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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 am writing in regards to a DOT medication question. I am a semi truck driver and have a prescription for percocet . Is this prescription gong to fail me when I go in or do they accept it?
@tabatha
The questions regarding this medication can easily be answered by your primary doctor. Have your prescribing physician complete your medical release form. And be ready to answer any questions. If you are drug tested for any reason, you may pop positive and you will need to comply with the medical review officers request for a proper prescription. But the short answer to your question is no, percocet is not an instant disqualification.
What are the DOT rules regarding Wellbutrin? One company has told me that a driver has to be on Wellbutrin for 90 consecutive days in order to be legal to drive. Is this accurate and true?
@Ronald
The CME is looking for a few things here. How are you responding to the medication, are there any ill effects. Is your condition safe, stable, and has the medication been shown to be effective. That is why he is requesting a 90 day and see period. Have your medical doctor fill out your medical release form be fore you go for your DOT examination. The release will answer lots of questions right up front.
thank you
@Ronald
You are very welcome.
I’m writing you with regard to a never-say-quit family member that’s a 48 year old male, was deemed “disabled” back in 1996 due to an injury. He had a number of surgeries that required that heI live as sedentary of a life as possible while recovering from surgeries; in turn he gained a LOT of excess weight. Pain was extreme causing him to seek medicinal relief through what was back then a medical breakthrough. It came in the form of a Medtronic brand Pain Management Intrathecal Pump. The substances that are dispensed into his system via pain pump: Morphine,Baclofen & Clonidine.
This individual has been operating motor vehicles at the Class “C” level since the pump was implanted in 1997; to date makes it 20+ years with no problems. In other words, they are WELL-ACCLIMATED to the pain management drugs in pump.
Flash forward to a 1-1/2 ago when life circumstances caused him to take drastic measures in losing the excess weight he’d gained. They’ve lost over 110 pounds to date. Here’s my question: they realize that the substances dispensed by his pain pump are narcotics, but can they still earn a class “A” CDL if the pain management doctor fills out the medical release form required by the DOT Physical Examiner… Or is this individual going to be denied the opportunity to a Medical Card?
@Anonymous
Mainly, make sure his prescribing doctor and pain management doctor complete his medical release form for him before he goes for the examination.
He will most likely be limited to intra-state only, or he may be eligible for some type of FMCSA waiver. All depending on what type of driving he is looking to do.
California class a ups feeder driver a diabetic on invokana to control diabetes has worked so far but have dot coming up and invokana releases sugar in the urine are any waivers for this drug ?
@Steve
Before you go for your DOT examination, make sure your primary doctor completes your medical release form for you. That will answer any questions that the CME will have.
I have been prescribed Topamax to help regulate my migraines. Can I drive on this? I know it’s a seizure med. I’m afraid I will lose my CDL.
@Melissa
As a seizure medication, you had best have your primary doctor complete your medical release form for you, explaining your condition and why you are taking this particular medication.
It will be a major concern to the examining CME, but with your doctor’s explanation and medical release form ready to go, you should have all your bases covered. Good Luck
My patient takes trazodone for persisitent insomnia. She is driver for the ride. Can she continue to take this medication which is not habit forming. If not, can she take a short acting anxiolytic medication such as ambien. lunesta or sonatat?
Question: According to the Texas CDL Handbook. A driver must meet the qualification requirements of 49 CFR. part 391. Where can I find this? Due to the brief qualification requirements, say NO rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular problems that would affect vehicle control. Does this mean if afflicted with any of the above does it also disqualify you from applying?
I was taking Vicodin three months ago for pain but have not taken any since, do I have to disclose that on my dot physical?
@Bill
Not so much the medication, but the reason for taking the medications will be of interest to the medical examiner.
I have a class A CDL My Medical card is up for renewal I have a bad back and shoulders
I have been prescribed Percocet and Cyclobenzaprine for off duty hours and Tramadol for on duty
However I don’t take them as often as prescribed I take maybe 1 Percocet after work at least 12 hours before my next shift and I cant remember the last time I took a Cyclobenzaprine or Tramadol
will this disqualify me? I rarely drive a truck and am an equipment operator
@Steve
Make sure you have your prescribing doctor complete your medical release form for you before you go for your DOT examination.
