In 2021, the rate of positive drug test results in the U.S. workforce reached its highest rate since 2001 and was up more than 30 percent in the combined workforce from an all-time low in 2010 to 2012, according to the 2022 Quest Diagnostics Drug Testing Index™ (DTI) from workforce drug testing provider Quest Diagnostics.
The study – which was based on more than 11 million de-identified urine, hair, and oral fluid drug test results collected between January and December 2021 – offers revealing insights into workforce drug use as employers grapple with creating safe and healthful work environments amid an ongoing recruitment and retention crisis.
Based on nearly nine million urine drug tests collected between January and December 2021, the overall positivity rate in the combined U.S. workforce was up in 2021 to 4.6 percent compared to 4.4 percent in 2020 and up 31.4 percent from the all-time low of 3.5 percent just 10 years ago in 2010 to 2012.
Based on nearly 2.7 million urine drug tests collected between January and December 2021, overall positivity in the federally mandated, safety-sensitive workforce stayed even year over year, 2.2 percent in 2020 and 2021, and was 4.8 percent higher in 2021 than in 2017, 2.1 percent in 2017 versus 2.2 percent in 2021.
After five years of steady declines in several drug categories, positivity rates based on urine drug tests for the federally mandated, safety-sensitive workforce increased in 2021. Of note, marijuana increased 8.9 percent, amphetamines increased 7.8 percent, and cocaine increased 5.0 percent from 2020 to 2021.
“Our Drug Testing Index reveals several notable trends, such as increased drug positivity rates in the safety-sensitive workforce, including those performing public safety and national security jobs,” Barry Sample, PhD, Senior Science Consultant for Quest Diagnostics, stated in a news release about the study.
Based on more than 6 million urine tests, positivity rates for marijuana in the general U.S. workforce increased 8.3 percent, from 3.6 percent in 2020 versus 3.9 percent in 2021, the highest positivity rate ever reported in the DTI. Over five years, positivity for marijuana in the general U.S. workforce increased 50 percent.
“It is important for workers to know that certain employers are required to test for marijuana under federal law and if they use marijuana, they can still lose their jobs,” said Dr. Sample. “People who use drugs during working hours or before work can still be impaired and dangerous to co-workers, the general public, and themselves.”
In 2021, positivity in the general U.S. workforce based on oral fluid was 7.3 percent in 2021, a decline of 46.3 percent compared to 2020. The drop in oral fluid positivity, 13.6 percent in 2020 versus 7.3 percent in 2021, was driven by a decline in the number of pre-employment tests that included marijuana.
However, for tests that included marijuana, the oral-fluid drug positivity rate for marijuana was 14.8 percent in 2021, an increase of 20.3 percent compared to 2020 and up 68.2 percent over five years. At the same time, the positivity rate for cocaine increased 46.6 percent and methamphetamine increased 26.4 percent.
Oral fluid drug tests generally have a shorter window of drug detection than urine drug tests, and can detect some drugs faster, in a matter of minutes versus hours. Oral fluid collection also has the advantage of being observed, making it harder to subvert the testing process as in urine collection.
“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 wellbeing,” Keith Ward, General Manager and Vice President, Quest Diagnostics Employer Solutions, stated in the 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.”
The Quest Diagnostics Drug Testing Index™ (DTI) is a series of reports that provide 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. To learn more, download the full report here.
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