Increase in Positive Drug Tests for the First Time in 10 Years

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Drug test positivity rates increased in the workforce for the first time in 10 years, substantially due to a rise in marijuana and amphetamine-related positive results, according to a recent study by Quest Diagnostics.

After years of declining rates, this increase poses a real concern for employers tasked with maintaining a drug-free workplace. These results highlight how important pre-hire and random drug testing programs may be to an employer to help ensure the safety and health of their workforce and the general public, as well as helping satisfy industry regulations.

The Quest Diagnostics study was based upon urine, oral fluid, and hair drug tests analyzed in Quest laboratories throughout the U.S. in 2013.

Test results were considered in three workforce categories:

  1. Employees who work for private companies (U.S. general workforce)
  2. Employees subject to federal drug testing rules, including truck drivers, train operators, and airline workers (federally mandated safety-sensitive workers)
  3. A combination of both groups (combined U.S. workforce).

Marijuana Continues to be the Most Commonly Detected Illicit Drug

In the combined U.S. workforce, marijuana positive drug test results increased 6.2% (1.7% in 2013 compared to 1.6% in 2012). For federally mandated safety-sensitive workers, the positivity rates increased 5.6% (0.67% in 2013 compared to 0.63%). The general U.S. workforce, positive rate increased 5% (2.1% in 2013 compared to 2% the prior year).


Not surprisingly, significant shifts in marijuana positivity rates were experienced in Colorado and Washington, the two states that have enacted recreational use laws.

An analysis of urine drug test data for the combined U.S. workforce from these two states showed marijuana positivity rates increased 20 and 23 percent, respectively, between 2012 and 2013.

From 2009 to 2010, Colorado experienced a 22% increase, while Washington had a 10% decline in positivity. From 2011 to 2012, Colorado experienced a 3% increase, and Washington recorded an 8% increase.

“It is possible that relaxed societal views of marijuana use in those two states, relative to others, may in part be responsible for the recent increase in positivity rates. Yet this doesn’t explain why both states also experienced steep rises and declines in positivity in recent years,” said Dr. Barry Sample.

Even though some states have decriminalized the use of recreational marijuana, it is important to recognize the federal government has not legalized marijuana.

Though certain FDA approved synthetic forms of marijuana, Marinol (Dronabinol) and Cesamet (Nabilone), may be prescribed in the treatment of serious illnesses such as severe nausea and vomiting caused by cancer chemotherapy, by federal standards, marijuana itself remains an illegal Schedule I drug that cannot be prescribed by a physician.

Accordingly, employers have the authority to restrict the use of recreational marijuana use by employees and take appropriate disciplinary actions for employees that have positive drug test results without legitimate medical prescriptions.

Oral Fluid Testing Positive for Marijuana Continues to Increase
The positivity rate for oral fluid marijuana testing has seen an even more dramatic increase. The positive rate for marijuana increased 27% (5.1% vs. 4.0%) in 2013 compared to 2012. In 2012, the rate had increased 48% (4.0% vs. 2.7% respectively).

These higher rate trends may be partially explained by an increased use of marijuana among employees, though other factors like the observed collection process, the difficulty of the donor to cheat or adulterate oral fluid samples, and improving detection capabilities may provide additional explanations.

Continuing Multi-Year Upward Trend in Amphetamine Use
Amphetamine positivity rates have increased significantly and are now at their highest levels on record. Methamphetamine positivity rates are at their highest levels since 2007. This is the result across all specimen types. Urine tests for the combined U.S. workforce showed a 10% year-over-year increase in positivity (0.85% in 2013 compared to 0.77% in 2012).

In the U.S. general workforce methamphetamine positivity in urine tests increased 27% (0.14% vs 0.11%); oral fluid positivity increased by 50% (0.24% vs 0.16%). Hair testing positive jumped by 55% (1.2% vs 0.77%).

Oxycodone Rates Declining
The study found oxycodone positivity rates declining 8.3% (0.88% vs. 0.96%) between 2013 and 2012, and 12% (0.96% vs 1.1%) between 2012 and 2011 in the combined U.S. workforce. Hydrocodone positivity remained at 1.3% between 2012 and 2013. Hydrocodone and oxycodones are prescription opiates that are used for pain management.

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