The Federal Motor Carrier Safety Administration (FMCSA) defines Substance Abuse Professionals (SAPs) as persons who evaluate employees who have violated a Department of Transportation (DOT) drug and alcohol program regulation and make recommendations concerning education, treatment, follow-up testing, and aftercare.

Specifically, SAPs are licensed or certified professionals with expertise in the diagnosis and treatment of alcohol and controlled substances related disorders, but also of DOT drug and alcohol testing and return-to-duty processes as required by DOT Rule 49 CFR Part 40 Section 40.28.

In this article, we will discuss the requirements to act as SAP for the DOT, as well as the process involved, referral, assessment, and follow up according to the revised 2023 DOT guidelines.

What are the qualifications to be a SAP ?

The credentials required to become a SAP as outlined by FMCSA include the following :

  • A licensed physician (Doctor of Medicine or Osteopathy); or
  • A licensed or certified social worker; or
  • A licensed or certified psychologist; or
  • A licensed or certified employee assistance professional; or
  • A state-licensed or certified marriage and family therapist; or
  • An alcohol and drug abuse counselor certified by one of the organizations listed at https://www.transportation.gov/odapc/sap.

In addition, knowledge of and clinical experience in the diagnosis and treatment of substance abuse-related disorders, understanding how the SAP role relates to the special responsibilities of employers for ensuring the safety of the traveling public, and knowledge of Part 40, pertinent DOT agency regulations, these SAP Guidelines, and any significant changes to them are also required.

Finally, qualification training and successful completion of examination are also required.

What does the evaluation process involve ?

SAP duties include evaluating the driver and making recommendations concerning education, treatment, follow-up testing, and aftercare. Specifically, a SAP must conduct a face-to-face evaluation of the client either in-person or remotely.

The evaluation also must include the following information:

  • A review of the employee’s psychosocial history;
  • An in-depth review of the employee’s drug and alcohol use history (with information regarding the onset, duration, frequency, and amount of use; substance(s) of use and choice;
  • Emotional and physical characteristics of use;
  • Associated health, work, family, personal, and interpersonal
  • problems);
  • An evaluation of the employee’s current mental status.

Furthermore, written reports must be provided by the SAP directly to the employee if the employee has no current employer and to the gaining DOT-regulated employer if the event the employee obtains another transportation industry safety-sensitive position.

What is the referral process?

After completion of the evaluation, the SAP must refer the employee to the appropriate programs according to their clinically evaluated needs, while the treatment plan should be sent to the treatment provider.

It is prohibited for a SAP to make referrals to their own private practice, a person or organization from which they receive remuneration, or to a person or organization in which they  have a financial interest.

Referrals can be made to the following :

  • A public agency operated by a State, county, or municipality;
  • A person employed by or under contract to the employer to provide alcohol and drug treatment and/or education services (e.g., the employer’s contracted treatment provider);
  • The sole source of therapeutically appropriate treatment under the employee’s health insurance program (e.g., the single substance abuse in-patient treatment program made available by the employee’s insurance coverage plan); or
  • The sole source of therapeutically appropriate treatment reasonably accessible to the employee (e.g., the only education program reasonable located within the general commuting area).

What is the follow-up evaluation process?

A SAP must provide an evaluation of the employee prior to their return to safety-sensitive duties for the employer.

The evaluation is carried out to determine whether the employee has demonstrated successful compliance with the recommended education and/or treatment plan, level of participation and the progress the employee made in addressing their alcohol or substance use issues.

In addition, the follow-up process also requires the SAP to conduct a face-to-face (in-person or remote) clinical interview with the employee. Following completion of the follow-up evaluation, a follow-up report must be transmitted directly to the employer or, in the case of an owner-operated trucking company, to the C/TPA for the employer.

What is the follow-up testing process ?

A SAP must present the employer with a plan for follow-up testing for the employee in the form of a follow-up report. The test schedule must be spread throughout the year by the employer, unpredictable, and unannounced. Moreover, the specific dates for each test should not be specified for the employer by SAP. 

If the SAP determines that the employee can benefit from specific aftercare, education, or support group services in order to maintain sobriety or abstinence, they must include recommendations in the follow-up report.