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Your employment drug screening program may not include testing for highly abused prescription painkillers

With opioid use and abuse continuing to increase at alarming rates across the nation, the opioid epidemic has quickly emerged as one of the most troubling and dangerous drug epidemics in U.S. history. According to the U.S. Department of Health and Human Services, 12.5 million people misused prescription opioids and roughly 33,000 people died from overdosing on opioids in 2015 alone.1 “Unintentional overdose deaths involving opioid pain relievers have more than quadrupled since 1999 and have outnumbered those involving heroin and cocaine since 2002.”2

In light of this unfortunate trend, employers would be well-advised to ensure that testing for opioids is included as part of any employment drug screening program. Many employers have a “DOT look-alike” program in place—a standard five-panel urine-based drug test that includes testing for opiates, mirroring the drug testing required by the Department of Transportation (DOT) for regulated positions— and often assume that this test will detect any opioid use, including use of any prescription painkillers.

But that assumption is incorrect—the standard five-panel drug screen only tests for “natural opiates” and does not include testing for synthetic and semisynthetic opiates, such as hydrocodone (e.g. Vicodin), hydromorphone (e.g. Dilaudid), oxycodone (e.g. OxyContin, Percocet) and oxymorphone.

The DOT recognized this critical gap in its drug testing program and recently amended its drug testing regulation to require testing for semi-synthetic opioids. Effective Jan. 1, 2018, the DOT will require all safety-sensitive transportation employees to be tested for semi-synthetic opioids. The semisynthetic drugs that must be tested for are hydrocodone, hydromorphone, oxymorphone and oxycodone. According to a press release, this is a direct effort by the DOT to enhance safety, prevent opioid abuse and combat the nation’s growing opioid epidemic.3

Employers who are not required to follow the DOT’s drug testing regulation, including employers who voluntarily use the DOT’s recommended drug testing program and panels to screen non-DOT personnel (through DOT “look-alike” programs), can and arguably should add on testing for these specific synthetic and semisynthetic drugs.4 Similar to the DOT regulated testing, non-DOT employers can simply add a panel to their existing drug testing program that will specifically test for these commonly abused prescription painkillers.

For additional information on your organization’s drug screening program, and to learn more about testing for prescription painkillers, please contact your sales executive or account manager.


1The Opioid Epidemic in the U.S., U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (May 2017), https://www.hhs.gov/sites/default/ files/2017-opioids-infographics.pdf
2 Misuse of Prescription Drugs, NATIONAL INSTITUTE OF DRUG ABUSE (Aug. 2016), https://www.drugabuse.gov/publications/research-reports/ misuse-prescription-drugs/summary
3U.S. Department of Transportation Publishes Drug Testing Rule to Enhance Safety While Combating the Opioid Epidemic, U.S. DEPARTMENT OF TRANSPORTATION (Nov. 13, 2017), https://www.transportation.gov/ briefing-room/dot8517.
4See Robert B. Swotinsky, M.D., M.P.H., The Medical Review Officer’s Manual 253 (5th ed. 2015).


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This document and/or presentation is provided as a service to our customers. Its contents are designed solely for informational purposes, and should not be inferred or understood as legal advice or binding case law, nor shared with any third parties. Persons in need of legal assistance should seek the advice of competent legal counsel. Although care has been taken in preparation of these materials, we cannot guarantee the accuracy, currency or completeness of the information contained within it. Anyone using this information does so at his or her own risk.

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