The DOT drug test screens for exactly five substances — no more, no less. That's not arbitrary. The federal government standardized the five-panel test for all DOT-regulated positions in 49 CFR Part 40, and the panel hasn't changed significantly in decades, though the cutoff levels and testing methods have been updated over time. Here's exactly what gets tested, what the DOT drug test cutoff levels are, and how the review process works.
Every DOT-required drug test under FMCSA — and the other modal agencies including FAA, FTA, FRA, PHMSA, and USCG — uses the same five-panel urine test. The five substances are:
1. Marijuana (THC metabolites)
Specifically, the test looks for THC-COOH (11-nor-9-carboxy-THC), the primary metabolite of cannabis that stays in the system after the psychoactive effects have worn off. The initial screening cutoff is 50 ng/mL. If the screening result is at or above that level, a confirmation test using gas chromatography/mass spectrometry (GC/MS) runs at a confirmation cutoff of 15 ng/mL.
Utah's medical marijuana law doesn't change anything here. A DOT drug test doesn't care about a medical marijuana card. The federal regulations are explicit: marijuana is a Schedule I controlled substance under federal law, and a positive THC result is a DOT violation regardless of state law or medical justification. This is the single most common question we get from Utah CDL drivers — the answer is always the same.
2. Cocaine (Benzoylecgonine)
The test looks for benzoylecgonine, the primary cocaine metabolite. Initial screening cutoff: 150 ng/mL. Confirmation cutoff: 100 ng/mL. Cocaine clears the system relatively quickly — typically 2 to 4 days for occasional users. The metabolite window varies based on use patterns and individual metabolism.
3. Opiates
This is the most complicated panel item because "opiates" covers several substances. The DOT test screens for codeine, morphine, and heroin (as 6-acetylmorphine). The initial screening uses a 2,000 ng/mL cutoff for codeine/morphine. Confirmation cutoffs are 2,000 ng/mL for codeine and morphine, and 10 ng/mL for 6-AM (heroin metabolite).
Prescription opiates are where the MRO review matters most. Codeine is in some prescription cough medications. Morphine is a legitimate pain medication. An MRO who gets a positive opiate result will contact the driver to ask about prescription medications. If the driver has a valid prescription and the medication could explain the result, the MRO can report it as a negative. That's an important protection — the MRO process isn't about punishing people for legitimate medication use.
4. Amphetamines and Methamphetamine
The amphetamines panel covers amphetamine, methamphetamine, MDMA (ecstasy), and MDA. Initial screening cutoff: 500 ng/mL. Confirmation cutoffs: 250 ng/mL for amphetamine and methamphetamine, and 250 ng/mL for MDMA and MDA.
Prescription medications like Adderall (amphetamine salts) and some other ADHD medications can trigger a positive amphetamine screen. Again, the MRO reviews these results. A valid prescription that explains the result can result in a negative report. The MRO is the safeguard against false positives from legitimate medication use.
5. Phencyclidine (PCP)
Initial screening cutoff: 25 ng/mL. Confirmation cutoff: 25 ng/mL. PCP positives are relatively uncommon in DOT testing compared to the other four substances, but it remains on the panel as a federal requirement. Unlike some other substances, there are very few legitimate prescription medications that produce a PCP positive — so MRO contact for this result is typically brief.
These are the federal cutoff levels every DOT urine drug test uses. They are set in 49 CFR §40.87 and they are the same at every SAMHSA-certified laboratory in the United States — a lab cannot use its own numbers, and a Utah result is measured against exactly the same thresholds as a result anywhere else.
