Actions to combat the rise in positive drug tests

A new analysis shows that the rate of positive drug tests for the U.S. workforce rose to a 14-year high in 2018. The increase raises difficult questions for employers concerned about maintaining drug-free workplaces and preventing drug-caused workplace accidents in the face of the increasing use of  recreational and medical marijuana and the opioid drug crisis.

The analysis was released on April 11 by Quest Diagnostics and looked at the results of more than 10  million workplace drug tests. Positive drug tests from urine samples in 2018 were at 4.4 percent, up 5 percent from 2017. Marijuana is the most frequently found drug in workplace tests. The good news is that opiate use (mostly morphine and codeine) had its most significant decline in nearly three years, dropping nearly 37 percent since its peak in 2015.[i]

In an effort to reduce opioid use, the federal government established new rules in January 2018 for opioid drug testing in safety-sensitive industries. While overall opioid use in the U.S. declined, the addition of four semi-synthetic opiates tests for the safety-sensitive workforce contributed to the large increases in year-over-year positivity among those workers, but it is still less than 1 percent of those tested.

Post-accident positive drug tests continue to rise. Increases in post-accident positive drug tests rose 51 percent over last year to 4.7 percent. The jump in 2018 was primarily driven by the addition of prescription opiates to the panel of required drugs for testing.[ii]

Workplace accidents involving the use of marijuana have increased by 55%, and accidents involving injury have increased by 85 percent.[iii] This rise in positive drug tests is a remainder to employers about the risk drugs pose for workforce accidents and safety, as well as for the quality of worker decisions.

Drug use is a costly problem for employers according to the National Drug and Alcohol Screening Association, a new industry association that launched in 2018. Its director, Jo McGuire, says “Employee substance use costs U.S. employers over $164 billion annually. The small-business owner can lose upwards of $7,000 per month in lost revenue due to employee turnover, absenteeism, lack of productivity, accidents, injuries, and even workplace fatalities.”[iv]

Over half the states and the District of Columbia allow medical marijuana. However, lawsuits brought by employees charging unfair dismissal for using medical marijuana have all been dismissed to date. Some of these laws have antidiscrimination language that consider medical marijuana users as being disabled. Alaska, California, Colorado, Oregon, Washington, and the District of Columbia have passed recreational marijuana use, but three of these jurisdictions allow employers to prohibit marijuana use in the workplace.[v]

Employers will need to watch over the next few years to see if the courts or states begin to strengthen the rights of medical marijuana users.

Is drug testing a waste of time and money? Michael Frone in his book Alcohol and Illicit Drug Use in the Workplace says that there isn’t any proof that drug tests reduce drug use. With more than half of Americans saying they have used marijuana, casual or medical marijuana users may choose not to work for companies that have preemployment drug screening. He also states that employers know that drug testing doesn’t mean anything. Anyone who smokes pot will just stop for a few days before their drug screening. It is an empty ritual that nobody wants to be the first to give up.”[vi]

Michael Frone makes some valid observations. Yet, I believe the cost of impaired workers is too high to ignore, and it is not an empty ritual. Drug testing speaks to the values of your company and is a commitment to the quality and reliability of your products and services.

I recommend drug testing of new hires, for cause, and post-accidents especially if you are in an industry where it is legally required, such as federal contractors with contractors of over $100,000. Or where the public confidence in your products and services would be jeopardized by sloppy work or workplace accidents, such as biotech, pharmaceuticals, health care, aerospace, manufacturing, security, and transportation.

Besides, no one wants to ride on a train or airplane where the pilot is impaired, or have a medical device produced in a factory where employees may be under the influence of drugs.

If you do implement or continue your drug testing policy, you should take these steps:

  1. Have a written policy (in some states, it is a requirement to have a written policy).
  2. Decide on whether to have random drug testing or only post-accident drug testing (federal law may require it in your industry).
  3. Use certified drug testing labs (again follow the legal guidelines in your industry).
  4. Follow the National Institute of Drug Abuse (NIDA) procedures.
  5. Administer new hire drug tests after a conditional job offer is made.
  6. Know your local city and state laws and watch what happens with recreational and medical marijuana.

Contact me to learn more about workplace drug testing and watch for my new book, Hack Recruiting, to be released soon.

Victor Assad is the CEO of Victor Assad Strategic Human Resources Consulting and is a Managing Partner of InnovationOne. He consults and provides hands-on support to improve recruiting and retention, cultures of innovation, and train agile leaders and teams. Overcome your obstacles to these issues by subscribing to his weekly blogs. Go to to subscribe


[i] “Workforce Drug Testing Positivity Climbs to Highest Rate Since 2004, According to New Quest Diagnostics Analysis,” (April 11, 2019, 9:05 AM). The Wall Street Journal.

[ii] Ibid.

[iii] Robert S. Goldsmith, MD, MPH, FACOEM, corresponding author Marcelo C. Targino, MD, MPH, FACOEM, Gilbert J. Fanciullo, MD, MS, Douglas W. Martin, MD, FACOEM, FAADEP, FAAFP, Natalie P. Hartenbaum, MD, MPH, FACOEM, Jeremy M. White, JD, and Phillip Franklin, MD, MPH, MBA, (May 8, 2015), “Medical Marijuana in the Workplace: Challenges and Management Options for Occupational Physicians,” Journal of Occupational and Environmental Medicine.” Journal of Occupational and Environmental Medicine.

[iv] “National Drug and Alcohol Screening Association Formed,” (August 15, 2018), Occupational Health and Safety.

[v] Roy Maurer, “Drug Test Your Workforce Lawfully, Effectively,” Society for Human Resource Management (February 3, 2015);

[vi] Joe Pinsker, “Pointlessness of the Workplace Drug Test: Cup-Peeing and Mouth-Swabbing Are Reagan-Era Relics that Frequently Do Little More than Boosting the Revenues of Companies that Analyze Samples,” Atlantic (June 4, 2015);

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