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Business, Industry and Government Agencies expect physicians in many specialties to conduct work-related alcohol and drug tests. The need for trained Medical Review Officers to evaluate drug and alcohol test results extends to almost 20 million Americans. More than 70 percent of large private employers require drug and alcohol testing. Instant on-site tests and hair, saliva and sweat testing are gathering greater scientific credibility for use in schools and among private employers.

The Drug Free Workplace Act affects all federal agencies. Mandatory alcohol and drug testing is now required of all intrastate truckers, commercial driver's license holders, and other transportation workers.  In joint government agreements, the United States, Canada, and Mexico also monitor truckers crossing international borders.
 

The U.S. Department of Transportation regulations set the standard of practice for substance abuse testing of private workers in non-federally-regulated companies.  The DOT has updated drug testing procedures and expanded the role of the Medical Review Officer (MRO). MROCC certification is the ultimate mark of the MRO's competency and fulfills the requirement set forth in the Department of Transportation's revised 49 CFR Part 40 Rule:
"Following your completion of qualification training, you must satisfactorily complete an examination administered by a nationally-recognized MRO Certification board or subspecialty board for medical practitioners in the field of medical review of DOT-mandated drug tests. The examination must comprehensively cover all the elements of qualification training...