Drug Data Suggest Shifting Landscape
If you’re a glass-half-full kind of person, then I suppose you can interpret Quest Diagnostics’ latest data analysis on workplace drug-positivity rates as saying the problem isn’t getting any worse. Indeed, the testing company reports that the positivity rate for the combined U.S. workforce held steady in 2017 at 4.2 percent.
But if you’re among those with a glass-half-empty mindset, you probably won’t have any trouble grabbing onto the five-year trend line showing the overall positivity rate at a decade high.
Quest’s data (based on more than 10 million U.S. drug-test results) suggest a shifting pattern of drug use. Cocaine and amphetamine positivity surged in some areas of the country, and marijuana positivity climbed noticeably in states with new recreational-use statutes. Prescription-opiate-positivity rates, meanwhile, declined dramatically on a national basis.
In urine testing—the most common drug-test specimen type—the positivity rate for cocaine increased 7 percent for the general workforce between 2016 and 2017. Year-over-year increases were also observed for oral-fluid testing (up 16 percent) and hair testing (19 percent). Nebraska, Idaho, Washington, Nevada, Maryland and Wisconsin all experienced double-digit year-over-year increases (ranging from 91 percent to 13 percent) in at least four of the five past years. (Quest provides an interactive national map of its urine-drug-test-positivity findings.)
Similarly, marijuana-positivity rates continued their upward trajectory in urine testing for the general workforce, increasing 4 percent between 2016 and 2017. As might be expected, the trend was most striking in states that have enacted recreational-use statutes since 2016: Nevada (43 percent), Massachusetts (14 percent) and California (11 percent).
The analysis also revealed an increase in methamphetamine-positivity rates, especially in the Midwest and Southern regions.
Leading up to 2012, Quest’s analysis provided some “encouraging news,” with overall positive rates having plateaued, points out Dr. Barry Sample, senior director of science and technology for Quest’s employer solutions business in Secaucus, N.J. “But in at least the last two to three years, we’ve seen increases in rates for illicit drugs like cocaine, amphetamines and marijuana.”
While this reflects broad societal trends, he adds, the data should nonetheless concern employers that are looking to build drug-free workplaces.
One of the report’s few bright spots can be found in opiate use. In contrast to the cocaine data, opiates found in urine drug testing declined 17 percent between 2016 and 2017. Most notably, oxycodone positivity declined 12 percent between 2016 and 2017; hydrocodone positivity declined 17 percent; and hydromorphone positivity declined 22 percent. (With the exception of codeine, opiates were at their lowest positivity rate in more than a decade.)
Sample reports that Quest’s analysis shows three consecutive years of double-digit declines for hydrocodone and hydromorphone, down over that period 48.5 and 48.9 percent, respectively. What’s more, he says, “We’ve had six out of six consecutive years of decline in oxycodone positivity.”
(Urine drug test results for heroin also declined for the general U.S. workforce, the analysis showed.)
“While we can’t declare cause and effect,” Sample says, “it may be reflective of efforts at the state and federal level to have prescription databases and to control the number of units or prescriptions that can be filled at any one time, as well as education efforts. I’m not saying that there isn’t an opioid crisis, but I think at least among those workers who are subject to workforce drug testing … it would appear that there is a declining use of these by applicants or employees.”
Dr. Richard Chaifetz, CEO of ComPsych, a Chicago-headquartered employee-assistance-program provider, says he is cautious about the drop in opioid use for two reasons. First, he says, the federally mandated testing for opioids started only in late 2017; and second, synthetics were not included.
Further, he adds, the study reflects a short period of time that may not connote a trend; and because it is limited to employers that do drug testing, it doesn’t reflect more general opioid trends.
That said, Chaifetz points out that the overall analysis is further evidence that drug use is still a problem. His advice to HR leaders: Be cognizant of the increase in usage in the categories mentioned and make sure you have the right solutions in place to identify and provide intervention for people displaying behaviors consistent with drug use.