It’s likely not a big surprise due to the increased number of states that have legalized marijuana, but a new study reveals the percentage of employees in the general U.S. workforce testing positive for marijuana following an on-the-job accident increased is at its highest level in 25 years in 2022. Moreover, employees high on marijuana regardless of accidents occurring is also on the rise. Specific to the construction field, 4.6% of all employees tested positive for marijuana last year.
According to a new analysis released today by Quest Diagnostics (NYSE: DGX), a provider of diagnostic information services, in 2022, post-accident marijuana positivity of urine drug tests in the general U.S. workforce was 7.3%, an increase from 6.7% in 2021. The new peak follows a steady increase in post-accident marijuana positivity every year from 2012 to 2022. In that 10-year time frame, post-accident marijuana positivity increased 204.2%. From 2002 to 2009, post-accident marijuana workforce positivity declined. Overall, 10.3% of the U.S. workforce tests positive for marijuana while on the job, regardless of an accident occurring or not.
These increases in post-accident marijuana positivity correspond with legalization of marijuana in certain states. In 2012, Colorado and Washington became the first states to legalize marijuana for recreational use. Since then, 19 additional states and the District of Columbia have legalized the recreational use of marijuana and 38 states (plus the District of Columbia) have legalized medical use, although either kind of use remains illegal under federal law.
“It is imperative employers take the proper steps to create and maintain a policy that addresses cannabis use, build a safety-focused culture and educate the workforce to keep all workers safe on and off the job.”
— Katie Mueller, National Safety Council
“Intoxicating cannabis products, including marijuana, can have a major impact on safety at work and have been proven to slow reaction time, impact memory and impair skills essential to driving. State legalization of the drug creates new challenges for employers,” said Katie Mueller, a senior program manager at the National Safety Council focusing on cannabis safety. “The Quest data provide compelling evidence that increased use of cannabis products by employees can contribute to greater risk for injuries in the workplace. It is imperative employers take the proper steps to create and maintain a policy that addresses cannabis use, build a safety-focused culture and educate the workforce to keep all workers safe on and off the job.”

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In 2022, the combined U.S. workforce urine drug positivity for all drugs persisted at 4.6% – the highest level in two decades. The 2021 and 2022 positivity rates were the highest since 2001, up more than 30% from an all-time low in 2010-2012.
Marijuana, Amphetamine Usage Increase
While marijuana was the main driver of workforce positivity increases in the general U.S. workforce, amphetamines positivity also contributed to the increase. Positivity for marijuana in the general U.S. workforce increased to 4.3% positivity in 2022 versus 3.9% positivity in 2021, and amphetamines positivity increased to 1.5% positivity in 2022 versus 1.3% positivity in 2021. While the company’s amphetamines data does not differentiate between prescribed medications and illicit drug use, the increase correlates with other data suggesting that the use of amphetamines, prescribed or illicit, has grown in recent years in the U.S.
The rising overall drug positivity rate for general workforce urine testing was observed widely across U.S. industries. Over the past five years, the workforce positivity rate climbed in most industry sectors, led by Accommodation and Food Services increasing 42.9% (4.9% in 2018 versus 7.0% in 2022), Retail Trade increasing 42.6% (5.4% in 2018 versus 7.7% in 2022), and Finance and Insurance increasing 38.5% (2.6% in 2018 versus 3.6% in 2022).
“As employers express concern for employee health, wellness and safety, they may want to consider these data as a warning sign.”
— Dr. Suhash Harwani, Quest Diagnostics
“Year-over-year and five-year data point to continuously higher workforce drug positivity overall, by industry, and across multiple drug categories,” said Suhash Harwani, PhD, Senior Director of Science for Employer Solutions at Quest Diagnostics. “As employers express concern for employee health, wellness and safety, they may want to consider these data as a warning sign, particularly as a growing body of science demonstrates the risks of marijuana to mental and physical health.”
The new Quest Diagnostics Drug Testing Index (DTI) report is based on more than 10.6 million deidentified urine, hair and oral-fluid drug test results reported between January and December 2022, aimed at providing insight into behavior seen in workers across the combined U.S. workforce by industry and drug type. The combined U.S. workforce includes the general U.S. workforce of mostly company-policy testing by private employers as well as the federally mandated, safety-sensitive workforce, which 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.
The new findings will be presented at the National Drug & Alcohol Screening Association (NDASA) 2023 Conference taking place May 23-25 in Bellevue, Wash.
High on Marijuana Employees Higher in Legalized States
Marijuana positivity increased from 5.1% in 2021 versus 5.7% in 2022 in states in which recreational marijuana is legal and from 3.6% in 2021 to 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 from 3.0% in 2021 to 3.1% in 2022 year over year. That is a 14.8% increase since 2018 when there was a 2.7% positivity rate.
“In the general U.S. workforce, states that have legalized recreational and medical marijuana use exhibit higher positivity rates than the national average. States that have not legalized marijuana appear to have positivity rates below the national averages,” said Dr. Harwani. “Overall, post-accident and pre-employment positivity test rates among the federally mandated, safety-sensitive population have always been lower, suggesting the expectation of testing may be a deterrent.”
“”In the general U.S. workforce, states that have legalized recreational and medical marijuana use exhibit higher positivity rates than the national average.”
— Dr. Suhash Harwani, Quest Diagnostics
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.
Post-accident testing is conducted to evaluate whether drug use may have played a role in a workplace incident prompting the drug test. Both post-accident and pre-employment drug testing aim to protect non-drug using workers from others who may use drugs in the workplace and pose a danger. In the field of construction 4.7% of employees tested positive in 2022, up from 4.1% in 2018. Manufacturing increased to 4.5% from 3.7% over the past 5 years.
The study also shows that 0.21% of employees tested positive for cocaine, up slightly, while only 0.006% tested positive for heroin, which is down significantly (a 51% drop).
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