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Workplace Drug Positivity Rates Reach a Two-Decade ‘High’ (Pun Intended)

Issues surrounding drug use in relation to the workplace have plagued employers for decades. Unfortunately, circumstances surrounding an employee’s possession, use, and impairment are nothing new. In their unending efforts, employers struggle in an attempt to keep employees and customers safe, while complying with various laws that seemingly change daily. The statistics have ebbed and flowed—increasing and decreasing over the years based on many external factors. However, we have recently experienced a combination of significant factors that arguably have had the most profound impact—and not in a positive way.

Quest Diagnostics recently performed its annual Quest Diagnostics Drug Testing Index, where it evaluated eleven million employment-related drug test results from January through December of 2021. This data stemmed from private employers, federally mandated drug testing employers (e.g., DOT), and other federal employers. The index demonstrated staggering findings; namely, that the positive results are the highest they’ve been in the workforce in over two decades. In fact, the 2021 positivity rate of 4.6% represented a 31.4% increase from the rate just ten years ago—the all-time low of 3.4%. Additionally, the breakdown of drugs found was somewhat expected, with marijuana rising high once again.



With the increasing number of states legalizing marijuana for either medical and/or recreational use over the past several years, it’s probably no surprise that the marijuana positivity rate in the U.S. workforce in 2021 was the highest ever reported. Over the past five years, marijuana positivity rates have increased 50% (from 2.6% in 2017 to 3.9% in 2021).


Not Just Marijuana

Marijuana wasn’t the only drug positivity rate increase though. In oral fluid testing, the positivity rate for cocaine increased 46.6%, while methamphetamine increased 26.4%, showing year-over-year growth for the last five years.


Why such a large increase in positivity rates?

The reasons for this drastic rise in positive drug tests are understandable. In fact, they are right in front of us every day. While there are many varying factors contributing to this outcome, some of the largest include:

  1. Increasing number of states legalizing marijuana
  2. Rise of the remote workforce
  3. Increased mental health issues


States Legalizing Marijuana

The primary factor in the marijuana positivity rate increase surrounds the fact that most states have now legalized it for either medical or recreational use. While marijuana remains a Schedule I substance under the Controlled Substance Act (making it illegal for any reason under federal law), to date, there are approximately 40 states that have legalized it for medical purposes and approximately 20 for recreational purposes.

It’s logical then that more people are using the drug. And with so many states and cities becoming more lenient as to usage, employers have even started dropping marijuana from their screening panels—either by choice or mandate. For example, in 2021, we saw Philadelphia join New York City and Nevada with the implementation of a ban on pre-employment testing for marijuana. In those jurisdictions, most employers cannot legally test for the drug when hiring someone.

This gives rise to a number of considerable issues for employers. First, there is still no way to test impairment. Take, for instance, an employee who used marijuana legally (in that state) on off-duty hours, similar to drinking alcohol. However, unlike alcohol, marijuana stays in the system much longer. When the employee tests positive, an employer has no indication if the usage was recent enough for that person to be impaired at work. Additionally, each of these state and city laws have their own nuances, requiring multi-faceted compliance for employers whose operations cross geographical boundaries.


Remote Work

Another factor leading to the increase in positive drug rates has a direct correlation to Covid-19. We’ve all been impacted in some way by the remote work response to the pandemic. And working from home, for the most part, means no drug tests. Without at least the perception of workplace ramifications, more people have been inclined to use marijuana and other drugs. In fact, according to SHRM and a survey conducted by the National Safety Council, “More than one-quarter [of respondents] said an added benefit of working from home is the opportunity to use alcohol and other drugs during the workday.”


Mental Health Issues

The next factor also has a correlation to the pandemic, with potentially the direst of consequences. Numerous studies have shown an increase in mental health issues resulting from the isolation brought about by the pandemic. And the fact is that increased anxiety, depression, and loneliness have altered drug use behaviors. Simply, more people are using drugs in an attempt to self-medicate. This situation led to soaring instances of drug overdoses during the pandemic, with U.S. deaths surpassing 100,000 during the 12-month period ending April 2021.


Employer Concerns

These results show that employers are continuing to struggle with their employees’ possession, use, and impairment while on property and/or during working hours, as they strive to create the safest work environment possible. According to the National Safety Council, which still recommends a zero tolerance policy for employees in safety sensitive positions, “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.”

With more remote workers (some in states that differ from the employer’s state) and the ambiguity surrounding what is legal and where, uncertainty continues. Additionally, remote work, along with its lack of drug testing, has become the norm, at least in part, with many organizations opting for a hybrid workforce. And sadly, the mental health crisis is likely far from over. Further, issues such as accommodating marijuana use, drug-free workplace policies, and the possibility of being sued for terminating an employee for a drug test that is positive for marijuana continue to trouble employers—all amid an ongoing recruitment and retention crisis felt around the country.

What should employers do about it?

While there is no definitive solution to this problem, as of yet, employers must stay diligent by considering the following practices:

  • Staying educated about the changing laws in the jurisdictions in which they operate.
  • Revisiting policies and procedures, including drug free workplace policies and varying state and local requirements, to ensure they remain in compliance.
  • Ensuring employees understand these policies and acknowledge ramifications by having them sign off on them.
  • In as many ways as possible, treating remote and in-office employees the same way.
  • Evaluating risks with OSHA and DOT, if applicable.
  • Conducting mandatory and frequent employee trainings about issues surrounding drug use and impairment.
  • Working with a PBSA-certified background screening company to help ensure compliance.


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