Fewer Workers Test Positive for Prescription Opioid Use

Positive marijuana tests are up in states where the drug has been legalized

Roy Maurer By Roy Maurer June 4, 2018
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​Fewer workers tested positive for prescription opioid use in 2017 than the year before, but overall, workers are still using drugs at the highest rate since 2004, according to the annual Quest Diagnostics Drug Testing Index.

Based on an analysis of over 10 million drug tests conducted in 2017, Quest determined that 5 percent of the general workforce tested positive for drugs, while 2.1 percent of workers in safety-sensitive positions regulated by federal law did so. These occupations include pilots; rail, bus and truck drivers; and workers in nuclear power plants.

The combined data from the two workforce demographics show that 4.2 percent of the U.S. workforce had positive drug screens in 2017, the same as 2016 but a far cry from Quest's first drug-testing analysis in 1988, when the drug positivity rate was 13.6 percent.

The 2017 data also suggest shifting patterns of drug use, with cocaine and amphetamines positivity surging in some areas of the country and marijuana positivity rising sharply in states with recreational-use laws.

Rates of decline appear to have bottomed out, said Barry Sample, senior director of science and technology at Quest Diagnostics. "These changing patterns and geographical variations may challenge the ability of employers to anticipate the drug of choice for their workforce or where to best focus their drug prevention efforts to ensure a safe and healthy work environment," he said.

This makes it critical for employers to review their substance-abuse policies and drug-testing practices, experts said.

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Prescription Opioid Use Continues to Fall

The number of people testing positive for opioids other than codeine fell to its lowest point in more than a decade, according to the data. Positive tests for oxycodone declined 12 percent year-over-year, positivity for hydrocodone dropped 17 percent, and the positive rate for hydromorphone fell 22 percent.

The decline in positive tests "supports the possibility that efforts by policymakers, employers and the medical community to decrease the availability of opioid prescriptions and curtail the opioid crisis are working to reduce their use, at least among the working public," said Kimberly Samano, scientific director at Quest Diagnostics.

According to the Centers for Disease Control and Prevention, the national opioid prescribing rate in 2017 fell to the lowest it had been in more than 10 years, though rates vary by state and are high in some areas of the country.

The number of workers who tested positive for heroin also declined nearly 11 percent in 2017 from the previous year. The positive-test rate for cocaine, however, increased for the fifth consecutive year. In urine testing, the most common drug-test specimen type, the positive-test rate for cocaine increased 7 percent from 2016. Among federally mandated, safety-sensitive workers, for which only urine testing is permitted, cocaine positivity increased by 11 percent, representing the third consecutive year of increases for this segment of the workforce.

Marijuana Use up Where It's Legal

Positive test results for marijuana use continue to rise for both the general U.S. workforce and in regulated, safety-sensitive industries. The number of people testing positive for marijuana increased 4 percent in the general U.S. workforce and nearly 8 percent in the safety-sensitive workforce.

Increases in positive test results for marijuana among the general workforce were most evident in states that have enacted recreational-use laws since 2016, including Nevada (43 percent), Massachusetts (14 percent) and California (11 percent). These three states also saw significant increases in marijuana use for regulated, safety-sensitive workers.

"These increases are similar to the increases we observed after recreational marijuana-use statutes were passed in Washington [state] and Colorado," Sample said. "While it's too early to tell if this is a trend, our data suggest that the recreational use of marijuana is spilling into the workforce."

Marijuana Law Compliance

Over 30 states have legalized medical or recreational marijuana or both, and at least one state has effectively nullified pre-employment screening for the drug. Caesars Entertainment, the gaming corporation based in Las Vegas that owns and operates over 50 casinos and hotels, is the latest company to respond to the shift by announcing that it will no longer test applicants for marijuana. "A number of states have changed their laws, and we felt we might be missing some good candidates because of the marijuana issue, and we felt that prescreening for marijuana was, on the whole, counterproductive," said Rich Broome, executive vice president of corporate communications and community affairs for Caesars.

Many employers are pondering removing marijuana from pre-employment drug screens.

Howard Mavity, a partner in the Atlanta office of Fisher Phillips, says for most employers the answer should be no. "But because this is an area of the law that will continue to be tested in the courts, particularly in states with statutes protecting employees who engage in lawful off-duty conduct, you should consult with counsel when developing personnel policies and when deciding whether to take action regarding a specific incident."

He advised HR to stay informed on state-specific marijuana laws, develop state-appropriate policies for all applicants and employees, and apply marijuana policies in a uniform manner.

And while each state is different and the law may be starting to shift, generally employers have the right to require a drug-free workplace and enforce zero-tolerance policies. "Be careful, however, if your state law includes specific protections for medical-marijuana users or offers protections for lawful off-duty conduct," Mavity said.

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