Workforce Drug Test Positivity Climbs to Highest Level in Two Decades, Finds Quest Diagnostics Drug Testing Index Analysis (2023)

Workforce Drug Test Positivity Climbs to Highest Level in Two Decades, Finds Quest Diagnostics Drug Testing Index Analysis

Positivity for Cocaine and Marijuana Increase for Federally Mandated, Safety-Sensitive Workers Required to Test Under Federal Law

Amid Widespread Recruiting and Retention Challenges, Drug Positivity Increases in Post-Accident Tests at a Faster Rate Than Pre-Employment Tests for Cocaine, Marijuana, Opiates and Oxycodones

SECAUCUS, N.J., March 30, 2022 /PRNewswire/ --The rate of positive drug test results among America's workforce reached its highest rate last year since 2001 and was up more than 30% in the combined U.S. workforce from an all-time low in 2010-2012, according to a new analysis released today by Quest Diagnostics (NYSE: DGX), the world's leading provider of diagnostic information services.

Workforce Drug Test Positivity Climbs to Highest Level in Two Decades, Finds Quest Diagnostics Drug Testing Index Analysis (1)

The study, based on more than 11 million deidentified 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, healthful work environments amid an ongoing recruitment and retention crisis. To learn more, download the full report here.

The overall positivity rate in the combined U.S. workforce, based on nearly nine million urine drug tests collected between January andDecember 2021,was up in 2021 to 4.6% compared to 4.4% in 2020 and up 31.4 percent from the all-time low of 3.5% just 10 years ago (2010-2012). The combined U.S. workforce includes the general U.S. workforce of mostly company-policy testing by private employers as well as the federally mandated, safety-sensitive workforce, which includes federal employees and the transportation and nuclear power industries, and can include workers such as pilots, truck drivers, train conductors and others required to drug test under federal legislation.

Overall positivity in the federally mandated, safety-sensitive workforce based on nearly 2.7 million urine drug tests stayed even year over year (2.2% in 2020 and 2021) and was 4.8% higher than 2017 (2.1% in 2017 versus 2.2% in 2021). In the general U.S. workforce, positivity increased 1.8% (5.5% in 2020 versus 5.6% in 2021) and was 12% higher than in 2017 (5.0% in 2017 versus 5.6% in 2021) and up each of the last five years.

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For an interactive map of the Drug Testing Index with positivity rates and trend lines by drug categories and three-digit ZIP code inthe United States,

"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, as well as higher rates of positivity in individuals tested after on-the-job accidents," said Barry Sample, PhD, Senior Science Consultant for Quest Diagnostics.

"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," said Keith Ward, General Manager and Vice President, Quest Diagnostics Employer Solutions. "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 harms' way."

The new findings of the Quest Diagnostics Drug Testing Index™ are being unveiled this week at the Drug & Alcohol Testing Association 2022 Conference taking placeMarch 30-April 2inLouisville, KY.

Despite years of decline, positivity rates increased in several federally mandated, safety-sensitive workforce testing categories
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% (0.79% in 2020 to 0.86% in 2021), amphetamines increased 7.8% (0.64% in 2020 to 0.69% in 2021) and cocaine increased 5.0% (0.20% in 2020 to 0.21% in 2021).

"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."

Positivity for marijuana continues upward climb in general U.S. workforce
Positivity rates for marijuana in the general U.S. workforce, based on more than 6 million urine tests, continued an upward climb, increasing 8.3% (3.6% in 2020 versus 3.9% 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% (2.6% in 2017 versus 3.9% in 2021).

In oral fluid testing, overall workforce drug positivity decreased, but increased for marijuana, methamphetamine and cocaine
In 2021, positivity in the general U.S. workforce based on oral fluid was 7.3% in 2021, a decline of 46.3% compared to 2020 (13.6%) and 29.8% compared to 2017 (10.4%). The drop in oral fluid-positivity (13.6% in 2020 versus 7.3% in 2021) was driven by a decline in the number of pre-employment tests that included marijuana. However, for those tests that included marijuana, the oral-fluid drug positivity rate for marijuana was 14.8% in 2021, an increase of 20.3 percent compared to 2020 (12.3%) and up 68.2% over five years (8.8% in 2017). At the same time, the positivity rate for cocaine increased 46.6% (0.58% in 2020 versus 0.85% in 2021), its highest spike since 2006, and methamphetamine increased 26.4% (0.53% in 2020 versus 0.67% in 2021), exhibiting year-over-year increases for the last 5 years.

