Workforce Drug Positivity Rate Highest Since 2004

Workforce use of illicit drugs across the board—including cocaine, marijuana and methamphetamine—has climbed to the highest rate in 12 years, a study by Quest Diagnostics found.

Overall positivity in urine drug testing among the combined U.S. workforce in 2016 was 4.2%, a 5% relative increase over last year’s rate of 4%—the highest annual positivity rate since 2004 (4.5%), according to an analysis of more than 10 million workforce drug test results.

“This year’s findings are remarkable because they show increased rates of drug positivity for the most common illicit drugs across virtually all drug test specimen types and in all testing populations,” Barry Sample, senior director of science and technology at Quest Diagnostics Employer Solutions, said in a statement. “Our analysis suggests that employers committed to creating a safe, drug-free work environment should be alert to the potential for drug use among their workforce.”

The positivity rate in urine testing for cocaine increased for the fourth consecutive year in the general U.S. workforce and for the second consecutive year in the federally-mandated, safety-sensitive workforce. Cocaine positivity increased 12% in 2016, reaching a seven-year high of 0.28%, compared to 0.25% in 2015 in the general U.S. workforce, and 7% among federally-mandated, safety-sensitive workers to 0.28% from 0.26% in 2015.

Marijuana positivity continued to climb in both the federally-mandated, safety-sensitive and general U.S. workforces. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75%, from 5.1% in 2013 to 8.9% in 2016 in the general U.S. workforce. Marijuana positivity also increased in both urine testing (2.4% in 2015 versus 2.5% in 2016) and hair testing (7.0% in 2015 versus 7.3% in 2016) in the same population. Among the federally-mandated, safety-sensitive workforce, which only uses urine testing, marijuana positivity increased nearly 10% (0.71% in 2015 versus 0.78% in 2016), the largest year-over-year increase in five years.

In Colorado and Washington, the first states in which recreational marijuana use was legalized, the overall urine positivity rate for marijuana outpaced the national average in 2016 for the first time since the statutes took effect. The national positivity rate for marijuana in the general U.S. workforce in urine testing increased 4% (2.4% in 2015 compared to 2.5% in 2016).

Positivity for amphetamines (which includes amphetamine and methamphetamine) continued a year-over-year upward trend, increasing more than 8% in urine testing in both the general U.S. and federally-mandated, safety-sensitive workforces compared to 2015. According to Quest, this rise over the past decade has been driven primarily by amphetamine use, including certain prescription drugs such as Adderall.

After four straight years of increases, in 2016, urine testing positivity for heroin held steady in the general U.S. workforce and declined slightly among federally-mandated, safety-sensitive workers.

Positivity for prescription opiates—including hydrocodone, hydromorphone and oxycodones—declined in urine testing among the general U.S. workforce. Oxycodones have seen four consecutive years of declines, dropping 28% from 0.96% in 2012 to 0.69% in 2016. Hydrocodone and hydromorphone both showed double-digit declines in both 2015 and 2016 (0.92% in 2015 to 0.81% in 2016) and (0.67% in 2015 to 0.59% in 2016), respectively.

This decline may be due to the fact that state and federal authorities have made efforts in the past few years to place tighter controls on opiate prescribing in order to address the opioid crisis.

Positive Workforce Drug Tests Reach 10-Year High

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An analysis of 11 million workforce drug tests reveals a 10-year high in positive test results, with an increase of 4%, according to the Quest Diagnostics Drug Testing Index (DTI). Post-accident positivity increased 6.2% in 2015, compared to 2014, and has jumped 30% since 2011.

The report found that amphetamine positivity increased 44% and marijuana positivity increased 26% since 2011; and that nearly half (45%) of individuals in the general U.S. workforce with a positive drug test for any substance in 2015 showed evidence of marijuana use.

Heroin positivity in that period increased 146%. The oxycodone positivity rate has declined annually since 2011, confirming previous research showing that opioid prescriptions have declined in 49 states since 2012, Quest said.

“The DTI statistics for the last five years underscore the threat to employers—and employees—from drug abusers in our workplace. The numbers on hair testing—the methodology with the longest look-back and therefore a more telling measurement of regular use—show a 34% positive-rate increase for illegal drug use by the general workforce in the last five years,” Mark de Bernardo, executive director of the Institute for a Drug-Free Workplace, said in a statement. “However, all the numbers for various testing methodologies confirm this disturbing trend and should provide a wake-up call to employers to do more to combat workplace substance abuse and to do it more effectively.”

Barry Sample, senior director of science and technology at Quest Diagnostics, noted:

  • The percentage of employees in the combined U.S. workforce testing positive for drugs has steadily increased over the last three years to a 10-year high of 4.0%.
  • According to analysis of urine drug test results, the rate of amphetamine, marijuana, and heroin detection has increased annually for the past five years.
  • Positivity rates for post-accident urine drug testing are rising in both the general U.S. and federally-mandated, safety-sensitive workforces; rates have increased 30% and 22%, respectively, since 2011.
  • Almost half (45%) of individuals in the general U.S. workforce with a positive drug test for any substance in 2015 showed evidence of marijuana.
  • Heroin positivity, indicated by the presence of the 6-AM marker, increased 146 percent between 2011 and 2015 in the general U.S. workforce.
  • The overall positivity rate for oral fluid testing increased 47% over the last three years in the general U.S. workforce—equating to almost one in 11 job applicants who are unable to pass an oral fluid drug screen.
  • Overall positivity in the general U.S. workforce was highest in hair drug tests, at 10.3% in 2015, a 7% increase over the previous year.

