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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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is meclizine a disqualifier or is it tested for in a dot drug test?
@Dale
Make sure you have a medical release form completed by your prescribing doctor done before you go for your DOT examination. There are side effects that will trigger any good CME to re-consider your DOT medical card. Also, if tested for drugs, you may test positive. So make sure your have a copy of your prescription available for the MRO when he calls. That is the only way you can get your positive test results back to negative.
My husband has his DOT medical card but is on Suboxone. He’s wanting to get his CDL A/B. Is it allowed to be on Suboxone?
@Jess
Make sure he has a medical release form completed by his primary prescribing doctor in hand before he goes for the DOT examination explaining the uses and needs for such a medication. Good Luck.
Hello. Follow up? How did your husband do? I also have been on a very small dosage of suboxone (4mg) for 6 years. Its next to nothing but it’s in my urine. Quiting would be very difficult after 6 years. It has been beneficial to my life and chronic pain. I can live normally drive daily and am aware/unimpaired from my 4 mg. suboxone …and I don’t “get high”. I don’t have that lifestyle because of the suboxone and doctor visits. My doctor suggests I remain on it if possible. He will write whatever letter needed. Did your husband pass? Did he get hired? Thank you. M
yes i to would like to know if they gave you a pass
Will soma cause you to test positive on a DOT drug test.
@Stan
If you drug test positive, the MRO should call you and have a copy of your prescription faxed over to him. If you are properly prescribed and uses are in proper proportions then a positive test should be negated to a negative test.
I take Trazadone, never heard it called Methadone, for mild sleep insomnia and also taking zoloft for very mild depression. I have been on these meds for yrs, will they disqualify me from passing DOT physical?
@Lance
The very short answer is Yes. FMSCA has a few drugs that are instant disqualifies and methadone is on that short list.
You might try having your prescribing doctor complete a medical release form before you go for the DOT examination. His explanations regarding your medication needs and usage will help the CME make a more informed decision regarding your particular situation. Good Luck
I went last week for dot physical and drug screen. I passed drug screen,they only test for 5 drugs marjuana,cocaine, amphetamines,opiatesandpcp i have the fed regulation paperwork in my hand from the doc.Lond story short ive taken methadone for 11 years for knee pain.When the nurse came in and asked if i was on any meds i put my foot in my mouth and told them.If i wouldve kept my mouth shut i wouldve walked out with my dot card. Funny thing thou i knew that going in but i told the truth and now im unemployed.If their so tuff on methadone why dont they drug test you for it. lol
@Brad
It should have popped positive with the opiates.
You might try a medical release form filled out by your primary with an explanation of what and why you use certain medications and for what length of time you have been using these meds.
if the drug screen is a standard 5 panel, methadone will not show.on this particular test under opioids. It has to be requested for and tested for specifically methadone.
To drive a school bus is it ok to take aderall and prozac
@Tammy
Your best bet here to to check with your state DMV. Bus driving within your state falls under a different set of rules than FMCSA and interstate drivers.
I’m an OTR driver. I used to take Bupropion for stress, anxiety. As a side effect it helped me stop using smokeless tobacco. I stopped taking it about 4 years ago. I remember taking random drug tests and not having any problems. All of things have crept back into my life, including the dip. I’ve thought about getting another script for it. Would it be a problem to take this drug now?
Thanks
@William
If you do, make sure you get a medical release form completed by your primary prescribing doctor explaining your needs for the medications and their effects on you. The side effects are going to be looked at very strictly due to the negative issues that have been associated with this pharmaceutical.
I recently went to renew my medical card but doctors said a new law on October 6 regarding pain medication norco saying if your taking that pain kill medication it disqualify you for getting a medical card. I have low chronic back pain for the last 8 years caused by falling off my semi truck at work
@Reyes
Get your medical release form completed by your primary doctor and have him explain in the release the need for and tolerance of your medications.
Then take the release form to the medical examiner to get your medical card renewed.
Is Phentermine a disqualifer for passing DOT drug test? Want to lose weight to get healthier and this medication was suggested by doctor but do not want to take any unauthorized meds?
@Jeannie
Properly prescribed meds and proper usage are easily supported for the MRO during a drug test.
Just make sure you have a prescription handy if the MRO calls and interviews you.
