Fentanyl Positivity Falls by Half in U.S. Workplace Drug Tests

Fentanyl use has significantly declined in U.S. workplace drug test results, according to the 2026 Quest Diagnostics Drug Testing Index.

The analysis of about 8 million tests conducted in 2025 by Secaucus, N.J.-based Quest Diagnostics, one of the country’s largest drug-testing laboratories, found that year-over-year fentanyl positivity decreased by nearly half in the general U.S. workforce.

“We’re encouraged to see this significant decline in workforce fentanyl positivity, which reflects the collective impact of ongoing efforts to protect and champion employee health and safety,” said Claire Bryant, senior program manager of workplace wellbeing at the National Safety Council in Itasca, Ill. “Employers play a critical role in addressing the root causes of substance misuse through supportive policies, benefits and recovery.”

The decline may indicate that employers are taking steps to address fentanyl use through expanded testing, education, and deterrence strategies.

Fentanyl has proliferated in the U.S. in recent years, and most overdose deaths are estimated to involve illegally manufactured fentanyl, according to the Centers for Disease Control and Prevention. Beginning in July 2025, the U.S. Department of Health and Human Services added fentanyl to its authorized drug testing panels for federal workplace drug-testing programs. 

Overall workforce drug positivity dipped in 2025 to 4.3%, down from 4.4% in 2024. The rate was 4.6% from 2021-2023 and has stubbornly remained at 4% or higher since 2015.

Marijuana positivity in the general U.S. workforce (not including regulated, safety-sensitive positions) fell from 4.5% in 2024 to 4.4% in 2025. Marijuana remains the most frequently detected substance year-after-year by far.

Marijuana positivity following workplace accidents also remained high at 7.4% in 2025, just slightly below the record high of 7.5% in 2023.

In April, the acting U.S. attorney general signed an order to change the federal classification of medical marijuana from Schedule I to Schedule III under the Controlled Substances Act and also announced an administrative hearing to more broadly assess whether all marijuana should be reclassified to Schedule III. Such reclassification could affect the ability to test for cannabis in federal programs.

Amphetamine positivity increased to 1.8% in 2025, up from 1.7% in 2024, while cocaine positivity and the positivity of several opioids showed declines.

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Alternative Testing Methods Reveal Higher Rates of Drug Use

In the general U.S. workforce, marijuana positivity was found at significantly higher levels in alternative collection methods to urine testing, including 11.1% in oral fluid and 15.1% in hair testing.

Nearly one in five workers (19.1%) tested positive for drug use overall based on an analysis of hair specimens collected in 2025. Marijuana accounted for 52.5% of hair drug positives in 2025.

The findings suggest that a sizable share of the U.S. workforce is using drugs, principally marijuana, on a recurring or chronic basis, according to Quest. While traditional urine testing methods only capture drug use within a window of several hours or days, hair analysis provides an extended detection window that delivers a long-term history of substance use patterns over extended periods.

“Hair and oral fluid testing not only capture different windows of use but are also more resistant to tampering and substitution than traditional methods. This gives employers more accurate insight into safety risks,” said Jason Hudson, scientific director and laboratory director, workforce solutions, at Quest Diagnostics. “That matters because substance use in the workplace doesn’t just affect productivity; it can directly impact safety, decision-making, and the well-being of employees, particularly in safety-sensitive roles where even small lapses can have serious consequences.”

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Drug Positivity Varies by Industry

Industry-level data showed that drug positivity is not evenly distributed across the general workforce, with certain sectors facing higher rates and therefore potentially greater risk. Healthcare workers had the highest overall positivity rate of any industry (5.8%), followed by retail trade (5.4%), and professional and technical services (5.3%), while lower rates were observed in manufacturing (4.2%) and transportation and warehousing (4.2%).

Retail trade had the highest marijuana positivity among worker categories, at 7.6%.