Drug test positivity rates among U.S. workplaces have increased by more than 30% compared to 2010-2012. That’s according to Quest Diagnostics’ 2022 Drug Testing Index (DTI), which is based on more than 11 million hair, oral and urine drug test results collected throughout 2021.
One of the most striking statistics is that drug positivity for post-accident workplace tests rose at a faster rate than preemployment tests for marijuana, cocaine, opiates and oxycodone over a five-year period.
Key findings of the DTI
The DTI indicates that:
- In 2021, the post-accident urine test positivity rate for marijuana was 63.4% higher than it was for preemployment tests. For cocaine, the difference was even greater: 266%.
- For opiates (hydrocodone/hydromorphone), post-accident positivity was 316.7% higher than it was for preemployment tests. For oxycodones (oxycodone/oxymorphone), positivity rates were 200% higher than for preemployment tests.
Even among federally mandated “safety-sensitive” roles, post-accident positivity rates for marijuana, cocaine and opiates went up compared with preemployment tests. (Safety-sensitive job roles are required to test under federal law. They include public safety and national security-related functions, such as federal employees, pilots, train conductors, truck drivers and many other transportation and nuclear-sector employees.)
These findings serve as an important reminder for workplaces to be proactive about on-the-job drug use that could impair an employee and lead to an occupational accident or injury.
Here are some other noteworthy findings from Quest’s drug test result data:
- Positivity rates for marijuana in the general U.S. workforce (based on more than 6 million urine tests) rose to 8.3%, the highest positivity rate ever reported in Quest’s DTI.
- The overall workforce drug positivity for oral fluid testing decreased, but for marijuana, methamphetamine and cocaine the positivity rate increased. These tests have a shorter window than urine tests and may detect drugs faster (often in a matter of minutes), making it more difficult for a worker to subvert the testing process.
- Positivity for marijuana continues to increase in the general U.S. workforce across all industries, with double-digit increases in 15 industries between 2017 to 2021. The accommodation and food service industries had the highest workforce positivity rates for marijuana, at 7.5%.
The retail trade industry had the highest positivity rate among key industries, and was the only industry to experience a year-over-year rise in methamphetamine positivity. From 2017 to 2021, the positivity rate went up by 55.6% (.09% in 2017 to .14% in 2021).
Workplace drug testing compliance refresher
Given the prevalence of drug use detected in Quest’s study, it’s a good time for a refresher on workplace drug testing regulation.
When you can test
In a 2018 memo, the Occupational Safety and Health Administration clarified that drug testing doesn’t have to be related to a workplace injury. Employers also have the right to conduct:
- Preemployment drug testing
- Random drug testing
- Any testing mandated under federal law
Testing after an incident
When a workplace incident occurs, employers have the right to conduct a drug test to determine the root cause. But if an employer wants to conduct a drug test under these circumstances, all workers whose conduct may have contributed to the incident must be tested, and not just those who reported the incident or related injuries. Testing only those who reported the incident could be construed as retaliatory, and in violation of the Occupational Safety and Health Act.
Reasonable accommodations under the ADA
Just because a job applicant tests positive for a specific drug doesn’t necessarily mean the employer can rule them out. An applicant may be able to take a prescription medication lawfully and be protected from employment discrimination under the Americans with Disabilities Act (ADA). If an employer automatically disqualifies an applicant solely due to the presence of drugs in their system, this could be grounds for a discrimination claim. The Equal Employment Opportunity Commission may also scrutinize the employer’s drug testing policy or the manner in which the drug screening was performed.
The key thing to remember is that if the use of the drug does not pose a safety or health threat to the workplace, allowing the employee to take a legally prescribed medication while working may constitute a reasonable accommodation under the ADA.
Beyond drug testing
It’s important to take a holistic approach to the issue of drug use in the workplace. That means not just focusing on drug testing, but also on employee assistance, education and outreach, as well as supervisor and employee training on the dangers of working while impaired.
Tips from the National Safety Council
The NSC offers an Employer Toolkit on developing drug testing policies and procedures, which discusses issues such as:
Choosing the right type of test
There are three main types to choose from:
- Urine tests
- Most common type of drug test
- Can detect an array of drugs
- Results may not be reliable unless observed collection is used
- Oral fluid tests
- Only available for certain drugs
- More easily administered (and less invasive)
- Hair tests
- Cost more
- Can detect drugs used up to 90 days before the test is administered
- Not as effective for benzodiazepines (psychoactive drugs commonly used for treating anxiety disorders)
Compiling the drug panel
The NSC recommends testing for substances that are common in your area, which may include:
- Illegal opiates
- Cocaine, amphetamines and other stimulants
Important note about testing for THC: The NSC advises employers to seek legal counsel before testing for THC, since there are a growing number of states where recreational marijuana is legal.
Deciding when to test
Depending on the type of industry, job function, state and local regulations, and other factors, an employer may choose to test at one or several junctures:
- Before making a job offer
- At random
- Due to reasonable suspicion
- After a return to work (as part of a fitness for duty exam)
- After a workplace incident
- On a routine basis (as required for certain job roles or functions)
Making a “last chance” agreement
A positive drug test doesn’t necessarily have to end in termination. An employer may choose to enact a “last chance” policy whereby the employee who tested positive can keep their job as long as they meet certain conditions, such as:
- Participating in a treatment program
- Submitting to regular drug tests going forward
- Having their progress monitored by an employee assistance program or other third party
Crafting a return-to-work policy
If an employee is returning to work after starting or completing treatment, the employer should:
- Clearly document performance requirements so there’s no question as to whether the employee is meeting expectations
- Request a return-to-work release from the employee’s treating physician or another medical professional
- Discuss reasonable accommodations with the employee, such as flexible work hours, coming back part time or working remotely
Making sure you’re in compliance
Lastly, the NSC offers these compliance tips:
- Work closely with your legal counsel to develop your testing program
- Keep employee records private
- Stay appraised of federal, state and local regulations
- If applicable, stay appraised of any union or industry regulations
Give your testing program the attention it deserves
With more workers testing positive for drugs, it’s more important than ever for employers to be judicious about testing and training. It could make the difference in preventing an unnecessary workplace injury — or worse.
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