(Video) Drug Testing Trends

Oral fluid tests generally have a shorter window of drug detection than urine, 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.

Urine positivity rates for post-accident testing increased at a greater rate than pre-employment testing over five years, driven by higher positivity on post-accident tests for marijuana, cocaine, and semi-synthetic opiates
Over the last five years in general U.S. workforce urine drug testing, pre-employment positivity increased 17.4% (4.6% in 2017 versus 5.4% in 2021); while post-accident positivity increased 26% (7.7% in 2017 versus 9.7% in 2021).

Similarly, in federally mandated, safety-sensitive workforce urine drug testing, pre-employment positivity increased 9.5% since 2017 (2.1% in 2017 versus 2.3% in 2021), while post-accident positivity increased 41.9% (3.1% in 2017 versus 4.4% in 2021). In 2021, the post-accident positivity as compared to pre-employment positivity was 79.6% higher (9.7% versus 5.4%) in the general US workforce and 91.3% higher (4.4% versus 2.3%) in the federally mandated, safety-sensitive workforce.

"Drug use affecting the work environment is a complex problem that is not going away," said Jenny Burke, Vice President of Impairment Practice, National Safety Council. "When workers use impairing substances, it can create incidents that compromise the safety of other workers and, in some cases, the general public. Employers should have the right and ability to maintain a substance-free workplace and the use of drug testing, including oral fluid in addition to urine. NSC supports policies and procedures that ensure safe and healthy workplaces."

In 2021, urine post-accident testing in the U.S. general workforce for the drugs marijuana and cocaine the positivity rate was 63.4% and 266.7% higher, respectively, as compared to pre-employment tests. For the two groups of semi-synthetic opiate drugs – opiates (hydrocodone/hydromorphone) and oxycodones (oxycodone/oxymorphone) – in these tests, post-accident positivity was 316.7% and 200% higher, respectively, than in pre-employment testing.

For federally mandated, safety-sensitive workforce urine drug testing in 2021, post-accident positivity for marijuana, cocaine, opiates (hydrocodone/hydromorphone) and oxycodones (oxycodone/oxymorphone) was 63.6%, 119%, 257.1%, and 194.1% higher, respectively, as compared to pre-employment tests.

Pre-employment drug tests are meant to be a deterrent in hiring workers whose drug-use behavior may cause unsafe work conditions or poor work performance. Post-accident testing is conducted to evaluate whether drug use may have played a role in the workplace incident prompting the drug test.

"The increase in post-accident positivity is alarming and suggests more drug-associated accidents may be occurring even with employers with pre-employment drug testing in place," Dr. Sample said. "The high cost of work accidents cannot be understated. While employers often think of accidents in terms of wage and productivity losses, medical expenses, and administrative expenses, accidents also impact morale, competitiveness and recruiting. Given that employers are in a war for talent, creating a safe, healthful work environment is critical for attracting and retaining people."

(Video) Drug Testing State of the Union 2023

Mixed picture for cocaine positivity in the general U.S. workforce
Positivity for cocaine based on urine tests in the general U.S. workforce decreased 4.5% (0.22% in 2020 versus 0.21% in 2021) and positivity for cocaine over the past five years declined 30% (0.30% in 2017 versus 0.21% in 2021). Positivity rates for cocaine based on urine tests in the federally mandated safety, safety-sensitive workforce increased 5.0% (0.20% in 2020 versus 0.21% in 2021), the first increase in five years.

Positivity for opiates and oxycodones in the general U.S. workforce decreased last year and over five years
Positivity for opiates (codeine/morphine) based on urine drug tests in the general U.S. workforce decreased 19% (0.21% in 2020 versus 0.17% in 2021) and 56.4% over five years (0.39% in 2017 versus 0.17% in 2021). Positivity for opiates (hydrocodone/hydromorphone) in the general U.S. workforce decreased 3% (0.33% in 2020 versus 0.32% in 2021) and 37.3% over five years (0.51% in 2017 versus 0.32% in 2021). Positivity for oxycodones (oxycodone/oxymorphone) in the general U.S. workforce stayed the same in 2020 and 2021 (0.29%) and decreased 52.5% over five years (0.61% in 2017 versus 0.29% in 2021). To see a U.S. map depicting positivity rates for different classes of opiates and oxycodone,

Positivity for 6-AM (heroin) in the general U.S. workforce decreased over five years
Positivity for 6-AM metabolite (heroin) based on urine tests in the general U.S. workforce decreased 27.8% (0.018% in 2020 versus 0.013% in 2021) and 56.7% over five years (0.03% in 2017 versus 0.013% in 2021). Positivity for the 6-AM metabolite (heroin) in the federally mandated, safety-sensitive workforce decreased 37.5% (0.008% in 2020 versus 0.005% in 2021) and 73.7% over five years (0.019% in 2017 versus 0.005% in 2021).

