Workforce Drug Positivity at Highest Rate in a Decade, Finds Analysis of More Than 10 Million Drug Test Results
Nationally, the positivity rate for the combined U.S. workforce held steady at 4.2 percent in 2017, the same as in 2016, but a dramatic increase over the 3.5 percent positivity rate from 2012, which represented a thirty-year low. The analysis of 2017 data also suggests shifting patterns of drug use, with cocaine and amphetamines positivity surging in some areas of the country and marijuana positivity rising sharply in states with newer recreational use statutes. Prescription opiate positivity rates declined dramatically on a national basis.
For an interactive map with positivity rates and trend lines by three-digit zip code in
The findings were unveiled today at the
"It's unfortunate that we mark 30 years of the Drug-Free Workplace Act with clear evidence that drugs continue to invade the country's workplaces. Not only have declines appeared to have bottomed out, but also in some drug classes and areas of the country drug positivity rates are increasing," said
Cocaine positivity increases overall, jumps sharply in some areas
The positivity rate for cocaine increased for the fifth consecutive year in the general U.S. workforce across every specimen type. In urine testing, the most common drug test specimen type, the positivity rate for cocaine increased seven percent in the general U.S. workforce (0.28% in 2016 versus 0.30% in 2017). Year-over-year increases were also observed in the general U.S. workforce in oral fluid testing (up 16%) and hair testing (19%).
In the federally-mandated, safety-sensitive workforce, for which only urine testing is permitted, cocaine positivity increased by eleven percent (0.28% in 2016 versus 0.31% percent in 2017), representing the third consecutive year of increases in this workforce segment.
A new pattern emerged in this year's analysis, with cocaine positivity in urine testing increasing significantly in certain states among the general U.S. workforce. Double-digit year-over-year increases in at least four of the five past years were seen in the states of
Methamphetamine positivity skyrockets in Midwest and South regions
An analysis of trends in the general U.S. workforce based on the four U.S. Census regions identified large increases of methamphetamine positivity rates. Between 2013 and 2017, methamphetamine positivity increased: 167 percent in the East North Central division of the Midwest (
"Thirty years in, this year's results again demonstrate the ever-evolving threat that substance abuse poses to workplace safety. With the prescription opiate crisis filling the headlines, the significant drop in opiate positivity is a promising sign," said
Prescription opiates continue decline in workforce testing data
"The depth of our large-scale analysis supports the possibility that efforts by policymakers, employers, and the medical community to decrease the availability of opioid prescriptions and curtail the opioid crisis is working to reduce their use, at least among the working public," said
Nationally, the positivity rate for opiates in the general U.S. workforce in urine drug testing declined 17 percent between 2016 and 2017 (0.47% versus 0.39%). More notably, oxycodones (oxycodone and/or oxymorphone) positivity declined 12 percent between 2016 and 2017 (0.69% vs. 0.61%), hydrocodone positivity declined 17 percent (0.81% vs. 0.67%); and hydromorphone positivity declined 22% (0.59% vs. 0.46%). Opiates other than codeine were at their lowest positivity rate in more than a decade.
The company's workforce drug testing services generally test for drugs and metabolites associated with prescription opiates and semi-synthetic opiates. They do not typically test for synthetic opioids, such as fentanyl and its synthetic analogs.
Prescription opiate testing for the federally-mandated, safety-sensitive workforce has not been required until recently. Such testing was implemented in
According to the
Urine drug test results for heroin, indicated by the presence of the 6-acetylmorphine (6-AM) metabolite, also declined in the general U.S. workforce (0.033% positivity, a three-year low and down nearly 11 percent in 2017 compared to 2016). There have been concerns by some public health experts that a reformulation of OxyContin, a popular opioid medication, has led to a corresponding increase in heroin use,ii which has been reflected in the Drug Testing Index data where 6-AM positivity more than doubled between 2011 and 2015. Data from 2016 and 2017 suggests this may be abating among workers subject to drug testing.
Marijuana positivity is up in states with new legalization statutes
Overall, marijuana positivity continued its five-year upward trajectory in urine testing for both the general U.S. workforce and the federally-mandated, safety-sensitive workforce. Marijuana positivity increased four percent in the general U.S. workforce (2.5% in 2016 versus 2.6% in 2017) and nearly eight percent in the safety-sensitive workforce (0.78% versus 0.84%).
Increases in positivity rates for marijuana in the general U.S. workforce were most striking in states that have enacted recreational use statues since 2016. Those states include:
"These increases are similar to the increases we observed after recreational marijuana use statues were passed in
About the Quest Diagnostics Drug Testing Index™
The Quest Diagnostics Drug Testing Index™ (DTI) examines test results according to three categories of workers: federally-mandated, safety-sensitive workers; the general 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 the
The strengths of the Drug Testing Index 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.
30th Anniversary: In 2018, The Quest Diagnostics Drug Testing Index™ celebrates 30 years of examining drug test results in the U.S. workforce. To learn more about the effort and quest to provide actionable insights to employers, visit QuestDiagnostics.com/DTI.
Prescription Drug Monitoring: In addition to workplace drug testing, Quest is a leader in clinician-ordered drug testing services to aid the detection of potentially dangerous forms of prescription and illicit drug use. For more information on Quest's prescription drug monitoring services, visit QuestPDM.com
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Kim Gorode, Quest Diagnostics (Media): 973-520-2800, or Shawn Bevec, Quest Diagnostics (Investors): 973-520-2900