How the Covid-19 Pandemic Affected Drug Use at Work

The year 2020 presented a wide range of challenges to many of us. One tragic and alarming trend was a dramatic rise in substance abuse and overdose deaths throughout the United States. According to the Centers for Disease Control (CDC), we saw an 18.2% increase in overdoses in 2020. But how did drug use trends change within the workplace?

Data in the Quest Diagnostics 2021 Annual Report on workforce drug testing is drawn from over 7 million employee drug tests administered in 2020, and it shows mixed results.

The overall rate of positive results on workplace drug tests declined slightly from 4.5% in 2019 to 4.4% in 2020. Positive test results for marijuana continued to rise steadily, while amphetamine positivity rates stayed steady at 1.1%, which is what it has been every year since 2016.

Many workers in industries performing public safety or national security roles “requiring a high degree of public trust” are subject to federally-mandated drug testing requirements from the Department of Transportation (DOT), Department of Defense (DOD), or Nuclear Regulatory Commission (NRL). In 2020, positivity rates among these Safety-Sensitive workers decreased 8.3% from 2019, but were still 10% higher than the 2016 rates.

As the Safety-Sensitive workforce positive rates decreased, the general workforce rates increased. Overall positivity rates for the general workforce in 2020 increased 3.8% over the previous year, with 5.5% of all tests positive, putting the rate 12.2% higher than in 2016. Nevada and Oklahoma had the highest positivity rates in the country, and Nebraska and Wyoming showed a few of the lowest positivity rates.

Cocaine Positivity Rate Declines

In the general workforce, positive tests for cocaine were down 18.5% at 0.22% positive compared to 2019. This is the lowest number of positive cocaine tests since 2012.

Marijuana Positivity Rate Skyrockets

The positive test rate for marijuana continues to skyrocket in the general workforce, with positivity rate in 2020 being as high as 3.6% in comparison with the 2019 rate of 3.1%. The Safety-Sensitive workforce positive test rate for marijuana started to improve slightly in 2020 at 2.2% positive. While this is still 10% higher than the 2016 rates, it is at least an improvement.

Post-accident marijuana usage in the general workforce is also heading for the stars with 6.4% of tests administered following an accident testing positive. This is a huge cause for concern for employers and employees alike who strive to ensure a safe workplace. Positivity rates in the Safety-Sensitive workforce post-accident tests stayed steady at 1.6% throughout 2019 and 2020.

Not surprisingly, positivity rates in states that have legalized recreational marijuana usage is consistently rising. Positive workplace marijuana tests increased 118.2% since 2012 and sat at 4.8% positivity in 2020. In the states that have not legalized marijuana, the rate also increased, but only 68.4% since 2012 and were charted at 3.2% positive.

Nevada, once again, had one of the highest positivity rates for marijuana in 2020, with the northern midwest and Rocky Mountains area showing the lowest rates.

Ecstasy Positivity Rate Climbs

Positivity for MDMA/MDA 3,4-Methylenedioxymethamphetamine–usually referred to as ecstasy–is also on the rise, increasing 25% from 2019 to land at 0.01% positive in 2020. Yes, this is a small number, but ecstasy rates have slowly, yet steadily increased year after year and could become a larger issue if the trend continues.

Helpful Resources for Employers

The US Substance Abuse and Mental Health Services Administration (SAMHSA) recommends Workplace Prevention Basics as a resource for employers to learn about preventing substance abuse in the workplace. Find more information about Drug-Free Workplace Programs here

If you want to learn about simple, cost-effective employment drug testing solutions for your business, email us at


6 Signs of Employee Drug Use

Most employers want to respect the privacy of their employees, yet they also need to ensure a safe and productive work environment. Navigating those two important principles can become challenging when there is reason to believe an employee is using drugs. It is important to exercise caution and adhere to regulations regarding employee protections. On the other hand, employee drug abuse is both dangerous and expensive, costing businesses an estimated $81 billion annually and often playing a role in on-the-job injuries and even deaths.

