Positive Workplace Drug Tests Hit 16-Year High

​U.S. workers tested positive for drug use in 2019 at the highest rate since 2003, according to annual drug-testing results compiled by Quest Diagnostics, a laboratory based in Secaucus, N.J. Positive test results have been steadily rising since 2013, and experts believe the 2020 data will show even higher rates, due to the coronavirus pandemic.

"There is no question that before COVID-19, rates of workplace drug positivity were trending in the wrong direction, based on our data," said Dr. Barry Sample, senior director of science and technology for Quest Diagnostics. "The enormous strain caused by COVID-19 may prove to be an accelerant on this disturbing trend. Organizations will need to consider the impact of COVID-19 not only on workplace safety but also as a health concern for their employees for some time to come."

Positive rates for marijuana use in 2019 climbed by double digits across nearly all employee testing categories, while positive rates for opiates declined.

"As expected, marijuana was the most detected drug, including in states where marijuana remains illegal," said Catherine Cano, an attorney in the Omaha, Neb., office of Jackson Lewis. "The study reported a surge in positive results in the Midwest for cocaine, methamphetamine and marijuana … [and] a decline in positive opioid tests for 2019. The report also highlighted the industries producing the most positive results. Retail had the overall highest positive rate, and the accommodations and food service sector had the highest positive rate for marijuana."

Positive Rates Going Up Overall

Based on an analysis of nine million drug tests conducted in 2019, Quest determined that 5.3 percent of the general workforce tested positive for illicit drugs (up from 5.1 percent in 2018) and another 2.4 percent of workers in safety-sensitive positions regulated by federal law did so. That's down from 2.7 percent in 2018. Those in safety-sensitive jobs include pilots; rail, bus and truck drivers; and workers in nuclear power plants.

The combined data from the general and safety-sensitive workforce demographics show that, overall, 4.5 percent of the U.S. workforce had positive drug screens in 2019, the highest such rate since 2003 but a far cry from Quest's first drug-testing analysis in 1988, when the drug positivity rate was 13.6 percent.

Marijuana continues to top the list of the most-detected illicit substances across all workforce categories and specimen types—urine, oral fluid and hair. The number of workers and job applicants overall who tested positive for marijuana rose to 2.5 percent from 2.3 percent.

"Changing attitudes toward marijuana use could pose heightened risks, especially in safety-sensitive positions and those states exploring legalization," Sample said.

In addition:

• The positivity rate for methamphetamine use stayed the same at 1.1 percent.
• The positivity rate for cocaine fell to .26 percent in 2019 from .28 percent in 2018.
• The positivity rate for opiates (mostly codeine and morphine) fell to .35 percent in 2019 from .46 percent in 2018.

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"The report provided encouraging results on the types of testing triggering positive results," Cano said. "As in prior years, for-cause testing produced the highest percentage of positive results, followed by follow-up and return-to-duty testing." Pre-employment and random testing produced the least positive tests.

Dark Forecast

Cano said that while the opioid trend is promising, there is concern about how the COVID-19 pandemic will influence opioid use as well as other illicit substances. She cited a recently published report from the National Institute of Environmental Health Sciences, which stated that in the last two months, at least 30 states have reported increases in opioid fatalities since the start of the pandemic.

"The institute also identified multiple COVID-19-related factors that are likely driving these trends, including social isolation, loss of in-person recovery meetings, anxiety, loss of contacts, work-related stress like loss of income, fear of being infected with COVID-19 and work-related ergonomics related to remote work," she said.

The findings generally align with other research, Sample said. "Drug deaths in the United States rose 5 percent in 2019, driven largely by methamphetamine, cocaine and fentanyl, following a decline in 2018. During the first few months of 2020, drug deaths increased about 13 percent compared with last year, attributable partly to social isolation and other disruptions caused by COVID-19."

Cano said that some employers have decreased or stopped conducting drug testing during the pandemic. However, as the country begins to reopen it may be a good time to reassess the best strategies to minimize drug use in the workplace. "One part of the solution includes supporting employees who may be faced with stressful personal circumstances, including offering resources to deal with stress, such as employee assistance programs," she said. "It may also be a good time to review drug-testing programs and consider how to make those programs more effective in the world of remote work."