Dilute drug test? Follow these steps to compliance
For truck and bus drivers, having too much to drink can be problematic in several ways — even if the drink is just water.
Staying hydrated is normally a good thing, but drinking too much water can cause a driver’s urine to become so diluted that testing it for drugs becomes difficult. There can be multiple (and legitimate) reasons for dilute urine, but so far this year, over 1,000 drivers have tested positive but dilute, according to the Federal Motor Carrier Safety Administration (FMCSA).
If your medical review officer (MRO) reports that a driver’s urine was dilute, do you know what to do next? The actions you need to take will depend on a few specifics.
Positive dilute
If a test result is positive but dilute, you’ll need to treat it the same as a positive test result. You must:
- Not order another test;
- Notify the driver;
- Remove the driver from safety-sensitive functions;
- Give the driver a list of substance abuse professionals (SAPs) from whom the driver can seek treatment;
- Not use the driver again until the driver completes treatment and passes a return-to-duty test; and
- Retain the test results for five years.
The MRO will report the test result to the Drug & Alcohol Clearinghouse, the same as any other positive test.
Learn more about Clearinghouse reporting in our ez Explanation! |
Negative dilute
For results that are negative but dilute, your actions will depend on the creatinine level (creatinine is a waste product found in urine), as follows:
2 to 5 mg/dL — The MRO will contact you to request an immediate re-collection under direct observation.
- If the driver refuses this test, it’s treated the same as any refusal (which means following the steps above for a positive test, including reporting to the Clearinghouse).
- If the driver goes for this follow-up test, the result becomes the official result of record.
- If the result comes back as negative dilute again, the test is declared negative.
Over 5 mg/dL — No retest required. However, you can have a company policy requiring a retest, as long as you communicate it to drivers and enforce it uniformly. If you do retests in this situation, be aware that:
- The test cannot be under direct observation;
- A refusal of the test is treated the same as any other refusal;
- If the result is once again negative dilute with a creatinine level over 5 mg/dL, you cannot retest the driver (i.e., no third test) and it’s deemed a negative result.
- If the result is negative dilute with a creatinine level of 2 to 5 mg/dL, the MRO will demand yet another test immediately under direct observation.
A positive, adulterated, or substituted test result on any retest becomes the result of record, and all the consequences of a drug testing violation apply.
Key to Remember: If a driver’s drug test result comes back as dilute, be sure you know what to do next.