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Drug abuse is up. Positive drug test results are up. The number of companies testing for marijuana is down.
We know this from three major annual reports on substance abuse and drug testing:
1. The National Survey on Drug Use and Health (NSDUH) from the Substance Abuse and Mental Health Services Administration (SAMHSA),
2. The Drug Testing Index (DTI) from Quest Diagnostics, and
3. The Annual Drug Testing Industry Survey from the Current Consulting Group.
The finger of blame can be pointed at one main culprit—the legalization of marijuana. As of August 2023, 40 states, including the District of Columbia, have made using marijuana legal for either medicinal or so-called recreational purposes. The trend to legalize marijuana corresponds precisely with the trend lines from these three major reports that indicate that substance abuse is here to stay, that drug testing is more needed than ever, and that the decision to drop marijuana from a company’s drug test panel is ill-advised at best and potentially dangerous and costly.
According to the NSDUH released on January 4, 2023, substance abuse is on the rise.i Key findings include:
In other words, marijuana use is fueling America’s dramatic overall increase in substance abuse. And one specific key indicator within the NSDUH data portends more trouble on the substance abuse horizon. According to the report:
“Among people aged 12 or older in 2021, 69.2 percent of people perceived great risk of harm from smoking one or more packs of cigarettes a day, and 68.4 percent perceived great risk from having four or five alcoholic drinks nearly every day. Percentages of people who perceived great risk from cocaine or heroin use once or twice a week were 83.7 and 92.3 percent, respectively. In contrast, about one fourth of people (26.5 percent) perceived great risk from smoking marijuana once or twice a week.”ii
This may be why the NSDUH reported that in 2021, 2.6 million people tried marijuana for the first time.iii
Bottom line: Marijuana use is up, fear of harm from using marijuana is down, and first-time marijuana users are in the millions.
Quest Diagnostics Drug Testing Index
The overall increase in substance abuse is no respecter of boundaries. The latest Quest Diagnostics Drug Testing Index (DTI) shows a direct impact on the workplace.
“The overall positivity rate in the combined U.S. workforce, based on more than nine million urine drug tests, was 4.6% in 2022 and 2021, an increase of 31.4% from the all-time low of 3.5% just 11 years ago (2010-2012). In the general U.S. workforce, positivity increased 1.8% (5.6% in 2021 versus 5.7% in 2022) and was 11.8% higher than in 2018 (5.1% in 2018 versus 5.7% in 2021).”iv
Regarding marijuana specifically among non-DOT tests, the DTI noted:
“In the general U.S. workforce, marijuana positivity increased 10.3% year over year (3.9% in 2021 versus 4.3% in 2022). Marijuana positivity increased 11.8% (5.1% in 2021 versus 5.7% in 2022) in states in which recreational marijuana is legal and 8.3% (3.6% in 2021 versus 3.9% in 2022) in states in which medical marijuana is legal. In states in which neither recreational nor medical marijuana is legal, marijuana positivity increased 3.3% (3.0% in 2021 versus 3.1% in 2022) year over year and 14.8% over five years (2.7% in 2018 versus 3.1% in 2022).”v
An increase in positive drug tests conducted after workplace accidents is particularly troublesome.
“The rise in marijuana post-accident positivity among private employers mirrored an increase in overall drug positivity in individuals tested post-accident. In the general U.S. workforce, rates of post-accident drug positivity increased both year over year and over the past five years in nearly all specimen types tested.
Over the last five years, in general workforce urine testing, overall post-accident positivity increased 22.6% (8.4% in 2018 versus 10.3% in 2022). Specifically, post-accident positivity as compared to pre-employment tests in urine specimens tested for marijuana and cocaine in the general U.S. workforce was higher by 58.7% and 230%, respectively.”vi
Bottom line: The legalization of marijuana appears to be a key factor in the overall increase in workplace positive drug test results and for post-accident drug testing, as well.
Current Consulting Group’s 25th Annual Drug Testing Industry Survey
All of this brings us to the results of the Current Consulting Group’s 25th Annual Drug Testing Industry Survey.vii The legalization of marijuana continues to have a negative impact on employers’ drug testing policies. When drug testing providers were asked: “Have you had clients drop marijuana from their drug test panel in the last year?”:
The top reasons why employers drop marijuana from their drug test panel include:
With so many employers dropping marijuana from their drug test panel, it is not surprising that nearly 33% of providers said in five years employers will no longer test for marijuana while 36% said employers will still test for marijuana but it will be a lot fewer. Only 20% predicted that just as many employers as now will still be testing for marijuana.
When asked if employers who drop marijuana from their drug test panel will eventually reinstate it, 50% said “probably not.” About 10% said “many if not all” will add marijuana back into their panel.
What does all of this mean for employers? Here are three key take-aways:
First, with substance abuse trends heading in the wrong direction, it would be a bad time to discontinue drug testing all together. For those employers considering dropping marijuana from their drug test panel, it would be wise to at least include it when conducting reasonable suspicion and post-accident tests if not for all testing situations.
Second, Current Consulting Group’s survey indicated a significant shift toward oral fluid drug testing. When survey participants were asked: “In the future, what drug testing specimen will be used the most?”, only 46% said urine (down from 50% in the previous year’s survey) while 46% indicated it will be oral fluid (up slightly from 45%). Just a few short years ago it was inconceivable to imagine oral fluid would be in a dead heat with urine.
The advantages of oral fluid testing, including the ability to detect recent drug use and a relatively shorter window of detection when compared to urine and hair but that still covers the entire 3- to 10-hour cannabis window of impairment make it possible for employers to continue testing for marijuana and address workplace safety concerns while simultaneously not prying into the private lives of their employees.viii
Third, 57% of participants in Current Consulting Group’s survey indicated they believe drug testing will increase over the next five years.
In the final analysis for employers, it comes down to workplace safety and protecting the bottom line. For those reasons, among others, drug testing is here to stay.
[i] Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health National Survey on Drug Use and Health. SAMHSA. January 2023. https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf
[ii] Ibid. p. 28.
[iii] Ibid. p. 26.
[iv] Increase Seen in the General U.S. Workforce Started Same Year First States Legalized Recreational Marijuana Overall Workforce Drug Test Positivity Persisted at Two-Decade High Across All Workers. Quest Diagnostics Drug Testing Index. Press Release. May 18, 2023. Find more information and the full brochure here: https://www.questdiagnostics.com/business-solutions/employers/drug-screening/knowledge-center/drug-testing-index
[v] Quest Diagnostics Drug Testing Index. 2023.
[vi] Post-Accident Workforce Drug Positivity for Marijuana Reached 25-Year High in 2022, Quest Diagnostics Drug Testing Index Analysis Finds. The Quest Diagnostics Drug Testing Index™ (DTI). May 18, 2023. https://newsroom.questdiagnostics.com/2023-05-18-Post-Accident-Workforce-Drug-Positivity-for-Marijuana-Reached-25-Year-High-in-2022,-Quest-Diagnostics-Drug-Testing-Index-Analysis-Finds
[vii] Current Consulting Group’s 25th Annual Drug Testing Industry Survey. May 2023.
[viii] Scientists put the stopwatch on cannabis intoxication. April 2021. https://www.sydney.edu.au/news-opinion/news/2021/04/12/scientists-put-stopwatch-on-cannabis-thc-intoxication-lambert-drug-driving.html
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