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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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Does the DOT FMCSA drug test for suboxone?
@ Michael C
Drug testing will uncover the use of suboxone.
@ Trucker Docs. Everywhere on the internet says Suboxone doesn’t show up as an opiate. Are you sure there?
@ Bubba
Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication, sometimes called a narcotic.
Buprenorphine . Does not come up as a opiate on a drug test ! My buddy is a driver and got tested only 1 time in 5 years. It is a whole different test , to test u for suboxone .
@ Mike
Make sure you have a prescription available if it does come up on a drug screen.
I am prescribed hydrocodone for legit back pain. Had surgery over 20 yrs ago and only take if needed. Have been prescribed for years. I have a non-cdl DOTFMCSA pre-employment physical and urine test.Legit prescription. Will I be okay?
I had a bout with major depression and took time off from my CDL A job with a major company. When I returned I was told to update my medications and unfortunately I was honest with the PA at the clinic about the xanax, lexapro and abilify. He disqualified me for the xanax for being a benzodiazepine and the abilify because it comes up as a bipolar med, even though it’s also used for depression and anxiety. He said to just get a letter stating the abilify was for depression and to quit taking the xanax. In the meantime e-screen the drug testing company got involved, made me get a psychiatrist, even though I provided a letter from my primary and a PA in a mental health clinic. They all agree I’m fine to work but the drug testing company after 4 months says that they wont talk to me anymore and slapped me with a 6 month disqualification.
Should I just go back to the original PA that disqualified me, also I checked with the DOT, FMCSA and secretary of state and nothing is on my license or med card stating that I’m disqualified.
Is my job just trying to run me out?
@ mel
If the CME accepted the letter and passed you on the medical certification examination, then go back to the original examiner.
I have been taking gabapentin for a few years. It was prescribed to me to help with hot flashes due to menopause, NOT for seizures. I am applying to get my cdl soon and want to know what would be the best way to handle this medication when I go for my testing? Will a notice from the prescribing doctor suffice? Should I have her explain that I am only taking this for hot flashes and have NEVER had epilepsy or a seizure? Or am I just out of luck no matter what my doc says?
Dont say anything about it, it’s not tested for so there is no need to be honest. Trust me I found out the hard way.
@ melissa
Not the best advice, could cost you more than expected.
@ Desirae
You will need a medical release form from your prescribing doctor and any medical documentation. A note from the prescribing doctor explaining the reasoning for your taking the meds you take, will be a huge help and will aid in the decision making process of the CME.
What is the name of the form and where can I get it
@ kevin l k
??? please refresh our memory, for what type of condition or medication?
Is the use diclofenac at up to 3 doses a day if needed at 50mg acceptable/is diclofenac acceptable at all to take since the some of the side effects to do include drowsiness and dizziness?
@ Vincent F
It would not be the medication but the reasons for having to take it that would raise questions. If you have been on these meds for some time, then there will be questions regarding the need for the anti-inflammatory. But in and off itself, diclofenac is not an issue.
I am in the process of having my fungal toenails removed. I’m half way through the process. The Doctor prescribed oxycodone/acetaminophen 10-325MG PRN for pain. I usually only take it the first couple of days, then the pain subsides. I usually have the procedure done on Thursday so I can have 3 days to rest. I’ve only been prescribed 20 tablets and it’s not refillable. I’m going to see the DOT Dr. tomorrow, what do you think he’ll say?
@ John S
If you are not done with your treatments then the CME should not perform a DOT/FMCSA medical certification examination. Only when you are finished and have been released to return to work, without restrictions or limitations, should you go for your new DOT medical certificate.
Do mro’s or cme’s have access to you prescription history?
Just took physical for CdL class b. Been on ambien over 7 yrs. will this disqualify me?
@ Drexel
For a class b license you fall under the states guidelines and variances, not DOT/FMCSA. Make sure your examiner has that information. As a class A driver, your meds are a reason to disqualify, but as a class b you may be OK.
Thank you!!!
@ Mike L
If there is a question from the MRO, he will request a copy of the prescription be sent to him in a timely fashion. If a CME has reason to suspect he is being lied to, then he may explore your medical records or request additional medical documentation.
