Workforce Drug Test Positivity Hits Two-Decade High

An increase in positive drug tests for marijuana seen in the general U.S. workforce started the same year the first states legalized recreational use.

The percentage of employees in the general U.S. workforce testing positive for marijuana following an on-the-job accident increased to its highest level in 25 years in 2022, according to a new analysis by Quest Diagnostics.

The Quest Diagnostics Drug Testing Index™ (DTI) provides insights into trends in workforce drug use based on positivity rates of deidentified laboratory tests performed by Quest Diagnostics for a range of illicit, legal and prescription drugs. It examines test results according to three categories of workers: federally mandated, safety-sensitive workers; the general U.S. workforce; and the combined U.S. workforce. Federally mandated, safety-sensitive workers include pilots, bus and truck drivers, and workers in nuclear power plants.

workplace drug testing
2022 Quest Diagnostics Drug Testing Index™ Overview. (click to enlarge)

 

In 2022, post-accident marijuana positivity of urine drug tests in the general U.S. workforce was 7.3%, an increase of 9% compared to 6.7% in 2021. The new peak follows a steady increase in post-accident marijuana positivity every year from 2012 to 2022. In that 10-year time frame, post-accident marijuana positivity increased 204.2%. From 2002 to 2009, post-accident marijuana workforce positivity declined.

These increases in post-accident marijuana positivity correspond with legalization of marijuana in certain states. In 2012, Colorado and Washington became the first states to legalize marijuana for recreational use. Since then, 19 additional states and the District of Columbia have legalized the recreational use of marijuana and 38 states (plus DC) have legalized medical use, although either kind of use remains illegal under federal law.

“Intoxicating cannabis products, including marijuana, can have a major impact on safety at work and have been proven to slow reaction time, impact memory and impair skills essential to driving. State legalization of the drug creates new challenges for employers,” said Katie Mueller, a senior program manager at the National Safety Council focusing on cannabis safety. “The Quest data provide compelling evidence that increased use of cannabis products by employees can contribute to greater risk for injuries in the workplace. It is imperative employers take the proper steps to create and maintain a policy that addresses cannabis use, build a safety-focused culture and educate the workforce to keep all workers safe on and off the job.”

 

 

“Intoxicating cannabis products,
including marijuana, can have a major impact on safety at work and have been proven to slow reaction time, impact memory and impair skills essential to driving. State legalization of the drug creates new challenges for employers.”

— Katie Mueller, NSC

 

In 2022, the combined U.S. workforce urine drug positivity for all drugs persisted at 4.6% – the highest level in two decades. The 2021 and 2022 positivity rates were the highest since 2001, up more than 30% from an all-time low in 2010-2012.

While marijuana was the main driver of workforce positivity increases in the general U.S. workforce, amphetamines positivity also contributed to the increase. Positivity for marijuana in the general U.S. workforce increased 10.3% (4.3% positivity in 2022 versus 3.9% positivity in 2021) and amphetamines positivity increased 15.4% (1.5% positivity in 2022 versus 1.3% positivity in 2021). While the company’s amphetamines data does not differentiate between prescribed medications and illicit drug use, the increase correlates with other data suggesting that the use of amphetamines, prescribed or illicit, has grown in recent years in the U.S.

Marijuana, Amphetamines Positivity Climbed In Key Industries

The rising overall drug positivity rate for general workforce urine testing was observed widely across U.S. industries. Over the past five years, the workforce positivity rate climbed in most industry sectors, led by Accommodation and Food Services increasing 42.9% (4.9% in 2018 versus 7.0% in 2022), Retail Trade increasing 42.6% (5.4% in 2018 versus 7.7% in 2022), and Finance and Insurance increasing 38.5% (2.6% in 2018 versus 3.6% in 2022).

In the general U.S. workforce, marijuana positivity increased 10.3% year over year (3.9% in 2021 versus 4.3% in 2022). Marijuana positivity increased 11.8% (5.1% in 2021 versus 5.7% in 2022) in states in which recreational marijuana is legal and 8.3% (3.6% in 2021 versus 3.9% in 2022) in states in which medical marijuana is legal. In states in which neither recreational nor medical marijuana is legal, marijuana positivity increased 3.3% (3.0% in 2021 versus 3.1% in 2022) year over year and 14.8% over five years (2.7% in 2018 versus 3.1% in 2022).

workplace drug use by industry
Source: 2022 Quest Diagnostics Drug Testing Index™ (click to enlarge)

 

In the federally mandated safety-sensitive workforce, marijuana positivity increased nationally 14% year over year (0.86% in 2021 versus 0.98% in 2022). Marijuana positivity increased 17% (0.94% in 2021 versus 1.1% in 2022) in states in which recreational marijuana is legal. Marijuana positivity increased 5.9% (0.85% in 2021 versus 0.90% in 2022) in states in which medical marijuana is legal. In states in which neither recreational nor medical use marijuana is legal, marijuana positivity increased 12.7% (0.79% in 2021 versus 0.89% in 2022) year over year and 1.1% over five years (0.88% in 2018 versus 0.89% in 2022).

“In the general U.S. workforce, states that have legalized recreational and medical marijuana use exhibit higher positivity rates than the national average. States that have not legalized marijuana appear to have positivity rates below the national averages,” said Suhash Harwani, PhD, Senior Director of Science for Employer Solutions at Quest Diagnostics. “Overall, post-accident and pre-employment positivity test rates among the federally mandated, safety-sensitive population have always been lower, suggesting the expectation of testing may be a deterrent.”

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Attitudes About Marijuana Impacting Workplace Behaviors?

Quest Diagnostics has analyzed annual workplace drug testing data since 1988 and publishes the findings as a public service. The latest report is based on more than 10.6 million drug test results reported between January and December 2022.

“Our 2022 Quest Diagnostics analysis shows that the overall U.S. workforce positivity rate continued to be at a historically elevated level in 2022, even as much of the nation’s workforce returned to the office post-pandemic,” said Keith Ward, General Manager and Vice President for Employer Solutions at Quest Diagnostics. “This historic rise seems to correspond with sharp increases in positivity for marijuana in both pre-employment and post-accident drug tests, suggesting that changing societal attitudes about marijuana may be impacting workplace behaviors and putting colleagues at risk. The increase in amphetamines positivity is also notable, given the addictive potential and health risks associated with this class of drugs.”

 

“This historic rise seems to correspond with sharp increases in positivity for marijuana in both pre-employment and post-accident drug tests, suggesting that changing societal attitudes about marijuana may be impacting workplace behaviors and putting colleagues at risk.”

— Keith Ward, Quest Diagnostics

 

 

“Year-over-year and five-year data point to continuously higher workforce drug positivity overall, by industry, and across multiple drug categories,” said Dr. Harwani. “As employers express concern for employee health, wellness and safety, they may want to consider these data as a warning sign, particularly as a growing body of science demonstrates the risks of marijuana to mental and physical health.”

These findings will be presented at the National Drug & Alcohol Screening Association (NDASA) 2023 Conference May 23-25 in Bellevue, WA.

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