Update: Getting CDL on Buprenorphine

Sweet revenge

Since I posted last week about my patient on MAT getting turned down for a commercial driver’s license, some interesting things have developed.

Colleagues gave me suggestions for places where I could refer my patients on medication-assisted treatment to get their commercial driver’s license. As it turns out, several colleagues who work in addiction medicine also work in offices where DOT exams are done. Those doctors suggested I send my patients who need DOT exams to them. I can send a letter of support, describing their progress in recovery, and if everything else checks out, the CDL will be granted. Of course there can be no guarantees, but those offices won’t reject a person for a CDL only because they are being treatment for opioid addiction with medication-assisted treatment.

Problem solved. I thank my fellow physicians who offered that solution!

Additionally, some smart people in NC state government read my post, and contacted me. They suggested that our state’s prescription monitoring program does not permit use of its data for the purpose of denying a person their commercial driver’s license. My patient wasn’t seeing this doctor to get medical treatment, and did not give his permission for his records to be checked. Penalties for misuse of the NC Controlled Substance Reporting System can potentially be $10,000 per offense.

My patient is now deciding if he wants to pursue this issue by filing a complaint with the state. Outwardly, I told him it’s his decision.

Inwardly, I’m thinking, “Oh pleasepleaseplease file a complaint!!”


6 responses to this post.

  1. This is the most timely, helpful, and hopeful response to your post that you could have ever hoped for. It’s nice to see people care enough to solve such an ‘edge’ issue, then follow-through. As for filing a complaint, definitely leave it up to him, as once you open the legal can of worms, who knows how much time and money it may suck up. Still, if they abused the reporting system as reported, that should be dealt with, though I wonder if it would be, given you previous reporting that some doctors are flagrantly skirting the federal rules.


  2. Posted by Theodore D Fifer MD FACS on May 26, 2016 at 3:08 pm

    Bravo, Dr Burson. Patient advocacy can be very satisfying.


  3. Posted by kevin on June 7, 2016 at 9:12 am

    I think he should. He could be a sounding mechanism for us people that struggle with a real medical illness that needs someone to speak up for us. We need someone that will stand up for our rights. I say yes and I will back you 100%, my spouse doesn’t use or in treatment program but does have a cdl and I don’t think your rights should be any different than his rights


  4. Posted by Chris on September 24, 2016 at 7:33 am

    Hey I am so glad I came across this I am in a similar situation, and I dont know where to go! I to live in NC could you point me to the right Dot doc that will understand my situation and cam see all my drug test for 4 years , never failed, and tappered for 32mg-8. I CANNOT believe how we can be stigmatized and profiled by our own government! I’m so lucky to be alive and clean, and finally enough time has passed my 1 little 7 yr old misdemeanor isn’t holding me from this job, and I was so excited until this?! Really?! Your noty doctor it’s none of your business what my doctor and I have been successfully treating, this is unbelievable, please help I’m not gonna abandon the medication that saved my life all at once I will be done when I’m ready? Where can I turn?


    • In NC, officials say the doctor who does the CDL exam can’t use the prescription monitoring website to deny you a CDL. But if that happens, you need to get a statement from your doctor who prescribes the buprenorphine saying that you are OK to drive and get a CDL.


  5. Posted by Jana on February 10, 2018 at 6:57 pm

    I just want to thank you for writing about this topic, as I’ve been trying to research where the laws fall I’ve ever encountered so much seemingly contradictory information that I’ve gone from terrified to confident in a matter of hours.
    I’m also from NC and wanted to know if the laws still protect people in MAT against having their treatment disclosed in the state prescription monitoring program. Despite never having had so much as a speeding or seat belt ticket in over 15 years I was really close to turning down a job until I read the information you posted out of fear of having something I’ve done to better my life being used against me to lose my job. Now I have a better understanding of where the law falls thanks to your writing and advocating on behalf of your patients and people in MAT as a whole.

    As far as I am aware, even with the extended opiate testing the DOT adopted January 1 2018 full synthetic opiates like methadone and bupe are not tested for by the dot drug testing, does that jive with your knowledge and experience in the past couple months since the new expanded testing has been in place?

    Im not sure where in NC you practice but your patients are very lucky to have such an advocate in their corner that goes beyond prescribing and really helps to ensure their lives are not negatively impacted by the decision to treat their condition. I would also love I know what that medical examiners that do medical certification agreed to help advocate for patients so when I’m at the step in the process of getting my dotl physical I can see one of them.

    Thanks again for your valuable information. While researching this topic I found literally nothing else online than clearly explained the regulations from the perspective of supporting people in MAT.


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