That form will answer many of the questions that the examiner will have regarding your conditions and need for the medications that you are prescribed. There will be safety questions and your personal doctor’s opinion will be of great help in the decision making process.
Has the 5 panal drug screen they used to use for Class A drivers changed in not qualified as I am tapering suboxone and do not want any positive test on any of my info but I was just curious as to what changed with the new laws I still wont drive till I’m off of it totally its too risky
@KenK
May show up as a positive, but if your doctor has written a prescription for the medication then the MRO will just need to see a copy of the script. That makes a positive test negative.
Even suboxone? If you have a script its not a disqualified……..i also was prescribed a little klonopin since I am tapering the suboxone so if I have the script for both it makes a positive a negative with the DOT?
Buprenorphine and other semi-synthetic and synthetic opiods WILL NOT result in a positive. Popular painkillers such as Percocet and Roxicodone are semi synthetics, if enough is taken they may show positive in the initial screening although the GC/MS confirmation will verify that it is not an opiate they test for and will result in a negative test. What is tested for is Morphine, Heroin and Codeine metabolites. Herion can be detected as such up to 24hrs after use then metabolizes into morphine and said metabolites. You can use Wilipedia or ChemSpider to find out what metabolites a medication breaks down into and reference the DOT test to see if it will be detectable. Suboxone aka a Buprenorphine DOES NOT show up on standard 5 panel which is a DOT test. They cannot deviate and test for anything else as it’s standardized by the Federal Motor Carriers Association.
Also, benzodiazepines are not tested for, common benzodiazepines are Xanax, Klonopin, Valium ect.
Also, fwiw, Buprenorphine (suboxone/subutex) is included in the prohibited medications list. I had to stop taking it (for pain management, I have Crohn’s Disease) as directed by the MRO. I even had my doctor fill out a release that I was able and capable of operating a CMV while taking suboxone, and I had been on it for three years and no other MRO took issue with it. They never would have known, as I never aroused any suspicion for them to look up my prescription history, although my honesty got me into some hot water. I learned the hard way, hopefully you won’t have to do the same.
True. I was on Suboxone for pain also. I didn’t mention it because it didn’t affect my driving at all, and figured why take the chance. The Dr looked in the Prescription Registry that’s now available to most physicians and saw I was on Suboxone. I had to get off of it, which isn’t easy. Be careful. Some of the DOT docs are checking the registry. He told me it is a disqualifying drug! Gotta be honest. It really fires me up, but it is what it is!!!
can i take norco and have class a cdl license
@Jerry
Not without some type of medical release form completed by your primary physician.
Otherwise it is a disqualifier.
Thank you so much for this very informative website and for taking the time to answer all of these questions, although many are the same and mine will be also. I currently take oxycodone 15 mg 4x daily for degenertaive disk disease. My nephew is a truck driver and has got my interest going. I recently had 2 procedures done on my back and I have faith that once I heal I will be pain free. I have been taking the medication for so long that I have no side affects and it just relieves my pain. I know I would have to have the medical release form complete and the Dr. to sign off. If he does will this be ok? I am also going to wean myself off the meds if I am in fact pain free after I heal and I am having faith in this. My concern is that once I go through the school, if I still have a small amount in my system because I have not fully gotten it out, will I be disqualified if it is explained that I am in the process of getting myself off? It is an addictive drug and although I am not an addict, my body is and one cannot just stop taking this drug without severe withdrawal when you have been taking it as long as I have. I have also considered stopping at once and taking suboxone but i feel if I do that, then I will have to ween off that and I would rather just stop. And final question, can you please tell me the process, as in the steps to get your CDL? The reason I ask is so that I don’t waste my time or the schools time. I would like to start school while I am weening off the meds and with this school, they actually put you to work with their company after school. So I am just trying to figure out the process so I can make sure the drugs are gone from my system before I drug test. Thank you so much again and I hope this all made since
@Kim
Do first things first. Get completely healed first.
