, will not request a pre-employment drug test — they most likely will. But the DOT physical exam requirements do not include a drug test.
What drugs are tested for, if a DOT drug test is requested?
The 5 Panel drug test analyzes urine for the following drugs:
- Marijuana (THC metabolite)
- Cocaine
- Amphetamines
- Opiates (including heroin)
- Phencyclidine (PCP)
What if the DOT drug screen tests positive?
The DOT drug screen is looking for illegal or non-prescription drugs. Yet, sometimes normal prescription medications can trip a positive test.
If the urinalysis is positive for one or more of the drugs on the 5 panel drug test, then the driver will be contacted in person by the Medical Review Officer. The MRO will interview the driver to determine if there is an alternative medical explanation for the drugs found in the urine specimen. If the driver provides appropriate documentation from a prescribing physician, a confirmation test with a split sample is performed for each identified drug. Confirmation ensures that over-the-counter medications or preparations are not reported as positive results. If the MRO determines that it is a legitimate medical use of the prohibited drug, the drug test result is reported as negative to the employer. Otherwise the drug test will be reported as positive.
Why do I have to have a urine test for my DOT physical?
The urine test is just a kidney screen to test for sugar and protein. It’s done to determine that there is no early onset of conditions like high blood pressure breaking down the kidneys, or early signs of diabetes, or kidney infection.
Is protein in the urine a disqualifier?
No, not necessarily. Protein in the urine may indicate kidney disease. The medical examiner will make a decision based on the amount of protein in the urine. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Is sugar in the urine a disqualifier?
Yes, it is an indicator of the onset of diabetes or already a diabetic that does not have the condition under control. The driver would be disqualified until the condition is under control, either with medications or diet.
Is blood in the urine a disqualifier?
No, not necessarily. If the medical examiner believes that the blood in the urine may indicate a condition that affects the ability of the commercial driver to safely, the driver may be referred to a primary care physician or specialist for further evaluation. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you have the condition checked by a specialist.
Can I get a medical certificate if I’m being treated for a medical condition by my doctor?
Depending on the risk posed by the condition and treatment, the medical examiner may require documentation from your doctor. To assist in the preparation of the documentation, you can get more information here, courtesy of Trucker Docs. Even though your prescribing physician may be of the opinion that your condition and treatment is safe to drive, the decision to certify still rests with the medical examiner.
If you have non-insulin treated diabetes the medical examiner will check that your diabetes is adequately controlled. If it is controlled, you will get a time-limited certification and most likely need to re-certify annually.
If your diabetes is treated with insulin, you will be disqualified for inter-state driving. You may be able to drive intra-state.
The DOT does have a few, very stable insulin dependent drivers testing on insulin waivers, but you would have to check with the FMCSA on this issue.
What if I take insulin by injection and my diabetes is under control?
Without a DOT Diabetes exemption waiver the answer is No, not for interstate driving, even if your condition is stable.
You may be able to drive intra-state. Each state has its own rules.
What are the requirements for blood sugar limits? I just found a job driving school bus. I am a diabetic, non-insulin dependent. When I took the test my blood sugar was 350, but in the past few days I’ve gotten it down to about 170. I have never had a low or high blood sugar blackout. Will I have to get an exemption?
The medical examiner needs to see your blood sugar levels below 120. That is the level for blood sugar spillover into the urine. The concern is not whether you have ever had a blood sugar blackout, it’s – Could you have a blood sugar blackout while driving a bus full of little people? Safety first for you, the driver, and for the public at large.
My doctor put me on Metformin. Can I still drive truck?
The Metformin is to control your blood sugar as a borderline diabetic. It will limit your DOT medical certificate to one year at a time.
I’m a CDL driver. I had to start insulin for my diabetes. My medical card expires in a month. Will the doctor know I’m taking insulin when he does my tests?
It does not matter whether he knows or not. On the DOT medical examination form that you fill out, it will ask if you are a diabetic and also how you control the condition. So you are the one who is going to tell him about the insulin.
Your examining doctor should ask quite a few questions regarding your insulin usage to help determine your options.
What medications disqualify me from getting a medical card?