I’m on Lyrica 75 mg 2 times a day for nerv damage in back that causes my feet to burn. The lyrica works well and have been on it for 5 years. Can I pass a DOT Physical on this medicine.
@ Bobby
More than likely. Just make sure you have a completed medical release form from your prescribing doctor explaining your condition and need for medications. The release form answers a lot of the questions that your CME will have at the time of your DOT examination. Good Luck
I just failed my DOT physical, because my doctorsaid he tthought it would be unsafe for me to use the Valium he prescribed me. I operate heabe equipment everyday. And he knows this. He told.me not to drive or operate for three day umtill I know how it affects me. So I did. Three months later and it still doesn’t make me tired but works for my axngsieth. He wrote on the physical paper that it would be unsafe. Is he just scared of official paper work because I’ve been on the Valium on equipment for three months. And do o need a DOT card if on not driving a vehical.
Hello. I have a prescription for tramadol that specifically states I can only take it on a ten hour break. This was prescribed due to a torn rotator cuff, and in the last 60 days I have only taken 8 pills. My docror has done a written certification that i am stable on the medication. I also take etodolac twice a day. My company is aware of both medications, but are leery of the tramadol. Does tramadol show in a drug screen, and would it be a disqualifying medication per DOT? If it is, what would be an alternative for the rare times of acute pain. Thank you
Hello friend, Typically medications such as painkillers run through the system within 3 days on average. Unless you’re blood is tested. You are certainly allowed to have the Tramadol if it is prescribed to you. However i do not know what the specifics are regarding DOT regulations. In my experience you could be held responsible if something were to happen while the chemicals are in your system. Tramadol just this past month was determined to be a controlled substance for i dont know why, but it is a recent development. The issue comes down to legality. Are you legally able to have it? Yes, it was prescribed. Could you be cited for having it in your system during a DOT test? Possibly. Could you be held responsible in the event of an incident on the road requiring a drug test? Likely, Yes. Its splitting hairs, i know. But when it comes to the DOT someone is always responsible even if its not their fault. Hope this helps.
@Rob
When you go for your DOT medical card, you will need to have, in hand, a medical release form completed by your prescribing doctor. That will explain to the CME what you are taking and how you are reacting to the meds. The meds may cause a positive drug screen, but with proper usage and a doctors prescription, you should be OK. Good Luck
I take 25 mg of Meclizine twice a day for Vertigo. When I went for dmv cert I was told by PA that I cannot get med cert because of the meds . He suggested I see my PCP and go off the meds for 6 months and do a review if I don’t have any events in that time line with Vertigo. He never made it clear If it is the Vertigo or meds that stop me from driving . Can you explain .. Thanks Joe
@Joe
With the information you are giving me, I suspect that he is questioning the vertigo. So follow up with the recommendations and you should only need to do a two month symptom free waiting period.
can i drive truck while taking tramadol and flexeril?
@Dave
First question would be – Why are you taking these medications?
This just raises more questions and not enough information.
Read the other Q&A on this page to get an idea of the appropriate answer to your question.
Can you take victoza which is non-insulin and still qualify as a driver
@Chris
If you are taking this medication and you are not having any issues, then have your medical doctor complete your medical release form for you and take it to your DOT examination. The release will answer all the questions that the CME has and that should be all you need. You will be limited to a one year card though, because you are a diabetic on medications.
The questions & comments are quite interesting to me. In, or on 8/17/89, while on a “yard tractor, the operator put it into motion, I couldn’t hold on to the safety bar, & came to 12 ft. away on concrete. That ended 24 yrs. of accident free driving (over 3,000,000 miles) mostly flatbed-high, wide & long. In that time I pulled reefer, dry box along with over dimensional loads.
The “Union” got his job back, I got operations on my neck-2, rt.knee-2, 1 on the lower back in 2008 (didn’t work), the last one this May 8, 2014. The end results are this: No more pain, I’m weaning myself off of methadone, [at one time I was on 140 mg. per da., then got it down to 60, now I’m down to 25 & tomorrow my wife will drop it to 15 mg. By the time I go for my exam, I Will Be Totally Off Of All Pain Medications.
