Hey George - It took me a while on this one, but I had to do my research. The Source of this reply is from the Federal Motor Carriers Safety Regulations - so here goes...
In the eyes of the DOT, refusal to take an employers alcohol or drug screen is the same as an admission of guilt - and it as viewed the same as if your test result was positive for a controlled substance.
This will stay on your record, but there is a way to make it stop affecting your career path. You must consult a substance abuse professional and be screened to see if you have a problem - If so you must satisfactorily rehabilitate yourself through whatever course your substance abuse counselor deems neccessary.
When the substance abuse professional determines that you are satisfactorily rehabilitated, and this is provided to you in written documentation, you must provide this information to a prospective employer and submit to subsequent drug screenings as dictated by your employer.
If a substance counselor will give you a letter stating that you are rehabilitated or do not have a problem - That is acceptable by the DOT. Just make sure you have every piece of documentation through every step of the process. It may be an expensive solution, but it is a solution. I hope this helps - X