When receiving results from a test done for an employer’s drug and alcohol testing program there are three different overall results which can be received; positive, negative, or negative with safety advisory. The first two are easy to understand, the third, however, can cause some confusion.
To understand what the negative with safety advisory (or “safety concern”) means you must first understand a little bit about how the testing process works. After an employee’s specimen is tested the results are sent to a medical review office, to be quality checked and have the results confirmed by a Medical Review Officer (MRO). If the results are negative they will simply get a quality check to confirm all the information is correct on the report and the MRO report will be generated and released to the Designated Employer Representative (DER). If a lab result is released positive to the MRO it means that they must interview the employee to discuss their results with them. This MRO interview is a time for the employee to discuss if there is a prescription that explains why they would have a particular drug showing as positive on their test.
If an employee is able to produce documentation to prove that they have a prescription to explain why a particular drug showed up in their drug test, this result will get turned over to Negative. However, there are situations where an employee will have a valid prescription for a drug that shows up on their test, but the prescription/drug in question is one that can produce cognitive impairment. This means that the employee is taking a prescribed drug, and they are taking it as prescribed, however, the drug is still one that may cause the employee to not be able to properly execute their safety-sensitive job functions. In this case, the MRO may choose to release the result as Negative with a safety advisory (or Negative with a safety concern).
The process can seem a little confusing due to the DOT updates which came into use as of January 2018 which included a timing change for when MROs communicate a significant safety risk to the DER. As of the 2018 DOT update, when an MRO feels that a safety concern should be attached to a Negative result, they must first release the result as just a “Negative” and advise the employee they have 5 business days to have their prescribing physician call in to speak with the MRO to discuss a change of prescription for the employee. If this does not happen, or if it does happen but the MRO still has concerns, the result will be re-released as “Negative with safety advisory” after the 5 days or the conversation with the physician, whichever happens first. If the physician does call in and talk to the MRO and the MRO feels there is no longer a safety concern, then the result will remain as a “Negative” after the 5 days.
A Negative with safety advisory may mean your employer will not clear you for safety-sensitive job duties, this depends on your employer and their policy and the prescription you are taking. A Negative with a safety advisory is NOT a violation, it is Negative result. Common prescriptions that could result in a Negative with safety advisory include drugs in the opioid or benzodiazepine families; these drugs have side effects which include drowsiness and cognitive impairment (such a confusion, slow reaction time, delayed decision making etc.). It is best practice to always make sure that your doctor is aware of the type of work you do when you are being prescribed medication.