NCJ Number
154382
Journal
Western Journal of Medicine Volume: 152 Issue: 5 Dated: (May 1990) Pages: 514-524
Date Published
1990
Length
11 pages
Annotation
In discussing the role of physicians in workplace drug- testing programs, this article focuses on the recent Department of Transportation regulations that require drug testing in such regulated industries as interstate trucking, air transportation, mass transit, and the railroads.
Abstract
These regulations require that applicable drug testing programs use physicians as medical review officers to evaluate positive tests that have been screened and confirmed by different techniques to determine if there is a legal medical explanation for the result. The drug testing program tests for the presence of amphetamine, cocaine, tetrahydrocannabinol, opiates, and phencyclidine. If an employee who tests positive has an acceptable medical explanation, the result is to be reported as negative. Little practical advice exists for medical review officers, and they must be aware of key elements of the regulations and potential trouble spots. After discussing the role of the physician in urine testing, this article provides an overview of the medical review officers' (MRO) tasks. This is followed by a delineation of the knowledge MRO's should have to perform their tasks effectively. The National Institute on Drug Abuse and the U.S. Department of Transportation have published booklets to guide MRO's. The relevant content of these booklets is discussed. Other topics considered are the MRO standard operating procedure, the limits of confidentiality, notice to employees of the potential for the disclosure of medical information to third parties, review of chain of custody documents, legitimate medical explanations for a positive test, and return-to-work recommendations. Also discussed are physicians with several roles, fees and time, documentation and records, standard of care, and the reporting of a verified positive test result. 45 references