POSITIVE DRUG TEST? NOW WHAT?

So, you, or an employee you supervise, have had a positive test or otherwise violated the Federal drug testing program. Now what? First and foremost, this means that you/they cannot perform US Department of Transportation designated safety-sensitive job duties until you/they are evaluated and cleared by a qualified Substance Abuse Professional (SAP). Suppose you/they are covered by the Federal Motor Carriers Safety Administration (FMCSA) to operate a Commercial Motor Vehicle. In that case, you/they are also listed as prohibited on the FMCSA Clearinghouse portal and will remain so until the Return to Duty Process is completed.

To return to a safety-sensitive position, the individual must have an evaluation by an SAP. An SAP is a professional with experience in Substance Abuse and has met standards set by the DOT to perform an assessment and make recommendations regarding education and/or treatment. It’s important to note that the SAP may not just tell someone, “This is just an isolated incident,” and send them back to work. The subject is required to go for education and/or treatment. The DOT also says the SAP cannot provide that education or treatment, nor may they work for any or have any financial relationship with the treatment or education providers.

The assessment that the SAP performs is comprehensive and in-depth. It is the same or similar assessment that is used by addiction professionals everywhere when admitting an individual to a treatment program. The period it takes to complete this questionnaire is sometimes over one hour. It’s not just about substance use, but questions are asked about every aspect of their lives to determine if there are any underlying stressors or conditions that put them at risk for continued substance use. It basically should encompass their life, up to the point that the person walks through the SAP door. Based on the evaluation, an Education or Treatment plan is established.

After the individual has completed and/or engaged in the education or treatment, the SAP will conduct a follow-up assessment to determine the suitability of putting this person returning person in a safety-sensitive position. When cleared by the SAP, the subject must submit to an observed Return to Duty (RTD) Drug and/or Alcohol test. Only after the employer receives a negative result, they may return to a safety-sensitive position. If you are in the FMCSA Clearinghouse, the Employer or their Consortia/Third Party Administrator (C/TPA) must input the test results to the portal. It is not the responsibility of the SAP or the Medical Review Officer to put those results in. Without the results being inputted, the person will still be listed as prohibited and would still be in violation of the DOT substance abuse policy.

After returning to safety-sensitive duties, they will be subject to periodic, unannounced Follow-Up (FU) drug and/or alcohol testing. These are also observed. There must be a minimum of six FU tests in the first 12 months following the RTD. The DOT says testing may be done for up to 5 years, and the total number of tests and frequency is 100% the responsibility of the SAP to determine. The DOT does not take a stance on who is financially responsible for the cost of the follow-up testing.

Not all SAP’s are created equal. There is no “cookie cutter” standard. The education and/or treatment plan the SAP recommends is completely up to them. Any monitoring or screening during this period is also up to them. They may want lab-based weekly drug tests that insurance may not cover. Other SAPs may include drug screening as part of the assessment process and included in the fee. Sometimes, an SAP may utilize another qualified SAP and/or counselor to provide the education. Insurance may not cover this, which is the individual's responsibility. This can get costly.

What does an SAP assessment cost? The price will vary depending on the region. The price may be as low as $200 or $300. I’ve also seen some charges being over $1000. Paying between $400 and $800 for the SAP assessment should not be shocking.

What happens if the positive drug test is a Pre-Employment test? The company is not obligated to pay for the SAP or hire the individual if/when the SAP clears them. To RTD, the individual will still require an observed test when cleared by the SAP. This may be accomplished as part of the pre-employment drug test for a future employer, provided that the test is observed. An SAP cannot tell an individual the course of education or treatment before completing the assessment. They may give them ranges, but they can’t say specifically what they must do. Every SAP is different.

In closing, having a positive drug test is not the end of the world. Being evaluated by a SAP is not always a bad thing. There has been a violation, which most likely involves some substance use. Does this mean a person is addicted? No, not always; however, when people are, they may never even see it, and the assessment could save somebody’s life because of treatment.

We also suggest www.saplist.com as an additional resource to obtain information on the SAP program and search for an SAP nationwide. If you or someone you care about has a Drug and/or Alcohol problem, help is available. Treatment works.

For additional information about treatment, the following resources may help:

• New York State Office of Alcohol and Substance Abuse Services: OASAS Treatment Availability (ny.gov)

• Substance Abuse and Mental Health Services (SAMHSA): Find Help and Treatment | SAMHSA https://www.samhsa.gov/find-help