A specimen has to clear both columns to be reported positive. The initial immunoassay screen has to hit the first number, and then a separate confirmatory test by GC/MS or LC/MS-MS has to hit the second number. A specimen that screens at or above the initial cutoff but falls below the confirmatory cutoff is reported negative.
| Substance / analyte | Initial screening cutoff | Confirmatory cutoff |
|---|---|---|
| Marijuana metabolite (THCA) | 50 ng/mL | 15 ng/mL |
| Cocaine metabolite (benzoylecgonine) | 150 ng/mL | 100 ng/mL |
| Codeine / morphine (opiates) | 2,000 ng/mL | 2,000 ng/mL |
| 6-Acetylmorphine (6-AM — the heroin marker) | 10 ng/mL | 10 ng/mL |
| Hydrocodone / hydromorphone | 300 ng/mL | 100 ng/mL |
| Oxycodone / oxymorphone | 100 ng/mL | 100 ng/mL |
| Amphetamine / methamphetamine | 500 ng/mL | 250 ng/mL |
| MDMA / MDA | 500 ng/mL | 250 ng/mL |
| Phencyclidine (PCP) | 25 ng/mL | 25 ng/mL |
Two things this table is often misread on.
The THC cutoff is not a "how much did you smoke" number. The 50 ng/mL screen and 15 ng/mL confirmation measure THCA, an inactive metabolite that lingers long after any impairment has passed. A confirmed positive means the metabolite was present above the federal threshold. It is not a measurement of being under the influence at the time of the collection, and the DOT rules do not treat it as one.
Methamphetamine has an extra rule. For a methamphetamine result to be reported positive, amphetamine must also be present at a concentration of at least 100 ng/mL. Methamphetamine metabolises into amphetamine, so its absence is a signal the laboratory takes seriously.
There is one more number that is not in the table because it is not a drug: DOT breath alcohol. A result of 0.02 or higher removes the driver from safety-sensitive duty; 0.04 or higher is a violation. See our DOT breath alcohol testing page for how that test is run.
If a result comes back at or above these levels, the Medical Review Officer contacts the donor before anything is reported. A valid prescription can turn a laboratory positive into a reported negative — that process is covered further down this page.
DOT drug tests must go through a SAMHSA-certified laboratory. That's not negotiable. Instant cup tests — the kind where you dip a strip in the specimen and get a result in a few minutes — are not acceptable for DOT testing purposes, period. They may be used for non-DOT workplace drug testing, but they cannot substitute for a lab-processed DOT test.
The reason is accuracy and legal defensibility. SAMHSA-certified labs use two-step testing: an initial immunoassay screening followed by gas chromatography/mass spectrometry confirmation for any non-negative results. GC/MS is the gold standard for drug testing — it identifies specific compounds at specific concentrations with a level of accuracy that holds up in legal and regulatory proceedings. An instant test strip doesn't come close to that accuracy level.
What this means practically: DOT drug test results take time. A negative typically comes back in 24 to 72 hours. Non-negative results require the additional confirmation step and MRO review, which can add time. Plan your hiring timelines and random testing windows accordingly — DOT testing is not a same-hour turnaround.
Every DOT drug test result — negative or non-negative — goes through a licensed Medical Review Officer before being reported to the employer. The MRO is a physician who specializes in evaluating drug test results in the context of the donor's medical history and any legitimate prescription drug use.
For a negative result, the MRO review is essentially administrative — they verify the documentation, confirm the negative, and report it to the employer. For a non-negative result (positive, adulterated, substituted, or invalid), the MRO contacts the driver directly. The driver has the opportunity to provide a medical explanation — a prescription, a documented medical condition — that might explain the result.
If the driver provides a satisfactory explanation, the MRO can report the result as a negative. If there's no satisfactory explanation, the MRO reports a verified positive — and that's what goes to the employer, and to the FMCSA Clearinghouse. The employer never sees the lab's raw result before MRO review. That's by design.
Every DOT urine specimen is split at the time of collection into two vials: the primary specimen (A) and the split specimen (B). The A specimen goes to the lab for testing. The B specimen is retained at a separate certified facility.
