CDL Medication Use: Don’t be Disqualified! – Part 1

If you’ve been denied a CDL medical examiner’s certificate because of medication use, you may still be able to be medically qualified to drive. As President of the largest network of DOT Certified Medical Examiners, I frequently get calls from drivers who have been disqualified for medication use.  Unfortunately, this almost always causes a major disruption in the driver’s ability to making a living, and the sad part is that most of the time, it was done in error.

There are only 2 times when medication use is always disqualifying:

If you are using Methadone or a Schedule I drug such as marijuana, peyote or another medication on the long Schedule I list of drugs that are never prescribed, then yes, you will always be disqualified from driving a commercial vehicle. These specific medications are in a special group called “Absolute Disqualifiers”. This means there are no exceptions whatsoever to this rule.  To make it absolutely clear, there is NO exception to this rule, including medical or legal recreational use of marijuana or religious based ritual use of peyote.

There is only one way to obtain your CDL card if you’re using these substances:

The only way around this is to stop using Methadone or a Schedule 1 drug.  You might have noticed that Chantix is no longer an absolute disqualifier.  It now falls into a category of medications that we will discuss in Part 2 of this blog.

Medications as they relate to treatment of a medical condition:

Keep in mind that if a driver is using any drug to treat a disqualifying medical condition, it will be the medical condition that will cause the driver to be disqualified, not the medication being taken.  An example would be a driver taking methadone for opioid addiction.  If the driver’s medication was switched to suboxone, the driver would still be disqualified because they are still in treatment for opioid addiction.  If a driver was taking methadone for pain relief, the driver would be disqualified for taking methadone but could change to another medication such as saboxone and be qualified to drive, even though suboxone is usually used to treat opioid addition.

Most other medications can be considered:

The good news is that, with the exception of  “absolute disqualifying” medications, all other medications can be considered for use in commercial driving. There are still a few restrictions that apply to certain medications when used to treat certain medical conditions.  Drivers with a history of stroke cannot be taking anticoagulant medication.  And if you are taking insulin for diabetes or an anti-seizure medication to prevent seizures you are only allowed to drive across State lines if you obtain a Federal Insulin or Seizure exemption.  If you only drive within your State, you should check your State medical requirements for driving a commercial vehicle when taking these medications.  Many States offer an Insulin Use waiver or exemption, and a few let drivers using insulin drive without requiring much more than a letter from the treating provider.  At this time, the Federal insulin use exemption take about 3 months to obtain, whereas State exemptions/waiver can usually be obtained in far less time.

Partner with a knowledgeable Medical Examiner for the best outcome:

For drivers taking medications that have serious side effects to safe driving, even medications where FMCSA guidance is that the driver be disqualified,  there is a process that medical examiners should take that greatly increases the chance the driver can be issued a medical examiner’s certificate.  We will discuss that in our next blog: CDL Medication Use: Don’t be Disqualified!

Continue reading part 2 here.

Michael Megehee, DC  NRCME President
TeamCME