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Workforce Drug Test Positivity Reaches 20-Year High
The rate of positive drug test results among American workers in 2021 reached its highest level since 2001, according to data recently published by Quest Diagnostics.
Findings were based on 11 million deidentified urine, hair, and oral fluid drug tests collected between January and December of 2021.
Positive test results for the overall combined US workforce, based on nearly 9 million urine tests collected in 2021, increased to 4.6% in 2021 after climbing to 4.4% in 2020. Furthermore, the 2021 rate was 31.4% higher than 2010 to 2012, when the positive test rate was at an all-time low of 3.5%. The combined US workforce includes the general US workforce of mostly company-required testing by private employers, as well as federally mandated, safety-sensitive workforce, including federal employees, the transportation and nuclear power industries, pilots, truck drivers, train conductors, and others subject to drug tests under federal legislation.
“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 well-being,” Keith Ward, general manager and vice president, Quest Diagnostics Employer Solutions, said in a news release.
“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 harm’s way.”
After 5 years of steady declines, positivity rates for federally mandated, safety-sensitive workers increased in 2021. The overall rise was attributed to an 8.9% increase in positivity for marijuana, 7.8% for amphetamines, 5% for cocaine.
Positivity for marijuana in the general workforce increased by 8.3%, and the 3.9% positivity rate observed in 2021 was the highest ever recorded. Over the past 5 years, positivity for marijuana in the general workforce has increased by 50%, to 3.9% vs 2.6% in 2017.
In oral fluid testing, overall workforce drug positivity decreased, but positivity rates increased for marijuana, methamphetamine, and cocaine. Quest noted that while positivity in oral fluid tests dropped 46.3% compared with 2020, the drop largely was driven by a decline in the number of pre-employment tests that included marijuana. For those oral fluid tests that did include marijuana, the positivity rate for marijuana increased by 20.3% in 2021. Meanwhile, the positive rate for cocaine increased 46.6% (0.58% positive in 2020 to 0.85% in 2021), the highest recorded spike since 2006, and methamphetamine positivity increased to 0.67% from 0.53%, a 26.4% surge.
Other notable findings from the study included the following:
- Positivity rates in postaccident urine screenings increased at a greater rate than pre-employment testing over 5 years—a surge led by higher positivity rates on postaccident tests for marijuana, cocaine, and semisynthetic opiates.
- While positivity for cocaine based on urine tests for the general US workforce declined in 2021, rates among federally mandated, safety-sensitive workers increased for the first time in 5 years.
- Positivity rates for opiates, oxycodone, and heroin in the general US workforce have declined over the past 5 years.
- The overall positivity rate increased in 16 of 17 key industries from 2017 to 2021, with retail trade seeing the largest increase.
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