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Does DOT Physical Drug Test?

In this article, we’ll run through the DOT physical procedure so you know what to expect at your doctor’s appointment, and we’ll answer one very common question: Does DOT physical drug test drivers?

All CDL holders have to pass a DOT physical every 2 years to be medically certified as fit to drive a commercial motor vehicle weighing 10,000 pounds or more.

Does DOT Physical Drug Test Drivers in 2024?

Does DOT Physical Drug Test

Let’s answer your most urgent question first – Does a DOT physical include a drug test?

Technically, the DOT physical does not include a drug test; you only have to produce a urine sample for medical testing. However, you must pass a separate DOT drug test before an employer can hire you as a driver.

If you’re taking the DOT physical during the pre-employment process, or the trucking school admissions process, you should expect to be given a DOT drug test when you take your DOT physical.

To be clear, the DOT physical does not include a drug test, but you may need to take a drug test at your appointment if an employer or CDL school has requested one.

If you’re booking the DOT physical yourself prior to applying for CDL jobs, you won’t take a drug test at your appointment.

As a CDL holder, you’ll also be subject to regular random drug and alcohol testing, reasonable suspicion testing, and post-accident testing.

Because of the repeated drug testing that CDL holders are subject to, it’s not advisable to use drugs if you want to pursue this career.

What Does The DOT Physical Include?

What Does The DOT Physical Include?

The DOT physical is a medical exam carried out by a DOT-certified medical examiner (CME)

The exam will determine if you’re eligible for the medical certification, which allows you to drive a commercial motor vehicle.

A DOT medical certification lasts for 2 years, which means you will need to pass a DOT physical exam every 2 years.

The DOT physical includes a health questionnaire and a basic physical exam.

Here’s what to expect.

When you arrive for your appointment, you’ll be asked for your photo ID and your payment, then you’ll be given a patient intake form to fill out.

  1. Fill out your name, address, date of birth, and driver’s license number.
  2. List any history of hospitalizations and any medications you currently take.
  3. Go through the list of medical conditions and check “yes”, “no”, or, “not sure”, next to each one.
  4. If you check “yes” for any condition, give more details in the next section of the form.
  5. Sign and date the form. Your signature confirms that the information you’ve provided is accurate and that you understand that supplying false information is an offense.

Once you’ve completed your intake form, you’ll go through to the exam room. The doctor will go through your form and ask you some questions based on the information you provided. You’ll also be asked if you wear glasses or contacts when you drive and if you use a hearing aid.

Next, the doctor will carry out a basic health check.

The first thing the doctor checks is your weight, then they’ll take your blood pressure and your pulse rate.

The doctor will use a stethoscope to listen to both lungs while you take a series of deep breaths, then the doctor will listen to your heart.

They’ll check your reflexes by tapping on your forearms, your knees, and your lower legs.

Next up is a vision test which has 3 parts. Again, this is an extremely basic test.

  1. First, cover one eye and read a line of letters on a card, then repeat with the other eye covered, and then with both eyes uncovered.
  2. Then, correctly identify 3 colors.
  3. Finally, use your peripheral vision to say when you see the doctor’s finger come into view.

After your vision test, the doctor will test your hearing. While standing several feet away from your right side and then your left side, they’ll whisper a short series of numbers that you need to repeat.

Now the doctor will ask you to lie back while they palpate your abdomen to check for hernias or other abnormalities.

That’s the end of the physical examination. All that’s left is the urine check. You’ll be given a sample cup, told to fill it about halfway, and sent out to a private bathroom to produce your urine sample.

What Does The DOT Physical Urine Test Look For?

What Does The DOT Physical Urine Test Look For?

Remember, this is the medical urine check, not the DOT drug test. The doctor will check your urine sample for glucose, protein, and blood.

  • Glucose in your urine usually indicates diabetes.
  • Protein can be a sign of high blood pressure, diabetes, toxin exposure, or infections.
  • Blood may indicate kidney stones, a bladder or kidney infection, or certain forms of cancer.

Once your urine has been checked, if everything is clear, you’ll be given your medical certificate. Your DOT physical is now complete, and you’re eligible to drive for the next 2 years as long as you pass your DOT drug test.

What To Expect At A Pre-Employment Or CDL School DOT Physical

Whether you’re a new CDL holder applying for driving jobs, or a candidate applying for CDL school admission, you could face a drug test at the same time as your DOT physical. It all depends on the employer’s, or CDL school’s policy.

According to the Federal Motor Carrier Safety Administration, when a drug test is scheduled at the same time as a DOT physical, the DOT drug test should take place after the medical examiner has completed the physical examination and certified the driver as medically fit.

This means that you’ll go through the process detailed in the section above, and then you’ll need to provide another urine sample which will be sent to a Health and Human Services-certified laboratory for testing.