Retail Trade had highest positivity among key industries
The overall positivity rate increased in 16 out of 17 industries from 2017 to 2021. Retail Trade industry had the highest overall positivity rate in 2021, at 7%, an increase of 34.6% since 2017. This sector also experienced the only year over year rise in methamphetamine positivity from 2017 to 2021 of 55.6% (0.09% in 2017 to 0.14% in 2021).

Marijuana positivity increased in all industries and by double-digits in 15 from 2017 to 2021. The Accommodation and Food Service industry had the highest workforce positivity for marijuana at 7.5%, a relative increase of 114.3% over five years (3.5% in 2017 versus 7.5% in 2021).

In the Health Care and Social Assistance industry, results saw positivity for methamphetamine decrease year-over-year. Across the last five years, it decreased by 50% (0.18% in 2017 to 0.09% in 2021).

About the Quest Diagnostics Drug Testing Index™
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. 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, for whom routine drug testing is mandated by government agencies like the Department of Transportation, Nuclear Regulatory Commission and the Department of Defense.

The strengths of the DTI analysis include its large, nationally representative sample size, longitudinal monitoring, a testing population that is generally reflective of the U.S. workforce and the quality of the company's drug testing services to confirm positive results. Limitations include analysis only of employers that perform drug testing with the company, and a lack of exact cross-specimen comparisons due to variations in substances for which employers test. Quest Diagnostics has analyzed annual workplace drug testing data since 1988 and publishes the findings as a public service.


Quest Diagnostics is the leading workforce drug testing provider, offering a broad range of drug testing options that allow employers to combine and customize a drug testing program that meets their unique business needs, all from a single, convenient provider. Employers seeking information on the company's services should visit the company's Employer Solutionspage for more information.

About Quest Diagnostics
Quest Diagnostics empowers people to take action to improve health outcomes. Derived from the world's largest database of clinical lab results, our diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors, and improve health care management. Quest annually serves one in three adult Americans and half the physicians and hospitals in the United States, and our nearly 50,000 employees understand that, in the right hands and with the right context, our diagnostic insights can inspire actions that transform

SOURCE Quest Diagnostics

Workforce Drug Test Positivity Climbs to Highest Level in Two Decades, Finds Quest Diagnostics Drug Testing Index Analysis (5)

(Video) Drug Testing State of the Union 2020

For further information: For further information: Jennifer Petrella (Media), 973-520-2800,; Shawn Bevec (Investors), 973-520-2900


What is Quest drug index? ›

The Quest Diagnostics Drug Testing Index reveals insights into patterns of drug use among the American workforce. It has examined positivity rates for workplace drugs tested by the company on behalf of employers since 1988.

How long does Quest Diagnostics take for drug test results? ›

Negative screening results are often released within 24 hours and non-negative screens are typically released within an additional 24 to 72 hours. Q: Can a urine drug test be beaten or adulterated?

How far back does a lab urine test go? ›

Drug testing specimen types

Illicit substances are detectable for only five to 10 days in urine; whereas, hair drug tests can detect drug or alcohol use for up to 90 days. Blood testing is very accurate, but costly and invasive. It does have a shorter detection period (minutes to hours), however.

Can you fail urine test from HHC? ›

While HHC is not technically the same thing as delta 8 or delta 9 THC, this cannabinoid can also lead to drug test failure. Therefore, if you are facing a drug test for any reason, it will be best to avoid HHC products.

What kind of drug screen does Quest Diagnostics use? ›

Our most commonly requested urine drug test is a 5-panel test that screens for the presence of the amphetamines, cocaine, marijuana, opiates, and PCP.

What does a 10 panel drug test Test for Quest? ›

Instant testing or Point of Collection Testing (POCT) is also available at our Quest Diagnostics or LabCorp testing facilities. This ten-panel instant test includes marijuana, PCP, amphetamines, methamphetamines, opiates, cocaine, benzodiazepines, barbiturates, methadone, propoxyphene & oxycodone.

