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Negative Dilute Result

A dilute specimen is basically weaker then usual urine – possible causes body chemistry, excessive liquid intake or possible adulteration attempt.

• The dilution is not significant enough for the lab to call this test an adulterated specimen.

The Company has 2 choices when you receive a “Negative – Dilute” test result:
(1)  Accept the test as a negative result
(2) Direct the donor to have a new, non-observed specimen collected, the second test result will be the final test, regardless of result
Your decision must be included in your written company policy and cannot be discretionary.  You must treat all employees the same. (Ex: example, you must not retest some employees and not others. You may, however, establish different policies for different types of tests (e.g., conduct retests in all pre-employment test situations, but not in all random test situations). And this must be clearly defined in your company policy. Do not amend this decision in your company substances of abuse policy with out providing written notification to all employees. 

Adulterated/Substituted

A medical review is required on adulterated and substituted results after the review or allotted time has passed; the MRO reports the result as a “refusal to test.”  The DOT treats these results with the same protocol as a positive result.

• Remove the individual from conducting covered duties and refer them to a Substance Abuse Professional. The Department Of Transportation requires that all Positive donors must be given access to a Substance Abuse Professional.
• Your company policy not The Department Of Transportation, determines the extent of the companies participation in the rehabilitation process inclusive of all monitory issues.
• Even if your company terminates the employee – it still must be give a referral to a Substance Abuse Professional (this is true for both employees and applicants)

Opiates Notification Report (positive for opiates)

A medical intervention (Medical Exam) is required when a donor has an opiate positive with a mam6 (heroine) result that is negative, while the opiate result level is between 2000 and 15,000 and the donor does not have a prescription or other medically acceptable reason.

The MRO advises the DER that the donor is required to report for a physical exam to be conducted by a physician agreeable to both the company and the donor within 5 business days.  The exam is conducted to determine if there are any physical signs of drug abuse or misuse. The examining physician must document their findings to both the DER and the MRO. The MRO will issue a result based on this examination. If the donor refuses to go for a physical examination the test becomes a refusal to test that is treated the same as a positive result.

• An opiate result with a level of 15,000 or higher without a medical reason is a positive result. 

Cancelled Results

• For all tests that are canceled a new test must be conducted immediately
• The cancelled tests for random do not count towards the required percentages until a completed test is resulted.
• Any challenged test that can not be resulted (requested retest of sample in 72 hours) – requires an immediate observed test to be conducted regardless of the reason for the initial test.

Post Positive Process
This process applies to all modes -  You must have a Company Policy for DOT Drug and Alcohol regulations. This policy must address all DOT issues including what happens when there is a positive result.

The DOT does not require that a company Hire or fire persons that test positive other then causing them to be removed from providing safety covered functions.  Your actions  must be addressed in your company policy.

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