Any habit forming drug; methadone; anti-seizure medication, is disqualifying.
The medical examiner will review every medication – prescription, non-prescription, and supplement to determine if its use will adversely affect the safe operation of a commercial vehicle. The medical examiner may require documentation from your prescribing physician. In this case the medical examiner may, but is not required to grant you a medical card.
Can I be qualified if I have a prescription for medical marijuana?
No. Marijuana is a disqualifier, even if you have a prescription.
A CMV driver cannot be qualified if on Methadone. There are exceptions to the rule regarding other drugs prescribed by a physician, but this does NOT apply to Methadone.
What if I take nitroglycerine for angina?
Nitroglycerine use is not disqualifying. The medical examiner may require an evaluation by your Cardiologist to make sure that your angina condition is stable.
Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?
These three drugs are going to be a red flag for any examiner. You should bring with you a letter from your prescribing physician, explaining the need for the medications and their possible side effects. All three are listed with side effects of drowsiness, weakness, dizziness, and should not be used while driving or using machinery. You are going to have to explain to the medical examiner why and how much if any of these medications you are taking and the basic circumstances for their needs.
Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.
One of the best ways for a driver to answer a question about whether a medication may be a disqualifier or not, is to read about the side effects of that medication.
Lets take a look at some of the side effects of Xanax which include: “Drowsiness, light-headedness, headache, tiredness, dizziness, irritability, talkativeness, difficulty concentrating, dry mouth, increased salivation, changes in sex drive or ability, nausea, constipation, changes in appetite, weight changes, difficulty urinating, and joint pain. Some other side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: shortness of breath, seizures, seeing things or hearing voices that do not exist (hallucinating), severe skin rash, yellowing of the skin or eyes, depression, memory problems, confusion, problems with speech, unusual changes in behavior or mood, thinking about harming or killing yourself or trying to do so, and problems with coordination or balance.”
As you can see, some of these issues can be unsafe for you and the public. It will cause any medical examiner to question your reaction to this medication. Talk with your prescribing doctor and ask questions with regards to driving while using any medication.
I take Prozac for anxiety and I no longer have anxiety attacks. Will this be a problem for my DOT physical?
If the anxiety disorder is controlled with the medication, then there is no real problem. Just make sure you inform the medical examiner about your condition and the medications you are taking for it.
I have been diagnosed with panic attacks. I don’t have them often but I do take Lorazepam for them on a PRN basis. Can this disqualify me from driving a school bus?
The side effects of the medication could be a disqualifier from driving a bus. I would bring a note from your physician stating how long and how often you use this medication.
A bus-load of kids could be stressful and may trigger your need to medicate. So the medical examiner would be concerned about the side effects of the medication. The big concern here is for your safety and the safety of the children.
I want to keep my CDL but I have anxiety and need to get on some medication. I don’t want to lose my license. What anti-anxiety medication in okay to take and still be safe to drive?
Talk with your MD and explain that you are a commercial OTR driver. That way the doctor can work out which, out of dozens of medications, will work best and not interfere with your ability to operate a commercial motor vehicle. Most of the anxiety meds do not run positive for drug testing. They usually have side-effects that cause drowsiness and that is the main problem. So give the provider as much information as possible and go from there.
You will need to get documentation from your MD stating that no side effects are present that will impact your ability to safely operate a commercial vehicle.
Can I still drive if I take a blood thinner?
Yes, you may still drive. You will need to get documentation from your treating physician as to when the condition started, what was the diagnosis, what has the treatment consisted of, what medication are you on, and is the condition stable. All of these things are to help the medical examiner determine whether you are medically fit to operate a CMV safely.
Can I still drive while taking Provigil (Modafinil)?
The use of Provigil needs careful supervision. Drivers being prescribed Provigil should not be qualified until they have been monitored closely for at least 6 weeks while taking Provigil. The medical examiner will require documentation from your treating physician stating that the treatment is effective, and that no side effects are present that will impact your ability to safely operate a commercial vehicle.
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I have deginative disk disease in the L area of my back.