How long does Quest drug test results take 2022? ›

We have contacted Quest Diagnostics regarding delays in drug testing results and would like to pass along some important information for Drug Screening in 2022. Negative results are returning within 24 hours after the collection. Positive results are taking about 5-7 days.

How does Quest Diagnostics drug test employees? ›

Quest offers the most relied upon urine drug test panels that mirror US Department of Transportation (DOT) testing standards, and panels that fit the distinct needs of your program, industry, or testing scenario. Employers may also select oral fluid and hair for the pre-employment drug testing of their job applicants.

How long does it take to get positive drug test results? ›

Almost all negative results will be available to you 1-2 business days after the testing lab receives the specimen. If additional testing is needed, we may need an extra day or two to confirm the results. Positive results may take between 4-6 days because of the repeated tests that are needed to confirm drug use.

What can cause a false positive on a urine drug screen? ›

Clinically, a false positive urine drug screen can be due to numerous xenobiotics: dextromethorphan, diphenhydramine, doxylamine, ibuprofen, imipramine, ketamine, meperidine, venlafaxine, buproprion, methylenedioxpyrolvalerone (MDPV), and tramadol.

How far back does a 10 panel urine test go? ›

A 10-panel drug test is one of many screenings employers can use to detect prescription or illicit drugs.
How Far Back Does A 10-panel Urine Test Go?
SubstanceDetection Time Frame
Amphetamines48 hours
Barbiturates24 hours to 3 weeks
BenzodiazepinesUp to six weeks for extended use
Cocaine2-4 days
5 more rows
Jun 8, 2022

What is considered a failed drug test? ›

You fail a drug or alcohol test by testing positive to a drug test, or registering a 0.04 or greater alcohol content.

How long will Delta 8 stay in your system? ›

The half-life of Delta 8 THC has been reported as anywhere from 40 minutes to 7 hours. Delta 8 THC can linger in the body much longer than other metabolites and it is generally believed that Delta 8 remains detectable in the body for one to three days after consumption.

How long does Delta 8 stay in your pee? ›

Delta 8 can remain detectable in the blood or urine for as long as 30 days or as short as two days. There are a lot of factors that can either shorten or prolong the amount of time it takes for delta 8 to be completely cleared from the body.

What is Quest Diagnostics Instant 6 panel urine drug test? ›

This is a 6-panel urine test that checks for the presence of amphetamines, benzodiazepines, marijuana metabolite, cocaine metabolite, opiates, and oxycodone used in the previous 24 to 72 hours, depending on the type of drug.

How much urine is needed for a drug test Quest Diagnostics? ›

Donor provides minimum 3 0 mL urine (4 5 mL for a DOT collection) in the privacy of a restroom. Collector pours specimen into bottle. Depends on whether test device is integrated into collection cup. Non-negative test specimens and CCF should be sent to the lab for confir ation.

What is a 5 panel urine drug test Quest Diagnostics? ›

The 5 panel drug test uses a urine specimen to test for five common illicit drugs including marijuana, opiates, PCP, cocaine, and amphetamines. The drug test specimen is sent to a SAMHSA-certified laboratory for analysis and results are reviewed by a Medical Review Officer (MRO).

What is Quest drugs of Abuse panel? ›

Our Drug Screen Test Panel checks for the presence of amphetamines, benzodiazepines, marijuana metabolite, cocaine metabolite, opiates, and oxycodone in the urine. Schedule an appointment, then visit one of our Patient Service Centers.

Is Quest a good stock? ›

Valuation metrics show that Quest Diagnostics Incorporated may be undervalued. Its Value Score of A indicates it would be a good pick for value investors. The financial health and growth prospects of DGX, demonstrate its potential to outperform the market. It currently has a Growth Score of D.

What is a Quest 7 panel drug test? ›

Test Details

Initial screen of 6-Acetylmorphine, Alcohol Metabolites, Amphetamines, Barbiturates, Benzodiazepines, Marijuana Metabolite, Cocaine Metabolite, Methadone Metabolite, Opiates, Oxycodone drug classes. Specimen validity consisting of Creatinine, Oxidant, and pH testing.

What is a drug index book? ›

This is a comprehensive and systematic source of drug information that has been customized to provide healthcare practitioners in Eastern Africa with easy-to-retrieve information on drugs and other related products.

How does Quest Diagnostic drug test work? ›

Typically, this drug test begins with a urine specimen provided at a collection site. Businesses rely on laboratory-based urine drug testing for its proven methodology and ability to screen for illicit and prescription drugs.


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