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Workplace Drug Testing Data Shows Growing Ratio of Post-accident Positives Among American Workers

Neil Campbell
Neil lives in Canada and writes about society and politics.
Published: March 30, 2022
US Workers are testing positive for drugs after an accident at an exponentially greater rate than pre-employment, indicating workplace drug use.
Members of the National Anti-Drug Police incinerate 8,447 kilograms of cocaine at the facilities of the Military Police of Public Order (PMOP), in Tegucigalpa, on March 10, 2022. Data from Quest Diagnostics’ 2022 Drug Testing Index indicates American workers are testing positive post-accident for drugs, especially hard drugs, at an exponential rate. (Image: ORLANDO SIERRA/AFP via Getty Images)

A new set of data published by a leading American narcotics screening firm revealed results indicating 2021 presented a year with not only a dramatic increase in workplace drug use, but an exponential increase in post-accident positive tests when compared to pre-employment screening results.

New Jersey-based Quest Diagnostics released results of their 2022 Drug Testing Index (DTI) on March 30, a study based on “more than 11 million deidentified urine, hair and oral fluid drug test results collected between January and December 2021.”


Articles from leading media outlets, such as a pre-release exclusive by the Wall Street Journal on March 29, focused primarily on an aspect of the report indicating a marginal increase in positive tests for marijuana users from 3.6 percent in 2020 to 3.9 percent in 2021 among six million urine samples.


The finding is, in fact, notable, as Quest reported in a March 30 press release summarizing the Index’s findings. The company noted the figure is both “the highest positivity rate ever reported in the DTI,” and a monumental 50 percent increase from 2017’s 2.6 percent positivity rate.

However, Quest disclosed a massive 46 percent decrease in oral fluid positivity rates when screening for all drugs of 7.3 percent in 2021 compared to 13.6 percent in 2020.

Oral fluid tests results, primarily utilized in pre-employment screening, were “driven by a decline in the number of pre-employment tests that included marijuana,” stated the release. 

When examining oral fluid tests that did screen for marijuana, however, Quest noted 2021 showed a 20 percent increase with a 14.8 percent positivity versus 2020’s 12.3 percent positivity rate.

An ‘alarming’ post-accident trend

What articles such as The Journal’s failed to mention, however, is a quietly embedded, yet frightening statistic nested in the latter third of Quest’s DTI statistics sheet that strongly indicates employees who are passing or evading pre-employment screening may be abusing drugs after gaining employment.

The concept is illustrated in both categories the DTI focuses on: general workforce and the “federally mandated, safety-sensitive workforce.”

The press release elaborates that the “federally mandated” group, “includes federal employees and the transportation and nuclear power industries, and can include workers such as pilots, truck drivers, train conductors and others required to drug test under federal legislation.”

Quest noted a major divergence between pre-employment and post-accident drug screening positivity rates.

The release elaborates, “Pre-employment drug tests are meant to be a deterrent in hiring workers whose drug-use behavior may cause unsafe work conditions or poor work performance.”

“Post-accident testing is conducted to evaluate whether drug use may have played a role in the workplace incident prompting the drug test.”

The data showed that overall, the trend is actually long-running.

During a five year period from 2017, overall pre-employment drug test positivity for the general workforce had increased 17.4 percent, but was eclipsed by an increase of 26 percent in post-accident urine test positives.

However, in the federally mandated category, since 2017, those numbers were relatively inverted with a 9.5 percent increase in pre-employment, but a 41.9 percent post-accident failure rate.

But the Devil is in the details.

When it came to post-accident urine testing, Quest found in 2021 that among the general workforce, when compared against pre-employment screening data, positivity rates for marijuana and cocaine were a staggering 63.4 and 266.7 percent higher.

More concerningly, when conducting post-accident testing for opioids, a 316.7 percent increase over pre-employment figures was shown.

With oxycodones, the increase was 200 percent.

Barry Sample, Senior Science Consultant for Quest, stated in the release, “The increase in post-accident positivity is alarming and suggests more drug-associated accidents may be occurring even with employers with pre-employment drug testing in place.”

Industry leaderboard

In the full report of Quest’s 2021 DTI, which examined data from the 2020 calendar year, the screener disclosed the segments of the general U.S. workforce with the highest drug positivity test results across all classes of drugs were retail sales and food and accommodation services.

While this result was more amplified for marijuana positives, in data on cocaine positives, the top guilty industry changed to construction.

When it came to opiates, mining was the top industry, and for amphetamines and methamphetamines, educational services were the top industry. 

A full report of the 2022 DTI does not appear to have yet been released.