Wouldn’t lie to them. Was wondering if they had access to your prescription history if they would question medication you quite taking or decided to not even take at all after researching it.
@ Mike L
They may have access, but would not use it routinely.
Yes
Yup they now know every thing about you. At least in Massachusetts
I have been a CDL driver for 5 years and have never been on any medications when I have gotten a medical card. I was just diagnosed with ADHD (family doctor referred me to a specialist). I have been undiagnosed my entire life. My new doctor wants to start me on a prescription of adderall. I have yet to fill the prescription because of job. I have found information regarding getting a medical card WHILE prescribed adderall, but nothing about receiving a diagnosis and prescription AFTER already having a medical card.
My question is; do I just start taking the prescription and deal with it the next time I get brought in for a UA? Do I start taking the medication and make an appointment to get a new medical card (even though mine does expire for 18 months)? Do I call the doctor that issued my current medical card?
Thank you in advance for your answer!
@ Ryan
Adderall is not going to show up in a UA drug screen. And should you be questioned, all you would need to do is produce a copy of the prescription. DOT/FMCSA wants you to be on a new medication for at least 30 days, making sure you do not experience any adverse side effects. Then acquire a new medical card. The CME may request additional documentation from your prescribing doctor and a medical release form also.
I take Bupropion, will I pass piss test?
Have prescription.
Sorry to have to reply to my own post again. Is Bupropion on the do not use list for cdl-a?
@ Mick O
This medication is going to raise questions with any CME. You will need to be on these medications for 30 days or more to rule out adverse side effects or reactions. The you will need a new medical card and supporting documentation from the prescribing physician regarding your need and usage. Also a medical release form from your doctors.
Thank you. I had quite taking it a year ago. Didn’t take long. Started back on it for 4 days last week until I read about it may cause problems with DOT. So not taking at all now. Just going to get rid of them.
Actually one more question.
Does the MRO have access to all prescribed medications?
Wondering because I have that bupropion script but only took 3-4 days and getting rid of them. Will they question that if they have access to my prescription history?
Did u get a scrip in a office visit or did you go to a OTP? And what state? Look these up and you’ll have your answer. If in a Dr office yes they will see it if they dig
I have been taking buspar for over 5 years and in the last 5. months my anixety and panick disorders or back full blown. i happend to look at my bottle that ive been taking for almost 2 months expired over 3 years ago. can this be why my meds stopped working
@ dedbie
Could be, best to confirm with your doctor or pharmacist.
I was recently prescribed Xeljanz XR after being diagnosed with psoriatic arthritis. My question is about the black box warnings of cancer risk, cardiovascular disease, and blood clots. Will I be denied a medical card due to the medication’s possible side effects?
Thanks in advance!
@ greencartguy
The medical examiner may request additional documentation before issuing a medical card. Best to have supporting documentation from your doctor, as well as, a medical release form also.
I did not pass my DOT physical today due to me taking 50 mg. of Seroquel. I was prescribed it to help me get to sleep. I’ve been on it for 90 days, and it’s been a miracle drug. Now, I have to get off it in order to pass my DOT physical. What other drugs are approved that I can take to help me get to sleep?
@ Karen T
You need to provide medical documentation to the examiner from your prescribing doctor explaining your need for this medication. There are high risk factors involved with the drug, but once using the meds for 90 days or better, with proper documentation, you could be OK.
Hello, I am looking to get a class A CDL for the first time. Have taken adderall 20mg for many years for restlesness and ADHD. It works well no side effects. I know from reading here and elsewhere that some doctors will approve me with my prescription and some won’t. My question is there a way to make an appointment with a doctor who is more likely to accept my prescription? And, if not, will a doctor tell me ahead of time if he won’t accept my prescription so I could find a different doctor or would he just fail me? What happens if I fail? Your response is greatly appreciated thank you
My husband takes Adderall and he just had to have a letter from the prescribing doctor stating that it was safe for him to take that medication and still drive a tractor trailer.
