Drug-specific verification

Drug-class-specific verification considerations (opioids, amphetamines, cocaine, marijuana/THC, PCP, MDMA), permitted prescriptions, and clinical interpretation of positive results.

A commercial driver’s urine specimen is reported by the laboratory as substituted, with a creatinine of 1.2 mg/dL and a specific gravity of 1.0008. During the verification interview, the driver provides medical documentation of a chronic renal condition and asserts this is the physiological reason for the laboratory findings. The MRO finds the driver's explanation potentially plausible. What is the MRO's most appropriate next step?

A.Verify the result as a refusal to test because MROs are prohibited from accepting any medical explanation for a substituted result.

B.Cancel the test immediately because the driver met the burden of proof by providing a clinical diagnosis of a renal condition.

C.Direct the employer to arrange and pay for a specialized medical evaluation to determine if the driver's condition caused the result.

D.Direct the driver to a referral physician to determine if the medical condition actually results in the physiological production of urine meeting the substitution criteria.

E.Verify the result as a refusal to test because personal medical history can never be used to establish a legitimate medical explanation for substitution.