A history of substance use alone does not automatically warrant a Not Suitable recommendation. Clinicians should evaluate the totality of the applicant's history and current functioning.

Consider:

• Recency of use

• Frequency and quantity of use

• Type of substance(s)

• Pattern of use

• Evidence of dependence or addiction

• Treatment history

• Sustained abstinence or recovery

• Current lifestyle

• Judgment and decision-making

• Honesty and consistency during the evaluation

• Impact on occupational functioning

• Compliance with employer policies

Remote substance use followed by years of stability generally carries less clinical weight than recent or ongoing use.

Alcohol consumption becomes clinically significant when the quantity, frequency, or pattern raises concerns regarding judgment, reliability, workplace performance, or public safety.

Examples include:

• Frequent binge drinking

• Daily heavy alcohol use

• Drinking that interferes with emergency response availability

• Alcohol-related legal problems (e.g., DWI)

• Evidence of impaired judgment

• Alcohol used as a coping mechanism

• Failure to recognize problematic drinking patterns

The focus should be on occupational risk rather than moral judgment.

Marijuana use should be evaluated within the context of:

• Employer policy

• State and federal law

• Safety-sensitive job requirements

• Frequency of use

• Purpose of use (recreational vs. medical)

• Evidence of dependence

• Potential impairment

• Ability to comply with required drug testing

Legal recreational use does not automatically eliminate clinical or occupational concerns.

Continued marijuana use despite known employer restrictions may reflect poor judgment and disregard for policy.

If employer expectations are unclear, consult the agency before finalizing recommendations.

Substance use concerns become more significant when accompanied by:

• Recent substance-related offenses

• Ongoing alcohol or drug use

• Repeated legal violations

• Failure to comply with treatment

• Poor insight

• Minimization of behavior

• Lack of accountability

• Dishonesty during the evaluation

• Functional impairment

• Poor judgment

• Evidence of dependence

The combination of multiple risk factors generally warrants greater clinical concern than any single issue alone.

Historical substance use should always be interpreted within context.

Consider:

• Age at use

• Time since last use

• Frequency and severity

• Whether the behavior was experimental or habitual

• Evidence of rehabilitation

• Sustained sobriety

• Subsequent occupational success

• Absence of recurrence

Remote experimentation without evidence of ongoing misuse generally carries less weight than recent or persistent use.

Consistency between:

• self-report

• collateral records

• criminal history

• employment records

• medical documentation

is an important part of every evaluation.

Minimization, omissions, conflicting statements, or attempts to rationalize substance use may raise concerns regarding:

• Integrity

• Judgment

• Insight

• Accountability

In many cases, dishonesty about substance use is more clinically significant than the substance use itself.

Safety-sensitive positions require applicants who can consistently demonstrate sound judgment, emotional regulation, and readiness to respond during emergencies.

Clinicians should consider whether alcohol or drug use could reasonably interfere with:

• Emergency response availability

• Decision-making

• Emotional regulation

• Reaction time

• Reliability

• Public trust

• Compliance with agency policy

The assessment should focus on future occupational risk rather than solely on past behavior.

• Substance use history alone is not an automatic disqualifier.

• Evaluate patterns of use rather than isolated events.

• Give greater weight to recent and ongoing substance use than remote experimentation.

• Heavy alcohol use may impair judgment, emergency response capability, and occupational reliability.

• Marijuana use should always be considered within the context of employer policy and safety-sensitive job requirements.

• Honesty, accountability, and insight are often as important as the substance use itself.

• Multiple risk factors occurring together (e.g., ongoing use, legal history, minimization, poor judgment) generally warrant greater concern than any single issue.

• FMRT evaluates clinical suitability; the hiring agency determines employment decisions.