Positive Results & Refusal-to-Test Instructions

Positive Drug Test Results Instructions

Remove the driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.

SAP Referral

• Document that the driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

• Positive DOT Drug Test Results are reported to the Clearinghouse by the Express Labs MRO

Can Drivers be Re-Tested?

• No. DOT does not allow drivers to be Re-Tested after a Positive Drug Test Result

Split Specimen Testing

If a driver requests Split Specimen Testing (Contested Results) through the MRO, Sample B is sent to a second SAMHSA-Certified laboratory for testing.

• Employers may not delay, cancel, or interfere with the process
• Express Labs charges $200 per Positive Drug Test for split specimen shipping and testing

Refusal-to-Test Instructions

Remove the driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.  A Refusal-to-Test is treated the same as a Positive Result.

• Employers are responsible for determining whether a driver's conduct is a Refusal-to-Test based on the collector's notes and available information.

Refusal-to-Test Includes: Failure to appear for testing, Leaving the collection site before the test is completed, Tampering with a specimen.

• DOT Policy for Refusal-to-Test
• DOT Policy for "Get Tested Immediately" (page 19)

SAP Referral

• Document that the driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

DOT requires employers to report refusals to the Clearinghouse.

• Clearinghouse Reporting

Positive Alcohol Test Instructions

Remove the driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.

SAP Referral

• Document that the driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

DOT requires employers to report refusals to the Clearinghouse.

• Clearinghouse Reporting

Alcohol Test Results

• 0.04 or higher — Remove from duty and begin the SAP process
• 0.02–0.039 — Remove from duty for 24 hours
• Below 0.02 — Negative result

Express Labs FMCSA Random Drug & Alcohol Consortium
Positive Results | Refusal-to-Test | Updated 2026