If the A specimen comes back positive, the driver has the right to request testing of the B specimen at a different SAMHSA-certified laboratory at their own expense. The B specimen test must confirm the same substance at or above the confirmation cutoff. If the B specimen tests negative or doesn't confirm the A result, the MRO reports the test as cancelled — not a positive. This split specimen protocol is a significant protection for drivers who believe a positive result is incorrect.
A verified positive DOT drug test result triggers an immediate sequence of events. The driver cannot perform safety-sensitive functions — they're removed from duty the moment the employer receives the positive result from the MRO. The positive result is reported to the FMCSA Clearinghouse. The driver must complete a Substance Abuse Professional evaluation before any path back to safety-sensitive employment is possible.
For employers: the action is clear and non-negotiable. The driver stops performing safety-sensitive functions immediately. Documentation goes into the driver's file. The Clearinghouse shows the violation. From there, whether the driver can eventually return through the return-to-duty process depends on the SAP's evaluation and the driver's completion of the required program.
BBB Mobile DOT Drug Test collects DOT urine specimens on-site at your Utah location — your truck yard, your job site, your office. $100 per DOT drug test. Certified collection, federal chain of custody, SAMHSA lab, MRO review included.
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The DOT five-panel screens for marijuana (THC metabolites), cocaine, opiates and opioids (including heroin, morphine, codeine, and semi-synthetic opioids), amphetamines and methamphetamine, and phencyclidine (PCP).
No. Alcohol is tested separately using a breath alcohol test (BAT) on an approved Evidential Breath Testing device. The five-panel urine drug test does not detect alcohol.
Marijuana use, including state-legal medical marijuana, can produce a positive THC result, and there is no medical marijuana exception under DOT rules. CBD products can contain enough THC to trigger a positive, so DOT-regulated drivers use them at their own risk.
Some legitimate prescriptions can trigger a non-negative lab result. That is why every non-negative goes to a Medical Review Officer, who contacts the donor to verify a valid prescription before deciding how to report the result.
DOT drug testing currently uses urine specimens processed by a SAMHSA-certified laboratory. Hair and oral-fluid testing are not interchangeable with the DOT urine test for compliance purposes today.
Each collection is split into an A and B specimen. If the A specimen is positive, the driver may request testing of the B specimen at a different SAMHSA-certified laboratory within 72 hours to confirm or refute the result.
Under 49 CFR §40.87: marijuana metabolite (THCA) 50 ng/mL initial and 15 ng/mL confirmatory; cocaine metabolite 150 and 100; codeine/morphine 2,000 and 2,000; 6-acetylmorphine 10 and 10; hydrocodone/hydromorphone 300 and 100; oxycodone/oxymorphone 100 and 100; amphetamine/methamphetamine 500 and 250; MDMA/MDA 500 and 250; PCP 25 and 25. A specimen must exceed both cutoffs to be reported positive. Full table above.
50 ng/mL on the initial screen and 15 ng/mL on the confirmatory test, measured as the inactive metabolite THCA. A specimen must exceed both. The cutoff measures presence of the metabolite, not impairment at the time of collection.
A federal 5-panel urine test: marijuana metabolites, cocaine metabolites, opiates and opioids, amphetamines, and PCP. The panel is fixed by regulation — it cannot be expanded or reduced for a DOT test.
No. Benzodiazepines are not on the federal DOT 5-panel, and neither are barbiturates, methadone, propoxyphene or synthetic cannabinoids. An employer can screen for those on a non-DOT test, but they cannot be added to a DOT test.
For methamphetamine to be reported positive, amphetamine must also be present at 100 ng/mL or above. Methamphetamine metabolises into amphetamine, so its absence is a signal the laboratory takes seriously before confirming.
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Need on-site DOT or non-DOT testing in Utah? Call (435) 395-1459 or schedule online - no down time, no drive time.
BBB Mobile comes to your job site. DOT-compliant collection, SAMHSA-certified lab, MRO-reviewed results. Serving Park City, Heber City, Salt Lake City, and all of Utah.
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