@ Simon
If you have been on this medication for years, then all you need is supporting medical documentation from your prescribing doctor and a medical release form from him also. You can always call a DOT examiners office before setting an appointment and ask what else they may need from your doctor.
I am a former CDL holder, and want to get it back. I have depression, diabetes, and minor anxiety. I am also taking medication for high blood pressure and cholesterol. I am taking the following medications broken down by diagnosis…
Diabetes: Xigduo XR and Lantus Solorstar
Depression: Prozac
Anxiety: Buspirone
Blood Pressure: Lisinopril
Cholesterol: Atrovastatin
I was wondering if any of these would pose a problem for my DOT physical and if I would need to acquire a waiver for something?
@ Cassie
As a class A cdl holder, you will have difficulty passing the federal DOT/FMCSA medical certification examination. Lesser class cdl and/or intra-state only license fall under your states guidelines and variances. Check your local DLD for guidance.
I went for a pre employment physical and drug test to drive a regular 4 wheel truck for a company(non dot) and I’ve been on and still on a high dose of xanax for 20 years and I’m perfectly capable of driving on it. But the company did a 10 panel drug test on me. Will taking this prescription disqualify me to drive for this company? I have been diagnosed with high anxiety I have a current prescription for it and have been on the same dose for 20 years. I’m in Alabama.
@ Jason
This should not be an issue, especially since you have been on this medication for so long. Make sure you have a medical release from your prescribing doctor and you should be good to go.
I’m taking eliquis 5 MG twice a day will that disqualify me from my class A dot medical card
@ Karen s
The CME will ask questions regarding this medication. Make sure you have a medical release form from your prescribing doctors and you should be OK.
My husband does not have a cdl, but needs a dot physical for his job. He has adhd and was prescribed adderall. Will he be able to pass his physical and get his meds card for work?
@ Samantha
Make sure your husband explains that he is not a cdl holder and falls under the states guidelines and variances. He should be fine after that.
I have Hypersomnia and was prescribed Adderall. I tried other medications, but this one works the best. I also have bad back and beck pain that I take hydrocodone for as needed. I would never take the hydrocodone while driving. I would want and take after my trip, but I’m sure it would still show up in a drug test. Any advice?
@ Leslie
It will depend on the level of license you are going to work toward. Class A, you will have a very difficult time passing the physical and with your over-all situation, most likely will not pass the medical certification examination. Lesser license fall under the states guidelines and variances and may not be as strict.
If you’re prescribe methadone for opioid addiction .You’re on maintenance dosage for the past 2 years can you get a CDL?
@ fred
CDL’s are state issued and do not fall under the Federal Registry. If you are going to work on a class A cdl, then you will have a very difficult time passing the medical certification examination with your particular situation.
I have been on methadone maintenance program for about a year now and am coming down in my mg.’s , I’m only taking 48 mg. Will I have a problem getting a DOT card ?
Thank you,
Kim
@ Kim
For class A interstate, you will have issues.
What about class B? My husband was disqualified for his medical card today because he’s on methadone.
@ Leigh
Class B license fall under the states guidelines and variances, not Federal DOT/FMCSA. Check with your local drivers license department for their ruling on methadone usage as a class B driver. Then when he returns to a certified medical examiner make sure the CME understands the states regulation as compared to federal regulations.
Thanks Trucker Docs. That’s a good idea, we hadn’t thought about talking to the dmv about it!
Have a question about 2 medications. trying to find out if they could cause me to fail my DOT drug test
Any comments would be much appreciated
meloxicam tabs 15mg
rosuvastatin tabs 20mg
One for Cholesterol the other for Arthritis
@ Will
Neither should be an issue with your drug screen.
I’ve been taking Adderall and Desoxyn for approximately a year. My Dr prescribed them to me and they have worked tremendously. I have recently learned that Desoxyn is evaluated or compared to the street drug crystal meth. So my question is, if I test positive for methamphetamine, am I not allowed to take what was prescribed to me after being analyzed and treated or does my Dr. Prescription covers me for that?
@ Richard G
If your drug test reports positive for methamphetamine, then the medical review officer will contact you and request a copy of your prescription. If it checks out then your positive test is reported as negative.