DOT Guidelines Highlight Risks of Medications for Drivers

Updated Department of Transportation (DOT) guidelines on the use of medications by commercial drivers highlight the liability that employers face regarding the operation of company vehicles.

Driver fatigue is a primary cause of tractor-trailer accidents, and impairment caused by drugs – including prescription and over-the-counter medications – is a major contributor to those events. In general, all medication has the potential to alter mental function, and certain medications may disqualify a driver from operating a DOT-covered vehicle.

Some of those medications include:

• Anxiolytic (anti-anxiety) medications such as Xanax^® (alprazolam); an exception is BuSpar^® (buspirone)
• Hypnotics, including sleeping aids like Ambien^® (zolpidem)
• Older antidepressants, such as amitriptyline
• Antipsychotics, such as Thorazine^® (chlorpromazine); lithium may be OK with documented stability from a psychiatrist
• Stimulants such as amphetamine; medications for attention deficit hyperactivity disorder, like Adderall, may receive exemption after expert review and documentation
• Methadone
• Narcotics, such as Lortab^® and Vicodin^®, which contain hydrocodone
• First-generation antihistamines, such as Benadryl^® (diphenhydramine)

Employers of DOT-covered drivers should appoint a medical examiner to protect the company and driver from adverse drug effects. The medical examiner should have experience working with drivers, DOT regulations and pharmacology. He or she also should exchange information with prescribing physicians, who sometimes must document a driver’s stability on medication.

The medical examiner may, but does not have to, certify a driver even if the driver has a letter of support from the prescribing physician.

For more information on commercial driver safety regulations, call Jason Bandermann, MBA, referral services manager, at 573-331-5825.

A Guide to Commercial Driver Medical Certification, 5th edition, 2010, OEM Press