Some OTC Meds Being Added to Railroad Post-Accident Testing

The Federal Railroad Administration's March 5 final rule adds tramadol and sedating antihistamines to the testing panel. Because these drugs are legal rather than illicit, it will keep the test results confidential.

The Federal Railroad Administration is adding non-controlled substances -- the prescription pain reliever tramadol and sedating antihistamines -- to the post-accident testing panel use to test rail employees who have been involved in a serious accident. The agency's final rule, which takes effect in 60 days, has been finalized despite comments from rail unions that to test for legal medications would discourage railroad employees from using necessary prescription and over-the-counter drugs, and also that the release of test results could result in discipline or dismissal for using a legal substance.

FRA cited its own research and studies of the general population in saying use of prescription and OTC drugs by rail employees is likely to be as high as that of the general population, which is significant. In any case, at this point, the purpose of adding non-controlled substances to post-accident testing "is to obtain data, not to deter the use of legal drugs by railroad employees," the agency said in the final rule. "FRA would not be fulfilling its accident investigation mission if it did not research the impact of legal drugs on the occurrence or severity of significant rail accidents, including the potential risks of using drugs with known adverse effects and the potential risks of using multiple prescriptions and OTC drugs which may cause unintended drug interactions."

Both tramadol and sedating antihistamines can cause drowsiness, which is why they are the initial non-controlled substances to be added to the standard testing panel, the agency stated. The rule says tramadol is widely used and is "a synthetic opioid similar to other synthetic opioids such as the controlled substances oxycodone and methadone."

Because the drugs being added are legal rather than illicit, FRA will keep the test results confidential. The substances already in the panel are alcohol, marijuana, cocaine, PCP, selected opiates, amphetamines, barbiturates, and benzodiazepines.

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