I take morphine sulfate ir 25mgs prn once to twice a day for pain control and i have hydrocodone for breakout pain. I get up at 3am and take one then and somedays i need take one again when i go to bed or I just take the hydrocodone instead. I am very stable and have been on the meds for the past 10yrs. I have had my cdl med card renewed every year since I am given just a one year card. Will the new rules keep my from getting my dot card?
@D Burnett
If you passed last year, then there are no new rulings that will disqualify you now.
First, I would just like to apologize for the following lengthy topic/question which has been causing me to lose sleep for a little while now, but I really need clarification..
I am planning on getting my CDL to drive OTR but after spending the last couple hours reading through these Q&A’s, now I’m a bit confused regarding a certain topic – not to mention pretty discouraged. Here’s my situation…
For approximately 5 years my doctor has been prescribing me pain medication for a couple problems with my back (confirmed with MRI reports). Over the years my tolerance for the medications has grown and so have the strengths of these meds to the point where currently I am prescribed 80mg Oxycontin 2x/day which is the long-acting AND ALSO 30mg Oxycodone 4x/day for breakthrough pain..I know, it’s a very heavy dose. Well, recently I’ve realized and have had to come to terms with the unfortunate fact that these medications have actually taken hold of and ‘got a hook in me’, so to speak. Since after bringing this problem out of the shadows and admitting that it has become a problem (within the last couple weeks) I have sat down with my prescribing doctor (two days ago) and discussed it with him. His suggestion is to wean me off by reducing the amounts 25% a month until off.. However, my position is that I just want this garbage out of my life completely, NOW! The only problem with my idea is that on the strengths I’ve been on for so long there will no doubt be some serious withdrawls trying to quit cold turkey.
I did some research and came across a medication that prevents the withdrawls called Suboxone. But after reading many of the Q&A’s here regarding Suboxone, I’m a bit confused if this is a medication that will absolutely disqualify/prevent me from obtaining my CDL and driving OTR. Some of the answers seemed to contradict others and ranged from being a definate disqualifier to being dependent on a doctors note and/or up to the discretion of the person administering the test, so thats where I am confused.. It sounds like it is a gray area so please go into detail as to when, if ever, is Suboxone acceptable. Are there any CDL jobs that would allow the use of Suboxone and if so, which ones?
I do not want to risk the opportunity to begin a new career in driving but I’m in a tough position because although I am committed to getting off the pain meds ASAP, the looming withdrawl stage is terrifying to me.. If it means the difference between being able to get my CDL or not and Suboxone is the deciding factor then I don’t want to touch it, which I guess in turn just means I have to be miserable for a week or two, so a thorough and in-depth understanding of this medication in the realm of the CDL driving world would be greatly appreciated.
Thank you in advance for taking the time to read and respond to my questions and concerns.
Signed,
Losing Hope
@Discouraged
Based on the information that you are giving right now, suboxone will be a disqualifier for the CDL, because you are not presently using this medication and you would be using it to get you off medications that are very addicting. Both of these issues are going to disqualify you from a CDL at this time. Also, because you are trying to get off of addictive medications at this time, you would not pass the medical certification process, you are not fit for duty, according to the FMCSA guidelines.
So first take your time and get off the present medications. Then see what, if anything, is needed for your pain situation. Then you can go from there.
Thank you for taking the time to read and respond to my issue/questions. I have a few follow-up questions I was hoping you could answer for me..
So, you are correct that Suboxone is also addictive and I do not want to exchange one addictive medication for another so I decided not to start taking the Suboxone and instead just deal with getting off the current meds and then being done completely with any and all opiate based pain medications. My first question is, once I do get off of the pain meds and my body is completely clear of it can I then proceed with getting my CDL without any issues pertaining to this subject or would the medical examiner make me wait a period of time for some reason and if so, why and how long could I be delayed? This question is assuming I have quit the pain meds completely without any problems and my body had rid them entirely.
My next question is based on the paperwork that must be filled out prior to meeting with the medical examiner. I found it online and there is one question which asks “Do you have chronic lower back pain?” My answer would be yes ,however, if I am not taking any pain medication for my lower back pain and the pain is manageable and not debilitating in anyway, would there be an issue with answering yes to that question?
