According to Quest Diagnostics Drug Testing Index Analysis, the rate of positive drug test results for Cocaine and Marijuana increased for federally mandated, safety-sensitive workers.

Drug positivity increases quicker in post-accident tests than pre-employment tests for cocaine, marijuana, opiates, and oxycodone amid pervasive recruiting and retention issues.

Based on a new analysis released by Quest Diagnostics, the world’s top provider of diagnostic information services, the rate of positive drug test results among the American workforce reached its highest rate last year since 2001 and was up more than 30% in the combined U.S. workforce from an all-time low in 2010-2012. It was up to 31.4% 10 years ago (2010-2012) from an all-time low of 3.5%. The overall positivity rate was up to 4.6% in 2021 compared to 4.4% in 2020.

The study reveals insights into workplace drug use as employers struggle to create a secure workplace. It examined more than 11 million de-identified urine, hair, and oral drug test results gathered between January and December 2021.

The total U.S. workforce consists of the federally required, safety-conscious workforce and the private employers’ company policy testing employees. The latter group consists of workers in the government, the nuclear industry, and the transportation sector, which includes train conductors, truck drivers, and pilots.

Overall, drug testing in the federally required, safety-conscious workforce was a consistent year over year (2.2 percent in 2020 and 2021). On the other hand, it was 4.8 percent higher than in 2017, when it was only 2.1 percent.

Drug Testing Index Reveals Notable Trends

Barry Sample, Ph.D., Senior Science Consultant for Quest Diagnostics, claims that our drug testing index reveals several noteworthy trends, including higher drug positivity rates in the workforce with a high safety concern, such as those working in national security and public safety, as well as higher positivity rates in people tested following on-the-job accidents.

According to Keith Ward, the General Manager and Vice President of Quest Diagnostics Employer Solutions, our data on the Drug Testing Index raises critical issues regarding what it means to be an employer dedicated to worker health and safety. As a result, employers may be tempted to compromise their standards to attract top talent. They also create the possibility of additional drug-related workplace impairment and accidents that endanger the public and other workers.

Drug Positivity Rates Increased in Several Testing Categories

For the federally mandated, safety-sensitive workforce in 2021, positivity rates increased in several drug categories despite five years of consistent declines. Cocaine increased by 5.0 percent, marijuana increased by 8.9 percent, and amphetamines decreased by 7.8 percent.

“It is important for workers to know that certain employers are required to test for marijuana under federal law and if they use marijuana, they can still lose their jobs,” said Dr. Sample. “People who use drugs during working hours or before work can still be impaired and dangerous to co-workers, the general public, and themselves.”

Positivity for Marijuana Rises in General U.S. Workforce

Based on more than 6 million urine tests, positivity rates for marijuana in the general U.S. workforce increased by 8.3 percent, the highest positivity rate ever reported. Over five years, positive attitudes toward marijuana in the U.S. workforce increased by 50%.

Positivity Decreases in Oral Fluid Testing

Based on oral fluid, the overall U.S. workforce’s positivity in 2021 was 7.3 percent, a 46.3 percent decrease from 2017. The decline in the number of pre-employment tests that included marijuana was the main factor in the fall in oral fluid positivity.

Drug detection windows for oral fluid tests are typically smaller than those for urine. It is also quicker than urine tests at detecting some drugs. In addition, the oral fluid collection has the benefit of being seen, which makes it more difficult to tamper with the testing procedure.

Greater Urine Test Positivity Rate for Post-accident Testing

Urine positivity rates for post-accident testing have increased over the past five years faster than pre-employment testing. Higher positive results on post-accident tests for cocaine, marijuana, and semi-synthetic opiates were the main contributors to the outcome. Pre-employment optimism rose by 17.4%, while post-accident optimism increased to 26%.

The prevalence of positive urine post-accident tests for marijuana and cocaine in the general American workforce increased by 63.4 percent and 266.7 percent, respectively, in 2021. Cocaine was 119 percent higher, and marijuana was 63.6 percent higher for the federally required, safety-conscious workforce.

Post-accident testing aims to determine whether drug use may have contributed to the workplace incident that prompted the drug test. Pre-employment drug tests discourage employers from hiring workers whose drug-using behaviour may result in risky working conditions or subpar performance.

“The increase in post-accident positivity is alarming and suggests more drug-associated accidents may be occurring even with employers with pre-employment drug testing in place,” said Dr. Sample. “The high cost of work accidents cannot be understated. While employers often think of accidents in terms of wage and productivity losses, medical expenses, and administrative expenses, accidents also impact morale, competitiveness, and recruiting. Given that employers are in a war for talent, creating a safe, healthful work environment is critical for attracting and retaining people.”

Mixed Picture for Cocaine Positivity in the General U.S. Workforce

In the general U.S. workforce, cocaine positivity determined by urine tests fell by 4.5 percent and 30 percent over the previous five years. However, for the first time in five years, the federally mandated, safety-sensitive workforce’s urine test positivity rates for cocaine increased by 5.0 percent.

Positivity Decreases for Opiates and Oxycodone

In the last five years, the percentage of workers in the general U.S. workforce who tested positive for opiates (codeine/morphine) by urine drug testing decreased by 19 and 56.4 percent, respectively. In 2021 and over five years, respectively, hydrocodone and hydromorphone use declined by 3% and 37.3%. However, oxycodone decreased by 52.5 percent over the previous five years and remained the same in 2020 and 2021.

Positivity Decreases for 6-AM (heroin) in the General U.S. Workforce

In the general U.S. workforce, the percentage of people who tested positive for 6-AM metabolite, also known as heroin, in urine tests decreased by 27.8% in 2021 and by 56.7 percent over five years. In addition, positivity fell by 37.5 percent in 2021 and 73.7 percent over the previous five years for the federally required, safety-sensitive workforce.

Highest Positivity for Retail Trade Among Key Industries

From 2017 to 2021, the positivity rate rose in 16 of the 17 industries. With a rise of 34.6 percent since 2017, the Retail Trade industry had the highest overall positivity rate in 2021, at 7%. The only sector from 2017 to 2021 to see an increase in methamphetamine positivity was this one, at 55.6%.

With a relative increase of 114.3 percent over five years, the Accommodation and Food Service industry had the highest workforce positivity toward marijuana at 7.5 percent.

Results showed a year-over-year decline in methamphetamine positivity in the health care and social assistance sector. Over the past five years, it has fallen by 50%.

Drug Testing Index Analysis

The Quest Diagnostics Drug Testing Index (DTI) is a series of reports providing information on trends in workforce drug usage based on positivity rates of deidentified laboratory tests conducted by Quest Diagnostics for several illicit, legal, and prescription drugs. It analyzes test results for three workers: those required by law to be safety-sensitive, the general U.S. workforce, and the total U.S. workforce. For example, pilots, bus and truck drivers, and employees in nuclear power plants are among the federally mandated, safety-sensitive workers subject to regular drug testing.

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