U.S. Drug Test Positivity Rates for Workers at a 10-Year High

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According to Quest Diagnostics’ recent Drug Testing IndexTM report, the percentage of employees in the U.S. workforce testing positive for drugs has increased over the last three years to a 10-year high of 4.0% in urine specimens.

Key Findings include:

  • The positivity rate for urine increased to four percent, a relative change of 2.6 percent over the positivity rate in 2014 (4.0% vs. 3.9%). This rate reflects a relative increase of 14% over the 10-year low of 3.5% in 2010 and 2011.
  • Of particular concern is that post-accident urine drug testing positivity increased 6.2% in 2015 compared to 2014 (6.9% vs. 6.5%) and increased 30% since 2011 (5.3%). Particularly noteworthy is that post-accident positivity for the safety-sensitive workforce rose 22% during a five-year time period (2.8% in 2015 vs. 2.3% in 2011).
  • Oral-fluid positivity rates increased 47% over the last three years to 9.1% in 2015 from 6.7% in 2013. In 2015, there was a 25% relative increase in marijuana detection compared to 2014 (7.5% vs. 6.0%).
  • Not surprising is that the highest positivity rate for drug detection testing methods was hair testing at 10.3% in 2015, a seven percent increase over 2014 (9.6%). Hair testing can show repetitive drug use for as far back as 90 days, while urine detects recent drug use, usually in one to three days. Oral fluid detects recent drug use in the previous 24-48 hours.
  • Almost half (45%) of workers with a positive drug test for any substance in 2015 showed evidence of marijuana.
  • Amphetamine positivity increased 44 percent and marijuana positivity increased 26% since 2011. Oxycodone positivity rates have declined annually since 2011, which confirms that opioid prescriptions have declined since 2012.
  • Heroin positivity increased 146% between 2011 and 2015 for the general U.S. workforce.
  • For federally-mandated safety-sensitive employees, heroin positivity increased a relative 4.5% since 2014 and a relative 84% since 2011. In addition, positive rates for amphetamines increased 7% year-over-year (0.58% in 2015 vs. 0.54% in 2014).

The results above are derived from analysis of more than 9.5 million urine, 900,000 oral fluid and 200,000 hair laboratory-based tests performed by Quest Diagnostics in 2015.

The Quest Diagnostics Drug Testing Index (DTI) examines test results from three categories of workers:  federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce.

The strength of the Drug Testing Index analysis includes its large, national sample size, longitudinal monitoring, and a testing population that is generally a good representative sampling of the total composition of the U.S. workforce.


These findings unfortunately provide a sound reason to increase your drug-testing efforts and to continue to enforce a drug-free workplace policy.

Build a testing program that meets your needs and clearly identify which roles require testing in your pre-employment documentation and drug testing policy.

Evaluate urine, oral fluid, and hair testing methods to determine which best meets your needs.

To decide among methods, consider cost, whether testing can be done on-site, and the length of the detection window.

For pre-employment screening, hair testing offers up to 90 days of visibility.

The one-week window of urine or oral fluid testing is appropriate for same-day ongoing screening.

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Dr. Todd Simo

Dr. Simo is the Chief Medical Officer and the Managing Director of Transportation at HireRight. He served as HireRight’s medical director starting in 2009 and was promoted to chief medical officer in 2015. Dr. Simo was also appointed to the role of managing director of transportation and drug & health screening in 2018. Dr. Simo came to HireRight with a decade of experience in the medical consulting arena. Before that he was the medical director for an occupational health clinic in Virginia and owned a consulting firm providing medical director services to employers across the United States

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