The DOT drug test is always a urine test. However, your prospective employer could ask for a hair test as well, although this additional testing isn’t common.

If your urine sample is positive for drugs, then the violation is recorded in the Drug and Alcohol Clearinghouse database. You won’t be able to drive a commercial motor vehicle until you’ve completed the Return To Duty (RTD) process.

Because hair testing is not currently recognized by the DOT, a positive result for that test will not be logged with the Clearinghouse, but a positive result will mean the loss of your‌ job offer or CDL school place.

Drug Test For DOT Physical – What Does It Screen For?

Drug Test For DOT Physical

The drug test you may need to take alongside your DOT physical is a 5-panel drug screen which checks your urine sample for the following substances:

  • Marijuana
  • Cocaine
  • Opiates – opium and codeine derivatives
  • Amphetamines and Methamphetamines
  • Phencyclidine – PCP

At the lab, your sample will undergo an initial drug screen using the following drug detection cutoff levels.

  • Marijuana metabolite (THCA) – 50 ng/mL
  • Cocaine metabolite ( Benzoylecgonine) – 150 ng/mL
  • Codeine/ Morphine – 2000 ng/mL
  • Hydrocodone/Hydromorphone – 300 ng/mL
  • Oxycodone/Oxymorphone – 100 ng/mL
  • 6-Acetylmorphine – 10 ng/mL
  • Phencyclidine – 25 ng/mL
  • Amphetamine/Methamphetamine – 500 ng/mL
  • MDMA/MDA – 500 ng/mL

Urine samples with drug levels at or above those cutoff levels will undergo confirmatory testing.

If, after confirmatory testing, your urine sample is positive for drugs, your result will be passed to the Medical Review Officer (MRO) who will contact you to ask about any prescription or over-the-counter medications you currently take.

If there’s a legitimate medical reason for your positive result, the drug test result will be recorded as negative, although some medications will disqualify you from driving while you’re taking them.

If the MRO finds no legitimate reason for the drugs found in your sample, then your result is recorded as positive. You cannot drive a commercial motor vehicle until you visit a Substance Abuse Professional (SAP) and complete all the steps in the Return To Duty (RTD) process.

Will Synthetic Urine Pass A DOT Physical?

Will Synthetic Urine Pass A DOT Physical?

The urine sample collected at your DOT physical is tested at the doctor’s office for the presence of glucose, protein, and blood. That sample isn’t analyzed for drugs.

If you want to use synthetic urine to hide a medical condition that would cause you to fail your physical, the fake urine is unlikely to be detected at the doctor’s office.

That being said, a medical condition discovered through the DOT physical urinalysis won’t always be a reason for the doctor to fail you.

For example, uncontrolled diabetes would be a reason for failing you, but if your diabetes is under control with medication and you check your blood sugar regularly, the doctor may certify you as fit to drive once they’ve seen your most recent lab work. In this case, you’ll need to undergo more regular DOT physicals on a 6-month or 12-month schedule.

It’s really not a good idea to try to cheat the urine test. If you’re not medically fit to drive, you need to know that for your own well-being and for the safety of other road users.

Will synthetic urine pass a DOT physical? Yes, fake urine can pass the protein, glucose, and blood test used to check for medical conditions.

Now, if you plan to use synthetic urine to cheat the DOT drug test, you’ll be curious to know if labs can detect synthetic urine.

Can Labs Detect Synthetic Urine?

Researchers are always working on new methods to detect fake urine and other adulterants used to cheat on drug tests. At the same time, product manufacturers try to stay one step ahead by developing new fake urine formulations.

Many people successfully use fake urine to pass their drug tests. However, some specimen validation tests can detect fake urine, and it’s impossible for you to know what validation testing method is used by the lab processing your urine sample.

So, can labs detect synthetic urine? Yes, if they use advanced validation tests.

Another big problem with using synthetic urine is making sure it’s at or close to body temperature. When you submit your urine sample, it must be checked for color and temperature within 4 minutes.

If your sample falls outside the acceptable temperature range of 90℉ to 100℉, you’ll have to provide another sample.

DOT rules state that the new sample must be obtained under direct observation. In other words, you’ll be watched while you urinate, making it very difficult to use fake urine a second time. Both urine samples are then sent to the lab for testing.


The DOT physical tests your urine for protein, glucose, and blood, all of which indicate medical conditions that could (but won’t always) make you fail your physical. The DOT physical does not test your urine sample for drugs.

An employer or CDL school can, however, schedule your DOT drug test at the same time as your physical. In this case, you’ll be asked to provide an additional urine sample, which will be sent to a certified drug testing laboratory.

It’s possible to use synthetic urine to try to pass a DOT drug test, but there’s no guarantee of success because of temperature checks and sample validation testing methods.

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