A DOT drug test checks for five drug classes listed in 49 CFR 40.85:

• Marijuana metabolites (THC)
• Cocaine metabolites
• Opioids, including codeine, morphine, heroin (6-acetylmorphine), and certain semi-synthetic opioids such as hydrocodone and oxycodone
• Amphetamines, including methamphetamine and MDMA
• Phencyclidine (PCP)

The panel and cutoff levels are fixed by regulation; an employer cannot add or remove drugs from a DOT test. A specimen that screens positive is confirmed by the laboratory, and a Medical Review Officer (MRO) reviews every confirmed result before it is reported to the employer (49 CFR Part 40, Subpart G).

Fentanyl: DOT proposed adding fentanyl and norfentanyl to the DOT panel on September 2, 2025. As of September 2026 no final rule has been published, so fentanyl is not yet part of a DOT test. Check the DOT Office of Drug and Alcohol Policy and Compliance for the current status.

Non-DOT tests can use a different panel chosen by your company policy. In a Med-Stop test request, the Drug Test Panel field appears only for non-DOT drug tests.

What is a Medical Review Officer? · Can prescription medication affect a drug test?