DC Feedback: Prescription drug use
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This month's installment deals with prescription drug use.
Dear DC Feedback:
What are the requirements for reporting the use of prescription drugs and over-the-counter medications?
In meetings held with FRA, the issue of medications commonly purchased over-the-counter and used in the treatment of colds and flu were discussed. It was stated, and for reasons of safety, that a policy that would not permit employees to lay-off when called if they reported they were unsafe to work because of alcohol or prescription drug use would be looked on unfavorably. Likewise, there is concern with the impact on safety that employees may have when they are not medicated when sick. It is important for railroad employees subject to part 219 that they confer with their physician on prescriptions and over-the-counter use of medications.
In regard to prescription drug use §49 CFR Part 219.103, provides:
"(a) This subpart does not prohibit the use of a controlled substance (on Schedule II through V of the controlled substance list) prescribed or authorized by a medical practitioner, or possession incident to such use, if-
"(1) The treating medical practitioner or a physician designated by the railroad has made a good faith judgment, with notice of the employee's assigned duties and on the basis of the available medical history, that use of the substance by the employee at the prescribed or authorized dosage level is consistent with the safe performance of the employee's duties;
"(2) The substance is used at the dosage prescribed or authorized; and
"(3) In the event the employee is being treated by more than one medical practitioner, at least one treating medical practitioner has been informed of all medications authorized or prescribed and has determined that use of the medications is consistent with the safe performance of the employee's duties (and the employee has observed any restrictions imposed with respect to use of the medications in combination).
"(b) This subpart does not restrict any discretion available to the railroad to require that employees notify the railroad of therapeutic drug use or obtain prior approval for such use."
Additionally, a Notice of Safety Advisory-98-3, titled, "Recommended practices for the safe use of prescription and over-the-counter drugs by safety-sensitive railroad employees" states:
"FRA issues this advisory in support of DOT's efforts to ensure that transportation employees safely use prescription and over-the-counter (OTC) drugs. Safe rail operations depend upon alert and fully functional professionals who have not been adversely affected by drug use, whether medically appropriate ("legal") or not. FRA has always prohibited illicit drug use and unauthorized use of controlled substances by safety-sensitive employees, but is equally concerned about the potentially adverse side effects from other prescription drugs and OTC products. Because DOT and FRA testing (including FRA's post-accident program) targets only alcohol and controlled substances, FRA does not have a clear picture of the extent to which the performance of safety-sensitive employees is adversely affected by legal drug use.
"Accordingly, although not specifically addressed in its alcohol and drug testing regulations (49 CFR part 219), FRA strongly recommends that rail employers and safety-sensitive employees follow § 219.103 guidelines when considering the use of all prescription and OTC drugs. Simply stated, in the interest of safety, FRA strongly recommends that either a treating medical professional or a railroad-designated physician make a fitness-for-work determination concerning all prescription and OTC drug use prior to permitting an employee to return to work in safety sensitive service. This determination should also be made whenever an employee currently performing safety-sensitive functions is concerned about possible effects on his or her job performance from the use of prescription or OTC drugs.
"Section 219.103(b) authorizes railroads to establish reporting and approval procedures for all prescription and OTC drugs which may have detrimental effects on safety. Additionally, FRA recommends that railroads educate their employees on these reporting and approval procedures and, most importantly, on how to use prescription and OTC medications safely.
"FRA will take all appropriate action to continue reducing the negative impact from inappropriate use of all prescription and OTC medications. Moreover, FRA strongly encourages the rail industry to voluntarily develop programs on safe prescription and OTC drug use before such programs are mandated or directed through legislation.
"Issued in Washington, D.C., by George Gavalla, Acting Associate Administrator or Safety."
Many OTC drugs contain alcohol in percentages greater than found in alcoholic beverages. This, in combination with other chemicals, can cause drowsiness or other effects that make them unacceptable for persons in safety sensitive positions. A balance must be struck between taking approved medications and/or going to work in a condition that threatens your health and the health and safety of your fellow workers. At all times comply with the provisions of part 219.
© 2001 Brotherhood of Locomotive Engineers