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Federal Officials Mull Adding Fentanyl to Drug Test Panel

Truck Drivers and Other Federal Safety-Sensitive Employees Would Have to Test for Potentially Deadly Drug

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A federal drug testing advisory board will begin discussions next month on possibly adding a testing panel for fentanyl to drug test drivers and other federal safety-sensitive employees for the potentially deadly drug.

In an announcement last month, the advisory board for the Substance Abuse and Mental Health Services Administration said it plans to meet virtually in an open session Dec. 5 as a follow-up on the Fighting Opioid Abuse in Transportation Act, which calls on the U.S. Department of Health and Human Services to determine whether adding fentanyl to the analyte table is justified based on the reliability and cost-effectiveness of mandatory testing.

“Fentanyl accounts for a large proportion of overdose deaths in the United States and is therefore an important public safety concern,” said the SAMHSA announcement. “Furthermore, fentanyl is increasingly used as a stand-alone substance of abuse, not in conjunction with heroin and other substances.”

SAMHSA, a sub-agency of HHS, is seeking public comments before the advisory board meeting, and 30 days after.

Fentanyl technically has been around since the 1960s, but experts now are labeling the synthetic drug as “emerging,” largely because users are dying in greater numbers, and it has become more readily available for legal and illegal use.

MORE: Truck Drivers Who Fail Drug Tests: Where Are They Going?

According to the U.S. Drug Enforcement Administration, fentanyl is a synthetic opioid that is 80 to 100 times stronger than morphine.

“Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin,” the agency said in a fact sheet. “Because of its powerful opioid properties, fentanyl is also diverted for abuse.”

fentanyl pills

The SAMHSA announcement was the second time in four years that Congress has asked drug agencies if federal workers, including truck drivers, should be tested for use of the drug. (Darwin Brandis/Getty Images)

DEA said fentanyl use can result in an intense, short-term high; temporary euphoria; slowed respiration; reduced blood pressure; nausea; fainting; seizures; and death.

Clandestinely produced fentanyl primarily is manufactured in Mexico, DEA said. The SAMHSA announcement was the second time in four years that Congress has asked drug agencies if federal workers, including truck drivers, should be tested for use of the drug.


Ron Flegel


At a December 2019 board meeting, advisory board chairman Ron Flegel said that the drug testing board forwarded to former HHS Secretary Alex Azar a recommendation that the agency add fentanyl to the list of drugs tested for by federal authorities. At the time, Azar had 180 days to decide whether to approve the board’s recommendation, Flegel said.

According to a National Forensic Laboratory Information System 2021 report, fentanyl was the fourth-most frequently identified drug and accounted for 11.61% of all drugs reported by forensic laboratories. Fentanyl has been detected in oral fluid in pain management patients, overdose cases, and driving under the influence of drugs cases.

MORE: ATA Honors Lawmakers’ Fentanyl Response

The chemical norfentanyl is an important component of identifying fentanyl users when urine is the specimen matrix. Information provided by HHS-certified laboratories in 2023 indicated that 84% of the laboratories analyzed unregulated workplace specimens for fentanyl and/or norfentanyl and that all had the ability to analyze urine specimens for fentanyl with sufficiently sensitive detection limits using commercially available immunoassay kits and confirmatory test instrumentation commonly used in HHS-certified laboratories.

Previously, federal drug czars said no to adding a test panel for fentanyl because the drug was being mixed with heroin, making it difficult to detect in drug tests. However, some officials reasoned that users could be identified through testing for heroin, according to Ruth Winecker, a senior research forensic scientist at RTI International.

“When we originally evaluated fentanyl, there seemed to be multiple mixtures of fentanyl with other drugs,” Flegel had said. “I think that is changing over time. Now you see a lot more fentanyl by itself and/or mixed in as a contamination product of other drugs.”

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