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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

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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