2022 Quest Drug Testing Index Reveals Record Workforce Positivity Rates

By Alana Smart / April 6, 2022 / Blog ,

2022 Quest Drug Testing Index Reveals Record Workforce Positivity Rates

An analysis of workforce drug positivity rates for 2021 are out and the numbers aren’t looking good. Quest Diagnostics’ study is based on more 11 million de-identified urine, hair and oral fluid drug specimens collected between January and December 2021. The overall positivity rate results showed that the United States workforce has reached its highest rate year in over 20 years, was up more than 30% in the combined U.S. workforce from it’s all time low in 2010-2012. While the overall positivity rate rose only 1.8% since the previous year, 2020, they were 12% higher than 2017 and have risen steadily each year, over the past five years.

The Quest Diagnostics Drug Testing Index, which is conducted and published yearly, is a strong tool which provides trend insights on workforce drug use based on positivity rates. Their analysis includes a nationally representative sample size, longitudinal monitoring and a testing population that is generally reflective of the national combined workforce.

The combined workforce is comprised of the general workforce, such as company policy testing by private sector employers as well as the safety-sensitive, federally mandated workforce, which includes those in transportation and nuclear power sectors.


 2022 Drug Testing Positivity

General workforce

Positivity rates increased 1.8% in 2021 compared to 2020 and were 12% higher than those rates in 2017 in the general U.S. workforce. Based on more than 6 million urine specimens, marijuana positivity rates continued to climb now up 8.3% from 2020. This is highest positivity rate to date to be reported by Quest. Over the past five years, positivity rates for marijuana in the general workforce have increased 50%. Urine positivity rates for post-accident testing increased at a greater rate in pre-employment testing in 2021 as well. Over the past five years, post-accident positivity increased 26% while pre-employment positivity increased 17.4%. In 2021, post-accident rates for marijuana and cocaine were up 63.4% and 266.7%, higher, respectively, compared to pre-employment rates. For opiates like hydrocodone, and oxycodone, post-accident positivity was 316.7% and 200% higher than pre-employment testing.

When examining oral fluid specimens, which typically have a shorter window of drug detection, overall positivity rates decreased 46.3%. However, the drop has been attributed to a decline in pre-employment testing that includes tests for marijuana. When marijuana was included in the testing panel, oral fluid positivity rates saw an increase of 20.3%. Additionally, positivity rates for cocaine and methamphetamine in oral fluid specimens increased last year as well.

Safety-sensitive positions

In a statement, Barry Sample, Ph.D., Senior Science Consultant for Quest Diagnostics said, “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.”

Overall positivity in the safety-sensitive workforce was based on nearly 2.7 million urine drug tests and stayed even year over year at 2.2%, however rates increased in several federally mandated, safety-sensitive workforce testing categories. Marijuana, cocaine, and amphetamine positivity rates increased in 2021 for these employees - marijuana increased 8.9%, amphetamines increased 7.8% and cocaine increased 5.0%.

Pre-employment urine drug testing positivity rates have increased 9.5% since 2017 for safety-sensitive employees while post-accident positivity increased 41.9%. Post-accident positivity for marijuana, cocaine, opiates like hydrocodone and hydromorphone and oxycodones like oxycodone and oxymorphone were 63.6%, 119%, 257.1%, and 194.1% higher, respectively, as compared to pre-employment tests. As marijuana use is not federally legal, certain employers are required to test employees for the substance and there are no employment protections offered to those safety-sensitive employees. Dr. Sample stated, “if they use marijuana, they can still lose their jobs. People who use drugs during working hours or before work can still be impaired and dangerous to co-workers, the general public and themselves."


Industry trends

Out of the 17 key industry sectors included in the study only mining saw a decrease in overall positivity rates from 2017 to 2021. The retail trade industry had the highest overall positivity rate at 7%; an increase of 34.6% since 2017. The retail sector also experienced the only year-over-year rise in methamphetamine positivity from 2017 to 2021 of 55.6%.

Not surprisingly, across all industries marijuana positivity increased. In 15 of those industries, it increased by double digits from 2017-2021. Out of the 17 industries examined, 6 have seen the marijuana positivity rate double or more than double across the last five years, including:

  • Transportation and Warehousing
  • Finance and Insurance
  • Utilities
  • Retail Trade
  • Professional, Scientific, and Technical Services
  • Accommodations and Food Services

The Accommodation and Food Service industry has the highest positivity rate for marijuana at 7.5% which is a relative increase of 11.3% over the past five years.

In the Health Care and Social Assistance industry, positivity results for methamphetamine have decreased year over year. Across the last five years, it decreased by 50%. While the construction industry saw a decrease of 16% in positivity rates of methamphetamines over the past five years.

"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," said Keith Ward, General Manager, Quest Diagnostics Employer Solutions, in a statement. "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."


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Quest Diagnostics. (2022, March 30). Workforce drug test positivity climbs to highest level in two decades, finds Quest Diagnostics Drug Testing Index Analysis. Quest Diagnostics Newsroom. Retrieved April 4, 2022, https://newsroom.questdiagnostics.com/2022-03-30-Workforce-Drug-Test-Positivity-Climbs-to-Highest-Level-in-Two-Decades,-Finds-Quest-Diagnostics-Drug-Testing-Index-Analysis

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