Looking for a definitve answer on legal adderall usage

Just as the title says: I'm looking for a definitive answer regarding the regulations that cover controlled substance use (Hopefully it's obvious I am focusing on the legally prescribed use of amphetamines).

49 CFR § 392.4(c) states the following: Paragraphs (a) (2), (3), and (4) do not apply to the possession or use of a substance administered to a driver by or under the instructions of a licensed medical practitioner, as defined in § 382.107 of this subchapter, who has advised the driver that the substance will not affect the driver's ability to safely operate a motor vehicle.

49 CFR § 382.213(b) states the following: No driver shall report for duty or remain on duty requiring the performance of safety-sensitive functions when the driver uses any non-Schedule I drug or substance that is identified in the other Schedules in 21 CFR part 1308 except when the use is prescribed by a licensed medical practitioner, as defined in § 382.107, who is familiar with the driver's medical history and has advised the driver that the substance will not adversely affect the driver's ability to safely operate a commercial motor vehicle.

Both sections state that as long as my prescribing physician has told me that there are no adverse side effects they are aware of, then I am safe to drive, and therefore by regulation should not be barred from obtaining a truck driving job.

The only regulation I've found that companies may be able to use to prevent the usage of prescription amphetamines is in 49 CFR § 390.3(d) which states: Additional requirements. Nothing in subchapter B of this chapter shall be construed to prohibit an employer from requiring and enforcing more stringent requirements relating to safety of operation and employee safety and health.

The only problem I've found with the entirety of 49 CFR § 390.3 is that it has been suspended indefinitely since 8 November 2021; and is therefore unable to be used by trucking companies.

To sum all this up: to me that means trucking companies can't use 390.3 to enforce more stringent requirements and that, as long as the amphetamine medication has been legally prescribed and the patient cleared by their doctor, no trucking company can discriminate in their hiring process against people with an ADHD disability.

And yes I am speaking from personal experience. I have been trying to get a driving job, only to get to the drug testing stage and told that I would need to discontinue my adderall usage or I would not get hired; So I may be a little biased in this thread.

Sources:

Federal Register :: Request Access

Federal Register :: Request Access

Federal Register :: Request Access

 

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What Doctor worth his/her salt is going prescribe Adderall, and not advise you of adverse side effects? Doctors know what the adverse side effects are.

 

I am sure you are familiar with organizations like this:
ADHD Workplace Accommodations
Anyone who reads the specifics of the ADA comes away with this:

Is My Employer Required to Provide Every Accommodation I Want?
Not quite. The law requires reasonable accommodations. These are things that don’t pose an undue hardship to the employer — things that aren’t outrageously expensive or burdensome to the business.

Since you are being considered for a safety sensitive position, any employer can make the judgement that is would be burdensome, and possibly illegal to hire someone with that diagnosis and using medication to control it. The outrageously expensive part they would cite would be the increase in their insurance premiums. And of course they would trot out their medical experts who would totally disagree with your physician's opinion. It is unlikely your doctor would be willing to go to bat for you in a drawn out legal battle either.

Your only recourse is to sue them. In order to do that, you have to have very deep pockets, many hundreds of thousands of dollars, far more than you could ever hope to earn as a truck driver.
The only other possibility is you find an attorney to take the case on contingency. Again, they would not see a clear winnable case and likely would not take it on, or if they did not fight very vigorously.

 

There really isn't one because the position taken by the US DOT/FAA and FMCSA for the condition and how it is interpeted by the insurance underwriters in this industry.

Under the FAA regulations, there is a process that has to be met in order to determine the qualifications of a pilot. This includes a clear process to actually determine if someone has ADHD or it is being used as a blanket diagnosis by a treating physician who has no clue other than looking at a couple indicators and claiming a patient has ADHD.

Mind you 80% of the cases are misdiagnosed.

Wrong, the physician must make clear what the side effects are, monitor you with the medication and adjust it accordingly. This is the standard protocol for administering it set by the FDA.

Just because they told you doesn't legally hold up.