Why do I want to drive, after all, I’m retired!, I’m 75. Someone else who thought playing what he thought were harmless jokes, & very nearly destroyed my life, now I would like to have about 5 years back. Wes
A friend of mine asked me if his using “Ritalin” would prevent him getting a medical card, & driving. I told said, I don’t know, perhaps I can find out for you. What do you think?
@Wes
In and of itself, it causes questions.
Just have your friend get a medical release form completed by his primary physician and take it with them to the DOT examination. That release will answer most of the questions that the CME will have.
I was at a Truck driving when they did a physical I told them I have been on medication for OCD it is Alprazolam. They said sorry can’t take you cause medicine makes you drowsy I told them I have been taking it for years it has never made me tired. Could you explain???? Thank you Lori
@Lori
Go get your medical release form completed by your prescribing doctor and take it back to your next DOT examination. The DOT examiner is looking for an answer regarding your need for the medication and your response to the medication. The medical release that is filled out by your prescribing doctor will answer the CME’s questions.
I am shocked at the way Suboxone is looked at. I have seen what a life saving drug this is for both My husband and My brother. Neither of them get high off of the suboxone or would in ANY way be impaired from driving or operating machinery, as a matter of fact that is what they both do for a living and have never had problems getting the simple medical card portion of the DOT certificate (not for driving a CDL vehicle, just the medical card portion) until this year by doctors who obviously have no idea how Suboxone really works for people. It does NOT impair you the way pain pills would. It gives people their life back only to be judged by medical examiners who think they know how every person reacts to a drug. What a shame.
I’m not certain that the medical examiners who did they exams on your husband and brother have no idea how Suboxone works. I actually believe they have a very good idea. However, this is out of the medical examiners hands as this is one of the VERY FEW medications that are identified by FMCSA as an automatic disqualifier. The fact that they did not pass their exams is not the examiners fault. Your husband and brother may want to take a look as to why they are taking this medicine and perhaps try something else if they want to stay employed. Ask yourself if you would want someone taking this medicine driving on the highway next to your parents or children. Would you find it ok if your surgeon or dentist were taking Suboxone?
@Objective
I can agree with parts of your discussion, but there is some information that you quote that is erroneous.
If, as you stated, Suboxone is on a list of VERY FEW medications that are identified as an automatic disqualifier, please forward the pages and or charts that you found that on in the FMCSA handbook.
The list of drug disqualifiers is a very short list and Suboxone is not one of them.
Your point is well taken on the facts that someone under the influence of this medication should not be driving. But there are individuals that have suffered for years with TRUE pain that will establish a tolerance for the medication and function without any problems. That decision making process has to fall back to the primary prescribing doctor’s interpretation of the medications effects on any particular individual.
The CME must utilize all the available information from the PCP to make his/her final decision: Is this driver’s physical, mental and emotional health in good enough condition to operate a commercial motor vehicle safely?
a job I’m applying for in Massachusetts uses a dot drug screen and sends to the lab the position is not a driver but a factory worker my question is will suboxone show up?…..
@Joshua
Most likely yes, but if you have a valid prescription for the MRO when he calls, you shouldn’t have any problems.
Hello, my fiancé has been wanting to get his cdl for a while now. He is finally ready to start the process and begin school. There is only one thing, he is prescribed methadone and doesn’t know how this will affect the process of beggining school and getting his cdl. If you could explain to me the process of obtaining your cdl, drug test involved, and if he could proceed on methadone? Also, if he cant be on methadone what could be used as a substitute that he could use while getting his cdl. Thank you so much.
@Samantha
Methadone is a disqualifier and there is no getting around it. So until he is off the meds he won’t be able to get his cdl.
You’ll have to check with his medical doctor to determine what other options he might have.
Is taking doxepin for depression a disqualifier for a dot exam?
Also would you suggest I talk to my doctor to switch to a different medication to be able to pass the dot exam..
@Kevin
Start with a completed medical release form from your primary prescribing doctor. The form needs to be read by your doctor to determine what will qualify you to drive and if he needs to change your meds.
I am looking to get my class a cold I take clonozapham .5 mg once per day and hydroxyzine 10 mg will this hurt my chances of getting a medical card
@Dale
Just make sure your primary doctor fills out your medical release form before you go for your medical certificate.
That release will have answered most of the CME’s questions right up front.
Good Luck