Workforce Drug Test Positivity Climbs to Highest Level in Two Decades

The rate of positive drug test results among America’s 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, according to a new analysis released on March 30 by Quest Diagnostics.

The study, based on more than 11 million deidentified urine, hair, and oral fluid drug test results collected between January and December 2021, offers revealing insights into workforce drug use as employers grapple with creating safe work environments amid an ongoing recruitment and retention crisis.

The overall positivity rate in the combined U.S. workforce, based on nearly nine million urine drug tests collected between January and December 2021, was up in 2021 to 4.6% compared to 4.4% in 2020 and up 31.4% from the all-time low of 3.5% just 10 years ago (2010-2012).

The combined U.S. workforce includes the general U.S. workforce of mostly company-policy testing by private employers as well as the federally mandated, safety-sensitive workforce, which includes federal employees and the transportation and nuclear power industries, and can include workers such as pilots, truck drivers, train conductors, and others required to drug test under federal legislation.

The water well industry is largely composed of family businesses. The Federal Motor Carrier Safety Administration Drug and Alcohol Clearinghouse provides a link between states and enables employers to obtain access to vital drug and alcohol violations.

For an interactive map of the Drug Testing Index with positivity rates and trend lines by drug categories and three-digit ZIP code in the United States, visit

“Our Drug Testing Index reveals several notable trends, such as increased drug positivity rates in the safety-sensitive workforce, including those performing public safety and national security jobs, as well as higher rates of positivity in individuals tested after on-the-job accidents,” said Barry Sample, Ph.D., senior science consultant for Quest Diagnostics.

“Employers are wrestling with significant recruitment and retention challenges as well as with maintaining safe and engaging work environments that foster positive mental and physical wellbeing,” added Keith Ward, general manager and vice president of Quest Diagnostics Employer Solutions.

“Our Drug Testing Index data raises important questions about what it means to be an employer committed to employee health and safety. Eager to attract talent, employers may be tempted to lower their standards. In the process, they raise the specter of more drug-related impairment and worksite accidents that put other employees and the general public in harms’ way.”

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