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Drug Abuse Rise Tests Employers

Drug usage by Americans in safety sensitive jobs is continuing to rise and expand, probably driven in part by the effects of the Covid 19 pandemic on the nation’s frayed social fabric, and the growing legalization of psychoactive drugs, such as marijuana and hallucinogenic mushrooms.

The most recent news on the marijuana legalization front came from the U.S. House of Representatives, which voted 216 to 202 to lift federal restrictions on marijuana on April 1 – and it was no April Fools’ joke. either. Although that legislation is not expected to survive its trip to the Senate, it offers a vivid glimpse of this country’s changing attitudes toward the drug.

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 workforce from an all-time low in 2010-2012, according to the Drug Test Index issued each year by Quest Diagnostics, which conducts many of the workforce drug tests for the nation’s employers.

The study is based on more than 11 million urine, hair and oral fluid drug test results collected between January and December 2021.

The combined U.S. workforce includes the general workforce of mostly company-policy testing by private employers as well as the federally mandated, safety-sensitive workforce, which covers federal employees and the transportation and nuclear power industries, and can include workers such as pilots, truck drivers, train conductors and others who are regularly drug tested under federal requirements.

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) but was 4.8% higher than 2017 (2.1% in 2017 vs. 2.2% in 2021).

In the general U.S. workforce, positivity increased 1.8% (5.5% in 2020 vs. 5.6% in 2021) and was 12% higher than in 2017 (5.0% in 2017 vs. 5.6% in 2021) and up each of the last five years.

“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,” observed Dr. Barry Sample, who serves as Quest Diagnostics’ senior science consultant.

Keith Ward, general manager and vice president of Quest Diagnostics Employer Solutions, pointed out that the new results are part of a larger picture. “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.”

He added, “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.”

Breaking Down the Data

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.

Among those workers, marijuana was up 8.9% (0.79% in 2020 to 0.86% in 2021), amphetamines jumped 7.8% (0.64% in 2020 to 0.69% in 2021) and cocaine rose 5% (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 rates for marijuana in the general U.S. workforce, based on more than six million urine tests, continued an upward climb, increasing 8.3% (3.6% in 2020 vs. 3.9% in 2021), the highest positivity rate ever reported in the annual index.

Over the previous five years, positivity for marijuana in the general workforce increased 50% (2.6% in 2017 vs. 3.9% in 2021).

Quest also reported oral fluid test results – which generally have a shorter window of drug detection than urine, and can detect some drugs faster, in a matter of minutes vs. hours. Oral fluid collection also has the advantage of being observed, making it harder for employees to find a way to subvert the testing process, it noted.

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%).

Quest said the drop in oral fluid-positivity (13.6% in 2020 vs. 7.3% 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% in 2021, up 20.3% compared to 2020 (12.3%) and 68.2% up from 8.8% in 2017.

At the same time, the positivity rate for cocaine increased 46.6% (0.58% in 2020 vs. 0.85% in 2021), its highest spike since 2006, and methamphetamine increased 26.4% (0.53% in 2020 vs. 0.67% in 2021), exhibiting year-over-year increases for the last five years.

Urine positivity rates for post-accident testing increased at a greater rate than pre-employment testing over the past 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 vs. 5.4% in 2021); while post-accident positivity increased 26% (7.7% in 2017 vs. 9.7% in 2021).

Similarly, in federally mandated, safety-sensitive workforce urine drug tests, pre-employment positivity rose 9.5% since 2017 (2.1% in 2017 vs. 2.3% in 2021), while post-accident positivity rose 41.9% (3.1% in 2017 vs. 4.4% in 2021).

In 2021, post-accident positivity compared to pre-employment positivity was 79.6% higher (9.7% vs. 5.4%) in the general workforce and 91.3% higher (4.4% vs. 2.3%) in the safety-sensitive workforce.

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

“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.”

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