Workforce Drug Testing Positivity Climbs to Highest Rate Since 2004

The rate of workforce drug positivity hit a 14-year high in 2018, according to a new analysis released on April 11 by Quest Diagnostics.

Positivity rates in the combined U.S. workforce increased nearly 5 percent in urine drug tests (4.2 percent in 2017 versus 4.4 percent in 2018), climbing to the highest level since 2004 (4.5 percent). The rates are now more than 25 percent higher than the 30-year low of 3.5 percent recorded between 2010 and 2012.

“Our in-depth analysis shows that marijuana is not only present in our workforce, but use continues to increase,” said Barry Sample, Ph.D., senior director, science and technology of Quest Diagnostics. “As marijuana policy changes, and employers consider strategies to protect their employees, customers, and the general public, employers should weigh the risks that drug use, including marijuana, poses to their business.”

Marijuana continues to top the list of the most commonly detected illicit substances across all workforce categories (general U.S. workforce; federally mandated, safety-sensitive workforce; and combined U.S. workforce, which includes the prior two populations) and specimen types (urine, oral fluid, and hair).

The rate of marijuana positivity increased in nearly all workforce categories. In the general U.S. workforce, marijuana positivity increased nearly 8 percent in urine testing (2.6 percent in 2017 versus 2.8 percent in 2018) and almost 17 percent since 2014 (2.4 percent). For the federally mandated, safety-sensitive workforce, which utilizes only urine testing, marijuana positivity grew nearly 5 percent between 2017 (0.84 percent) and 2018 (0.88 percent) and nearly 24 percent since 2014 (0.71 percent).

In the general U.S. workforce, the positivity rate for opiates in urine drug testing declined across all opiate categories. Among the general workforce screening for opiates (mostly codeine and morphine), positivity declined nearly 21 percent between 2017 and 2018 (0.39 percent versus 0.31 percent), the largest drop in three years and nearly 37 percent decrease since the peak in 2015 (0.49 percent).

Among the more specific tests for other prescription opiates, the positivity for the semi-synthetic opiates (hydrocodone and/or hydromorphone) declined 2 percent between 2017 and 2018 (0.51 percent vs. 0.50 percent) and 43 percent since the five-year high in 2014 (0.88 percent). Similarly, the positivity for oxycodones (oxycodone and/or oxymorphone) declined more than 29 percent between 2017 and 2018 (0.61 percent vs. 0.43 percent) and more than 46 percent since the five-year high in 2014 (0.80 percent).

Urine drug test results for the general U.S. workforce for heroin, indicated by the presence of the 6-acetylmorphine (6-AM) metabolite, declined 6 percent (0.033 percent in 2017 versus 0.031 percent in 2018) and more than 16 percent since its peak in 2015 and 2016 (0.037 percent). Cocaine positivity declined nearly 7 percent in urine and more than 19 percent in oral fluid testing but increased slightly year-over-year (6.3 percent) in hair testing.

Both heroin and cocaine positivity in the federally mandated, safety-sensitive workforce showed large declines between 2017 and 2018. Heroin positivity declined nearly 32 percent between 2017 and 2018 (0.019 percent versus 0.013 percent), with a decrease of more than 43 percent since 2015 (0.023 percent). 2018 positivity for cocaine declined nearly 10 percent compared with 2017 (0.31 percent versus 0.28 percent), when the positivity rate was the highest in more than five years.

Click to view an interactive map with positivity rates and trend lines by three-digit zip code in the United States.

The June issue of Water Well Journal will feature a Safety Matters column on opioids and the workplace.