Employers Concerned About Shift in U.S. Drug Use Rates

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While the share of workers who test positive for illegal drug use has dropped significantly since 1998, the rate of workers testing positive for prescription drugs has skyrocketed.

Quest Diagnostics, a leading drug testing laboratory network, reviewed more than 125 million urine tests administered since 1988.

Seventy-five percent of drug tests were conducted for pre-employment purposes, while the rest were performed after accidents or were part of a regular testing regimen.

Quest found that workers testing positive for illegal drug use was 3.5% in 2012 compared to 13.6% in 1988. For safety-sensitive workers, positive test results dropped to 1.6% in 2012 from 2.6% in 1992. Positive testing overall in the general population fell from 10.3% to 4.1%.

According to the 2012 National Survey on Drug Use and Health, marijuana use is increasing among the general population. For Americans over the age 12, 7.3% smoked marijuana in the previous month compared with 5.8% in 2007.

The disparity between positive test results and drug usage studies could mean that workers are finding ways to circumvent or manipulate tests. Labs have developed oral fluid and hair testing to combat the problem of urine specimen subversion by dilution, substitution, or adulteration.

Workplace drug policies are becoming much more complicated as some states consider or are moving towards decriminalizing marijuana use for either recreational or medicinal purposes.

Companies are facing more legal challenges as they must consider the actions they take for disciplining employees who smoke marijuana after work hours. Federally regulated safety-sensitive workers are prohibited from using marijuana regardless of state laws.

Amphetamine positive rates doubled between 2002 and 2012 (this includes drugs such as Adderall used primarily for ADD). Methamphetamine rates fell after 2005 when the government made a concerted effort to crackdown on clandestine labs; however, rates have been on the rise again, especially in safety-sensitive industries such as trucking and railroads.

Of growing concern for employers are the positive test rates for prescription drugs. Positive test rates for painkillers have increased dramatically, hydrocodone (e.g. Vicodin) rose 172% and Oxycodone (e.g. Oxycontin) rose 71% from 2005 to 2012.

The data shows a higher level of painkiller use when testing workers after they were involved in an accident on the job. “Even when used under prescription, these drugs can have an impact on workplace safety,” said Barry Sample, director of drug-testing technology for Quest.

Independent studies seem to indicate that 65-80% of positive tests for amphetamine and opiate use are overturned and reported negative by a Medical Review Officer because the user has a valid prescription for the drug. With the growing problem of painkiller addiction, employers need to be more alert to the possibilities that these drugs are being abused.

In 1988, Ronald Reagan signed the Drug-Free Workplace Act which mandates that employers in certain industries check prospective and current employees for evidence of drug use.

Today, many other types of industries do regular drug testing as well. Smaller companies tend to terminate employees who test positive, while larger companies will often send employees for treatment. “If you fire someone for a positive test, it has more preventive value.

But in the long run, what you want to do is help people get into recovery,” said Robert DuPont, former director of the National Institute on Drug Abuse.

As the drug usage landscape changes, it is important that your drug and health policies adapt accordingly.

Article source: “Drug Use on Decline at Work, Except Rx” by Lauren Weber, Wall Street Journal, November 18, 2013.

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