Marijuana’s Cost to Employers

With the adoption of more state laws to legalize marijuana, employers will face challenges to protect their employees from injury and to comply with federal requirements to maintain a drug-free workplace.

Employers also face potentially costly litigation as case law surrounding legal marijuana develops, according to the Quest Diagnostics whitepaper “What Will ‘Legal’ Marijuana Cost Employers?”

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Quest reports that medical marijuana legalization brought forth a new phenomenon: the production of marijuana-infused foods and gadgets, which presents a special problem for employers. Today, nearly half of marijuana users in states where it is legal consume marijuana by eating it rather than smoking it. In addition, vape pens, which are like e-cigarettes but contain capsules of concentrated marijuana oils, leave no marijuana smell and are impossible to tell apart from e-cigarettes. These two modes of consumption will make it more difficult, if not impossible, for employers to tell when employees are using marijuana on the job.

As marijuana use increases, so will workplace injuries, accidents, mistakes, and employee illnesses, escalating the costs of companies’ liability, workers’ compensation and health insurance.

Questions companies should ask include:

  • Will employers have to accommodate marijuana use in their workplaces? A closely watched case. Before the Colorado Supreme Court will establish, at least in Colorado, whether employees can use marijuana off the clock even if they may be impaired the next day.
  • Must employers pay for employees’ medical marijuana if they are injured on the job? By allowing a court of appeals decision to stand, the New Mexico Supreme Court finds that the answer is yes.
  • Must employers pay unemployment compensation to employees fired for failing a marijuana drug test?
  • What does increased adolescent marijuana use portend for the future workforce? Research shows that compared to nonusers, teens who smoke marijuana on weekends over a two-year period are six times more likely to drop out of high school, three times less likely to enter college, and four times less likely to earn a college degree?
  • How can employers meet federal requirements to maintain a drug-free workplace if states require proof of impairment rather than the presence of marijuana in the body when no level of impairment has been scientifically established and no noninvasive test to denote impairment has been developed?
  • If courts hold that drug testing is no longer a valid indicator of impairment, how can employers whose businesses involve driving or other safety-sensitive positions protect their workers and the public from injuries and deaths cause by stoned drivers?
  • What if courts hold that failing a pre-employment drug test is no longer a valid reason to deny employment to applicants?

There are, however, steps employers can take to protect themselves:

1) Stay up-to-date with the changing legal landscape and adjust workplace policies accordingly.

2) Remember that marijuana is still illegal under federal law.

3) Join other employers to monitor state legislation and take action with legislators to ensure workplace protections are included in any marijuana laws.

4) Educate your workforce about the dangers marijuana poses to children, families and the workplace.

5) Challenge the notion that marijuana is medicine, or risk paying for it in your health insurance program. No marijuana medicines being sold in states that legalized them have been approved by FDA as pure, safe, or effective. Doctors cannot prescribe them and pharmacies cannot sell them.

Quest Data Shows Rise in Positive Test Rates for Workplace Illicit Drugs

Organizations in the United States that tested employees for drugs saw a 9.3% jump in the number of positive drug tests for illicit drugs in the general workforce, to 4.7% in 2014 from 4.3% in 2013, according to data from Quest Diagnostics. These results may mark a rising trend, as 2013 was the first year since 2003 in which the overall positivity rate for about 1.1 million tests increased in the general U.S. workforce. The analysis shows a potential reversal of a decades-long decline in the abuse of illicit drugs in the U.S. workforce, Quest said.

“American workers are increasingly testing positive for workforce drug use across almost all workforce categories and drug test specimen types. In the past, we have noted increases in prescription drug positivity rates, but now it seems illicit drug use may be on the rise, according to our data,” Dr. Barry Sample, director of science and technology at Quest Diagnostics Employer Solutions, said in a statement. “These findings are especially concerning because they suggest that the recent focus on illicit marijuana use may be too narrow, and that other dangerous drugs are potentially making a comeback.”

While marijuana continues to be the most commonly detected illicit drug, others include cocaine, methamphetamine and heroin, Quest reported, noting that across all specimen types, the positivity rate for amphetamines is now at the highest levels on record and the positivity rate for methamphetamine is at its highest level since 2007. Amphetamines make up the category that includes both prescription amphetamine drugs like Adderall as well as methamphetamine. The positivity rate for 6-acetylmorphine, or 6-AM, a specific marker for heroin, doubled in the general U.S. workforce between 2011 and 2014, According to Quest.

In urine drug test data from two states with recreational marijuana-use laws, Colorado and Washington, the marijuana positivity rate increased 14% and 16%, respectively, in the general U.S. workforce between 2013 and 2014. This roughly paralleled the national average of 14.3%. By comparison, between 2012 and 2013, the marijuana positivity rate increased 20% and 23% in Colorado and Washington, respectively, compared to the national average of 5%, Quest said.

“We were surprised that marijuana positivity increased at about the same rate in Colorado and Washington as the rest of the United States in 2014, particularly given the sharp increases in the marijuana positivity rate in both of these states in the prior year,” Dr. Sample said. “It’s unclear if this data suggest a leveling off in marijuana use in these particular states or if some other factor is at work. We also find it notable that the national marijuana positivity rate increased as much as it did in 2014, and question if this means that people are more accepting and therefore more likely to use marijuana recreationally or for therapeutic purposes than in the past even in states where marijuana’s use is not clearly sanctioned by state laws. This will be an important area of continued analysis given the national debate about the legality and health impacts of recreational and medicinal marijuana use.”