DOT said the lower testing cutoffs will identify about 4,000 additional cocaine users annually.

DOT Testing Change to ID 8,000 More Drug Users

Besides adopting the lower laboratory testing cutoffs for cocaine and amphetamines, DOT's final rule will add MDMA (ecstasy) initial and confirmation testing to its program. But it did not adopt alternative specimens, such as hair testing.

Anyone in a safety-sensitive transportation job subject to DOT drug testing who uses cocaine or amphetamines will be more likely to be caught after Oct. 1, the U.S. Department of Transportation claims in a final rule published Monday that makes changes in its testing regulations effective on that date. As it proposed, DOT is adopting the HHS-lowered laboratory testing cutoffs for cocaine and amphetamines. Initial test cutoffs for cocaine metabolites will drop from 300 to 150 nanograms per milliliter (ng/mL); confirmation test cutoffs will drop from 150 to 100 ng/mL. For amphetamines, initial test cutoffs will fall from 1,000 to 500 ng/mL as confirmation tests for amphetamines and methamphetamines fall from 500 to 250 ng/mL.

Most commenters supported the change, but some contended amphetamine "false positives" will result. DOT disagreed and said identifying about 4,000 additional cocaine users and 4,000 additional amphetamine users will improve safety. "It stands to reason that it will be cost beneficial to identify the illegal drug use of an additional 8,000 safety-sensitive transportation employees annually, across all modes -- on roads, rails, water, or in the air, over land and underground. Furthermore, if identifying the illicit drug use by these employees prevents a single serious accident, then the economic benefits of the rule will outweigh its costs," the rule states.

In 2009, laboratories reported 12,918 DOT cocaine confirmed positive results. Labs in 2009 reported 14,195 DOT amphetamine/methamphetamine confirmed positive results.

One lab argued the cost of confirming the higher number of screened positive tests isn't worthwhile, given the small number of confirmed positives predicted by its data, and DOT said it would urge HHS to monitor amphetamine screening closely during the first year the new cutoffs are in effect. "We believe that the issue will be properly evaluated by HHS with DOT, the Center for Substance Abuse Prevention Drug Testing Advisory Board (CSAP DTAB), and laboratories in determining if the screening cutoffs for amphetamine would need to be modified upward if the added cost largely outweighed the benefits," the rule states.

DOT again refused to adopt alternative specimens, such as hair testing, because it continues to await HHS adoption of them. The rule adopts HHS initial and confirmation testing requirements for methylenedioxymethamphetamine (MDMA, known as ecstasy). Aside from being required to test for the drugs for which HHS labs are certified to test, DOT said MDMA is not only a "club drug" now -- "it is being marketed to a much larger population in American communities." An MDMA test will cost on average nine cents, making the total cost of annual testing for it around $450,000.

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