Unclassified

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(e) The DOD expanded military drug testing of the more commonly abused prescription (controlled) drugs beginning with hydrocodone and hydromorphone, including oxycodone, oxymorphone, and selected benzodiazepines. While these powerful pain management drugs can alleviate suffering, they are potentially highly addictive and their use outside of medical supervision places the Soldier and those around them at risk. Soldiers who are using prescription (controlled) drugs that have not been prescribed or dispensed by their healthcare provider are encouraged to voluntarily seek medical treatment and rehabilitation for themselves in a military medical treatment facility on a self- referral basis prior to the initiation of testing for these drugs. Prescription (controlled) drugs are inappropriately used when they are used outside the directions given by the legally prescribing healthcare provider, or when a Soldier uses another individual’s prescribed medications.
(f) Individuals who do not self-refer for treatment and are subsequently identified as positive for controlled substances for which they do not have a valid prescription maybe considered in violation of the UCMJ for drug misuse abuse. Prescription drugs are inappropriately used when they are used outside the directions given by the legally prescribing healthcare provider, or when a soldier uses another individual’s prescribed medications.
d. Procedures.
(1) The MRO will receive a request for review from the ASAP office. At a minimum, the referral information will include the Soldier’s DoD employee ID number, and the drugs) which were identified as exceeding the established
DoD cutoffs for the drugs.
(2) Upon notification the MRO will review any medical evidence in the form of a prescription documented in an electronic health record system, in a hard copy medical record, on a prescription bottle, and/or a statement from the Soldiers physician or dentist documenting the drug prescribed/administered and the date of the medical or dental procedures. MROs in a deployed area may have difficulty obtaining medical documentation. It is acceptable for the
MRO to request and obtain assistance from units in the rear to gather the required documentation. It is acceptable for command/medical staff members to gather the documentation needed for the MRO’s evaluation in order to expedite the review of positive urine drug test findings.
(3) To expedite the review process, the MRO will attempt to complete the review using the medical information available without having to interview the Soldier. If it is not possible to determine whether or not the positive result is due to an authorized use, the MRO will conduct a telephonic or in-person interview with the Soldier this interview will be scheduled through the Soldier’s unit commander.
(4) When conducting a telephonic or in-person interview, the individual contacting the Soldier will advise the Soldier that the purpose of the interview is to determine if there is a valid medical reason for the positive UA drug test result. The MRO is an investigative officer, and there are no patient-physician privileges concerns in the MRO process. Therefore, the MRO will advise the Soldier of their rights listed on DA Form 3881 and then ask for medical information related to the positive UA drug test result. The MRO should document any comments made by the Soldier relating to the positive UA. Soldier’s refusal to speak with the MRO or request for an attorney, information requested to evaluate the positive UA results such as a valid prescription or medical condition must be submitted to MRO within
30 days from date of request. The Soldier or his or her legal representative must provide medical review officer the required documents within 30 days. If no information is provided, the MRO will report use as illegitimate.
(5) If attempts to contact the Soldier for the interview are not successful, the MRO will contact the Soldier’s unit commander, and ASAP office or BAC manager. The MRO must document these attempts, to include the date, time, and method of attempted contact. If after 60 days, the Soldier has not been reached or has been reached but not interviewed due to no fault of the MRO, then the MRO may report the evaluation as illegitimate use. If the Soldier comes forward at a later date with a valid prescription then the results can be changed to authorized use.
(6) The MRO will make a determination regarding the positive urine drug test result. The standard reporting language is—
(a) EVALUATION COMPLETE - AUTHORIZED USE The Soldier has a prescriptions) or valid medical explanation fora drugs) that caused the positive UA result. Required fields to enter determination in DAMIS include
MRO Evaluation Result, Drug Prescribed, Prescription Date (must be prior to UA collection date, and MRO Evaluation Date.
(b) EVALUATION COMPLETE - ILLEGITIMATE USE The MRO did not find a prescriptions) or valid medical explanation fora drugs) that would account for the positive UA test result. Required fields to enter determination in DAMIS include MRO Evaluation Result and Comments.
(c) EVALUATION INCOMPLETE- SOLDIER UNAVAILABLE The Soldier is unavailable for any of the following reasons AWOL, death, discharge, dropped from the rolls of the Army, expiration of term of service, incarceration, permanent change of station, deployed, or redeployed. Required fields to enter determination in DAMIS include MRO Evaluation Result and Reason Soldier is Unavailable.
(7) The MRO will document the results of the review and provide comments in DAMIS.

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