DOT proposes to amend its drug-testing program regulation to add fentanyl to its drug testing panels. There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl. Both are considered synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer. Most cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, which is distributed through illegal drug markets for its heroin-like effect. It is often added to other illicit drugs because of its extreme potency, which makes those drugs cheaper, more powerful, more addictive, and more dangerous. 

Fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S. Even in small doses, it can be deadly. Over 150 people die in the U.S. every day from overdoses related to synthetic opioids, primarily fentanyl. 

DOT intends for this proposal to raise the level of safety for the transportation industry and the transported public. The DOT drug test, which currently screens for marijuana, cocaine, opioids, amphetamines, and PCP, will be expanded to specifically include testing for fentanyl and its metabolite, norfentanyl. The new standards would apply to both urine and oral fluid testing. Norfentanyl would be added to urine tests, while fentanyl would be added to both urine and oral fluid tests.

Public comments on the proposal are due October 17.