Medication Rules

Question 1

Is the medication standard discretionary or non-discretionary?

Answer 1

discretionary

Question 2

Which regulation deals with the medication standard?

Answer 2

49 CFR 391.41(b)(12)

Question 3

What does regulation 49 CFR 391.41(b)(12) say?

Answer 3

-driver cannot use a controlled substance, schedule 1 drug, amphetamine, narcotic, or other habit forming drug

Question 4

What is the exception to regulation 49 CFR 391.41(b)(12) ?

Answer 4

A driver can use a substance or drug if it is prescribed by a licensed medical practitioner who:
-is familiar with the driver’s medical hx and assigned duties
-has advised the driver that the prescribed substance/drug won’t adversely affect the driver’s ability to safely operate a commercial motor vehicle
Disqualifying substances are NOT included in the excepetion.

Question 5

A 39-year-old driver presents for initial certification. Her history reflects no disqualifying disorders; however, she has indicated that she has chronic low back pain and further elaborates by stating she has not lost any work (driving) time due to back pain over the past 24 months. The driver states the pain is adequately controlled by use of NSAIDs and combination acetaminophen/hydrocodone for breakthrough pain. Can this driver be certified?

Answer 5

FMCSA lists exception to use of habit forming drug if the drug is prescribed by a licensed practitioner who is familiar with the driver’s medical history and assigned duties and has advised the driver that the drug will not adversely affect the driver’s ability to safely operate a commercial motor vehicle.

Now, whether or not the prescriber is willing to tell the pt that acetamin/hydroxycodone won’t affect the ability to safely operate a vehicle is another question. The FMCSA regs only say that the prescriber must advise the driver that the drug will not adversely affect the driver’s ability to safely operate a commercial motor vehicle in order for the driver to be eligible for certification.

Question 6

Which drug is always disqualifying?

Answer 6

-methadone
-schedule 1 drugs (illegal drugs that have no recognized medical use)

Question 7

Parts of regulation 49 CFR 391.41(b)(12) are non-discretionary. When must the driver be disqualified?

Answer 7

-illegal drug use (schedule 1 drugs)
-methadone

Schedule 1 drugs have no currently accepted medical use in the US, have a high abuse potential, and are not considered safe, even under medical supervision.

Question 8

What are examples of schedule 1 drugs?

Answer 8

-heroin
-marijuana
The exception criteria of 49 CFR 391.41(b)(12) do not apply to any schedule 1 substance.
A driver taking medical marijuana cannot be certified.

Question 9

What are schedule 2 drugs?

Answer 9

-have legitimate medical use, but have a high potential for abuse
-usage may lead to severe psychological or physical dependence

Question 10

What are examples of schedule 2 drugs?

Answer 10

-opionds, depressants,amphetamines
-morphine
-oxycontin

Question 11

What are schedule3-4 drugs?

Answer 11

-lower potential for abuse compared to schedule 1 and 2 drugs
-abuse may lead to low or moderate physical dependence or high psychological dependence

Question 12

What are examples of schedule 3 drugs?

Answer 12

-tranquilizers

Question 13

What are examples of schedule 4 drugs?

Answer 13

-chlorhydrol
-phenobarbital
Schedule 4 drugs have the lowest potential for abuse, and include narcotic compounds or mixtures.

Question 14

What must you evaluate regarding medications that a driver takes?

Answer 14

-whether the medication has the desired effect on the underlying dz
-whether side effects of the medication interfere with safe driving