The other questions I have are does the Medical Examiner have access to the Colorado State pharmacy database and also my medical records? The reason I ask about having access to the pharmacy database is what if the medical examiner looks into that database and finds that I previously was being prescribed pain medication on a consistent basis (from the same doctor) and would that present an issue even though it was previously happening but not currently happening?
I really would like to get my commercial drivers license and I will do any thing required of me and take any advice I am given to lead me down this path to a new career. I greatly appreciate you taking your time and thank you in advance for your response.
@Discouraged
Start with getting off the medications and see how you’re doing.
Once you are cleared by your primary prescribing doctor, get a medical release form from him indicating how long you have been free from the medications and if you are having issues with your lower back, what new meds he may have placed you on.
You would want to answer yes to the chronic lower back pain, but if under control, simply state how you are handling the issue. Keep your PCP in the loop and a medical release form in hand before you start the process with the DOT.
I am looking at getting a DOT Physical card for a 14,500 lb GVWR or less truck that is less than 50 local miles driven each day and I have been on Suboxone for 3 almost 4 years. Is this going to be a problem? I understand it would be it it was for a CDL but is it for just a medical card?
@Chris
If you are intra-state only and need just a medical card, then check with your local drivers license department and see what they say. For DOT you will need a medical release form from your doctor explain your situation. With that a CME can make his decision.
Suboxone doesn’t show up on drug screen unless they look for it itself.
Suboxone doesn’t show up on drug screen unless they are actually looking for it, this is the case in Tennessee, I no for a fact.
Hi I suffer from trigeminal neuralgia, and I am taking carbamazepine, topamax and tram afoul. I’ve had this condition for about 4-5 years. Would this stop me from getting a DOT certificate? I won’t be driving but rather be working as a mechanic
@John
Will you be driving interstate at all or just intra-state? Will you have a class A or some other class license?
I am on Strattera for ADHD, Gabapentin for anxiety cause by my ADHD and Acomprosate for drinking will I be disqualified even with a release letter from my Doctor??????
@Micah
You are going to be ask questions regarding any and all of your conditions and your present situation. So start with having your primary doctor complete a medical release form for you before you go for the examination. This information is very helpful to the CME when having to make his final decision. Each person should be evaluated on a one on one basis, so any and all information that you can provide is a step in the right direction.
If I am going for a DOT physical only will the examiner already know what prescriptions I am being prescribed.
@Billy
No, you will be ask both on the federal form and by the CME. It is up to you to tell the truth. And if you are taking medications, it would be best if you have a medical release form from your doctor before you take the DOT examination.
Thank you for the information..
I have a driver with a sick daughter. He is think of donating his kidney in the next year. Would this affect him passing his physical? He is worried this will make him stop driving a truck.
@jstaff08
Once fully recovered and with a medical release form filled out by his surgeon and primary doctor explaining his situation and condition and as long as he can pass the medical examination as being fit for duty, then he should be OK.
Just remember it is a case by case evaluation, but he should not have any major problems once he is fully recovered.
I’ve taken both morphine and oxycodone for more than 10 years due to chronic pain resulting from a gunshot wound and have never had any side effects. Will I automatically be disqualified from driving a school bus? I also take maintenance drugs since undergoing bypass surgery 3 years ago. There have been no side effects with any of these drugs either. Please advise, your help would be appreciated.
@Steve
You are taking medications that are going to cause many questions. Your best bet is to get a medical release form completed by your primary prescribing doctor explaining your situation and conditions. Also, depending on what class of drivers license and what state you are going to be driving in, will come into consideration. With the medications that you are taking right now and driving a school bus full of children, you will have to answer a lot of questions because the risk factors are so very high.
How long after a patient has been discontinued from Methadone can qualify for commercial driver license in California?
@Gloria
You are going to need a medical release form from your doctors explaining when you came off the medication and what your present status is. It is not about a time frame as much as a how are you handling things today. Also what is the possible fall back to a narcotic intervention. Each case is handled on a individual basis and needs to be supported with proper documentation.
California has its own set of rules and regulations that sometimes go hand in hand with the FMCSA and at other times don’t. First check with your local Drivers License Department and see what they have in the way of rules for this situation.
Thank you very much!!