SAP Risk Assessment & Management 2 — Questions and Answers
Question 1: When a DOT-regulated employee tests positive for marijuana, the SAP must recommend which minimum level of education or treatment?
- Immediate termination
- At least one substance abuse education program (Correct answer)
- Inpatient detoxification
- A psychiatric evaluation before any treatment
Correct answer: At least one substance abuse education program
49 CFR Part 40 requires the SAP to recommend education or treatment appropriate to the clinical assessment, with at least a substance abuse education program for most first-offense positives.
Question 2: Which factor is LEAST likely to affect a SAP's determination of the severity of an employee's substance use disorder?
- Frequency and quantity of use
- The employee's job title or salary (Correct answer)
- Consequences experienced from use
- Loss of control over use
Correct answer: The employee's job title or salary
Salary and job title are not clinical criteria; severity is determined by DSM criteria such as frequency, consequences, and loss of control.
Question 3: A SAP's follow-up testing plan must include a minimum of how many unannounced tests in the first year after return to duty?
- At least 2 tests
- At least 4 tests
- At least 6 tests (Correct answer)
- At least 12 tests
Correct answer: At least 6 tests
49 CFR §40.307 requires at least 6 unannounced follow-up tests in the first 12 months after the employee returns to safety-sensitive duties.
Question 4: During a face-to-face clinical evaluation, the SAP notices the employee minimizes the DUI that led to the referral. This behavior is BEST described as:
- Rationalization and denial (Correct answer)
- Insight into the problem
- Somatic symptom expression
- Cognitive impairment
Correct answer: Rationalization and denial
Minimizing the significance of consequences is a hallmark of denial and rationalization commonly seen in substance use disorders.
Question 5: An employee referred to a SAP after a refusal to test must complete the evaluation process before they can:
- File a grievance with their union
- Return to any DOT safety-sensitive function (Correct answer)
- Speak to an Employee Assistance Program counselor
- Request a split specimen test
Correct answer: Return to any DOT safety-sensitive function
A refusal to test is treated the same as a verified positive under DOT regulations; the employee cannot return to safety-sensitive duties without SAP clearance.
Question 6: Which assessment tool is most commonly used by SAPs to screen for the severity of alcohol use?
- PHQ-9
- AUDIT (Alcohol Use Disorders Identification Test) (Correct answer)
- GAD-7
- PCL-5
Correct answer: AUDIT (Alcohol Use Disorders Identification Test)
The AUDIT is a validated 10-item WHO screening tool widely used to assess hazardous, harmful, and dependent alcohol use.
Question 7: If a SAP cannot complete the face-to-face evaluation within the DOT-required timeframe due to the employee's geographic location, the SAP should:
- Conduct the evaluation entirely by telephone
- Coordinate with the employer to facilitate in-person access, possibly via travel (Correct answer)
- Refer the employee to the nearest urgent care clinic
- Waive the evaluation requirement and proceed directly to testing
Correct answer: Coordinate with the employer to facilitate in-person access, possibly via travel
DOT requires face-to-face evaluation; the SAP and employer must coordinate logistics to make in-person assessment possible regardless of distance.
SAP Risk Assessment & Management 2
When a DOT-regulated employee tests positive for marijuana, the SAP must recommend which minimum level of education or treatment?