The FMCSA has two parts of the safety related operations and one part is on the carrier who has a duty to ensure safe operations of the vehicle under control of a on-duty person. This means that medical restrictions can be placed on a driver at ANY TIME in order to fulfill that safety duty, and the regs give lattitude for the carrier to remove the driver even if they fall under the ADA or some special consideration (exemption).

Wrong, they do not have to hire anyone who presents drug usage - prescribed or not, it doesn't matter what your doctor says, it isn't discrimination and like HIPPA, the ADA has exemptions written right in to the law to allow safety related or regulated activities to be exempt.

Exactly, safety over feelings.

This is the biggest obsticle, the insurance companies rule this industry and rightfully so.

They don't have to even go that far. a lot of physicians will not get involved with a legal issue involving one patient, their is a lot of money involved and like a doctor, most legal professionals will not even consider a case unless there is a clear path to a win and lots of money involved - which these cases will never have a clear path.

True, most doctors won't do anything other than write up a letter to say you were prescribed X and that's it.

 

Well my doctor says: if it feels good, do it! Toot toot-see you on the flip side!

 

My standard response to ANY applicant mentoning ANY issue was to always tell them that the decision was not mine and I can't use anyone that I cannot insure.

The FCMSA being operated under Federal boundaries MUST provide such 'ther is a chance' language as the OP quoted however the insurance industry is NOT required to be PC only the bottom line matters; their bottom line NOT their insured's.

With the onset of the drug and alcohol clearing house the FCMSA is demonstrating that they are NOT changing their stance on scheduled drugs.

OP needs to decide if they can find another form of treatment or persue a different carreer.

 

What would life be like without adderall?

 

First of all, good job on the research, you have done more than most drivers do in trying to understand the regulations, however you missed something important, While 390.3 has been suspended indefinitely, it was replaced with 390.3T on January 17, 2017 and last amended on October 14,2021,which brings back the ability of motor carriers to be more stringent than the minimum requirements. This means they can still decide that certain classes, or even specific drugs are not allowed at their company. See Federal Register :: Request Access

Additionally, it is not just as simple as your personal physician prescribing the drug with the understanding that you are a regulated commercial vehicle driver. A qualified medical examiner listed on the National Registry must also agree with your primary physicians opinion to issue you a medical certificate. Those DOT qualified medical examiners are going to look to the Medical Examiners Handbook for guidance (page 83), which does allow for medication use if it does not interfere with your ability to drive in their opinion. Now, depending on the trucking company, they may allow you to select the medical examiner or they may require you to use their choice, and if they go that route the doctor will likely be very conservative in their opinion, likely rejecting you for certification.

ADHD and Adderall use alone does not automatically disqualify you, however it requires a lot of follow up with treating medical professionals and will be strongly scrutinized at trial should you ever be involved in a serious crash that injures someone. This is another reason why many motor carriers shy away from hiring ADHD being treated with strong medications.

 

#### Ridgeline & wisbang, human resources? Feel like i'm back in the union trying to pick holes in the human resource managers interpretation of state/federal law come contract time.

To the OP, find a different occupation. My daughter had to give up her dream of becoming a commercial pilot because of Adderall and rightfully so. Whether or not you or her will need it in another few years will be determined by more extensive testing. My wife treated patients for MANY years in a behavioral health setting and first witnessed and advocated for our daughter when her pediatrician and me refused to just throw her on an amphetamine. It was until my daughter couldn't function in her AP classes in high school that it became apparent to me.

It took a rockstar of a provider (his parents were research level pharmacologists) and he himself held a doctorates in some behavioral health program and a masters in pharmacology to prescribe her a balance of meds that kept her keenly focused to the point where she felt (not me or her mother) she was succeeding in what SHE wanted to do. She was accepted into a great college and made a train wreck of an idea to go off Adderall beginning her junior year. From Deans List/Honor Roll to adding another semester.

Honestly OP I wouldn't want you or my daughter operating a semi-tractor trailer or an aircraft.
You are clearly an intelligent person OP. What specifically attracts you to truck driving?