Then talk with your doctor about getting of the present medications.
Once off the meds you’ll get your medical release form filled out.
Then you can go from there. Make sure you have your doctor help you get off the medications. You can’t just stop and not have your doctor be aware of this issue.
And the DOT medical examiner needs to know that you are working with your doctor regarding your present medical state. Once you’re healed up, then it will be time to get started.
I am a school bus driver. I had been taking 50 mg of Seroquel for sleep, the normal dose as an anti-psychotic is much higher. When I had my last physical I was told I would have to stop this medication because it could cause drowsiness. I explained I had been on this medication for 3 yrs for sleep, not as an anti-psychotic, with no daytime drowsiness and could I bring in a release form from my doctor. He said no and he needed verification from my doctor he would not give me this medication. I did this and now suffer from lack of sleep. Why could he not take the release form and where can I get a list of drugs that cannot be taken. No one seems to know.
@Peggy
Get your medical release form completed by your primary prescribing doctor.
Then take it to someone else for your DOT examination.
I take phentermine 35.5 MG to loose weight , will this medication disqualify me from getting my medical card and or will it fail my urine test and get terminated. ?
@Sammie
This is a medication that recommends that you not drive or do any activity that requires you to be alert. And it will probably kick positive in your drug screen.
Make sure your doctor understands what you are wanting to do and make sure you have a medical release form completed before you go for your DOT examination.
i dont have sleep apnea. but i do take on a rare occasion melatonin, it helps me to relax and fall asleep. but an inspection of my truck today . they found my bottle of melatonin. and terminated me on the spot. i dont feel this is right .. i havent even taken this over the counter vitamin while i have been on this job. what are my rights?
@Steve
Not real sure why such a thing would happen.
I would check with the FMCSA regarding this issue. Or check with the state DOT. It’s not a federal thing.
I’ve been taking vicodine 7.5 milligrams for over a year now for a work injury that hurt my back. I have absolutely no side affects from this medicine. Could I still go to a trucking school and get my CDL back
@Mike
Make sure you have your primary doctor who prescribed your medications, fill out your medical release form before you go for your DOT medical examination. That release will answer most of the questions that the CME will have. Good Luck
I’m starting driving school and im on paxil for anxiety with no problems but when they asked me if I’m on mind altering drugs before starting school I said no. Am I going to have any problems? I’m scared I won’t pass the DOT physical.
@Rich
Best choice is to have your prescribing medical doctor complete a medical release form for you.
This will answer most of the questions that a DOT examiner will have. Your meds don’t appear to be mind altering so just make sure you have the release and a copy of the prescription on hand before you go.
My question is that i take tramadol for nuropathy in my feet. It causes me alot of pain i take two pills at bed time. Will this disqualify me from a dot card and will it show up in my drug test
@James
Tramadol is one of those medications that is going to be tough to support in an interstate driving situation.
Unless you have a medical release form completed by your prescribing doctor and he is willing to sign off on your usage, you will have many questions regarding its usage and safety issues, from any CME. If you doctor feels that you can operate a CMV safely, then try the medical release form.
Or you may look into driving intra-state only.
I am on Testosterone Replacement Therapy and I inject 1ml of Testoterone Cypionate once every two weeks. My doctor told me that the DOT has changed their regulations in May 2014 and that Testosterone Cypionate would disqualify me from passing my DOT physical. Is this true? It makes no sense to me since it is not mood altering and has no effects on my mental or physical faculties.
@Tod
Unless your doctor is on the NRCME and does know the rules and regulations from the FMCSA, then he may not really know.
Just have the prescribing doctor fill out your medical release form for you before you take the DOT examination and you should be good to go.
I tool 2 tramadol tablets at 12:30 am Tues morning. I never took any before or since. I was called in for a pre-employment drug test Thursday morning for a school bus driver job. Will tramadol show up in the drug test?
Does sumatriptan disquiet drivers in California CDL.LICENSE privilege
@Carol
If you have a prescription and it tests positive the MRO will want a copy of the prescription. If you took someone else’s pills, you may have a problem. In most cases the medications are through the system within a few days.