Whether your organization already conducts periodic employment drug screens or not, it’s best to know what the common signs of employee drug abuse are. If you see signs of drug abuse, document what you observe as factually as possible.

How can I tell if an employee is using drugs?

While the only way to know for certain is to obtain a confirmed positive result on a drug test, here are six common signs that could mean an employee is using drugs.

  • Missing Work or Coming in Late
  • Accidents On or Off the Job
  • Decreased Productivity at Work
  • Behavioral Changes or Erratic Behavior
  • Changes in Appearance or Speech
  • Impaired Awareness or Poor Judgement

What to Do if You Suspect Employee Drug Abuse

  1. First of all, if the employee holds a safety-sensitive position and you have reason to believe he or she may currently be impaired, take immediate action. You can remove them from duty and conduct a “For-Cause” drug screen if an employee shows discernible signs of being unfit for duty. This is the best course of action when the health and safety of both the employee and others are involved.
  2. If the situation doesn’t require immediate action, but you suspect drug abuse, document your observations in an objective and factual way. Your workplace sleuthing doesn’t necessarily require you to make accusations right off the bat. Gather information from first-hand sources only, avoiding hearsay or gossip. If an employee shows a pattern of unsafe behavior at work, you can conduct a “Reasonable Suspicion” drug test.

If your organization already has a workplace drug testing program in place, review your policies before you confront or take disciplinary action against an employee for suspected drug use. The laws outlining legal next steps vary from state to state, so you’ll want to make sure you act in accordance with your state’s laws.

The Americans with Disabilities Acts protects individuals with alcohol dependency and those who develop an addiction to legally prescribed medications. It does not offer protection to a current user of illegal drugs, but it does cover a person in recovery who has already quit using them.

Federal contractors and safety-sensitive positions within the Department of Transportation (DOT) are required to establish a Drug-Free Workplace according to federal guidelines, and are mandated to carry out routine workplace drug screening.

An employer is permitted to conduct drug tests in five situations.

  1. Pre-employment
  2. As part of an Annual Physical
  3. For-Cause and Reasonable Suspicion
  4. Post Accident
  5. Post Treatment after rehabilitation

Urine testing has been the standard method of workplace screening for some time, but mouth-swab drug tests are becoming increasingly popular. They are easier to perform in a work environment, and saliva tests indicate past drug use within a shorter detection time window, generally between 1 hour and 3 days. This gives a better indication of what substances an individual has used more recently, which is more likely to directly affect performance at work due to impairment or withdrawals.

However your drug screening policy is structured, clearly communicate your expectations and policies to your employees before you hire them and whenever you implement a change. Your ultimate goal is not to catch someone doing something they shouldn’t, but to foster a productive, drug-free workplace from day one.


Highest Positive Workplace Drug Test Results in 12 Years

Drug use in the American workforce is compiled in the Annual Quest Diagnostics Drug Testing Index and 2016 showed the highest positive drug test results in 12 years.  The report analyzed results of over 10 million workplace drug tests to find that 2016 positive test results went up five percent over the previous year to 4.2 percent of all tests.  This is the highest annual positive rate since 2004.

In 2016 there was a 12 percent increase in Cocaine positive tests.  Cocaine positive testing has now increased 4 years in a row.  The press or media typically highlight our opioid epidemic and the marijuana laws, but cocaine use is also on the rise.

In the same study, they cited that heroin detection has plateaued and prescription opiate positive testing actually declined 28% from .96 percent of test results to .69 percent.  These facts are hopeful that possibly some of the attention on the opioid crisis is having a positive impact.

Quest Diagnostics also publishes this data on an Interactive Map showing urine drug test positivity regionally in the USA.

Drug Testing Index Map Drug Positivity 2016


Looking at this map shows that that the Southeast clearly leads the nation in positive drug test results.  The national average is 4.2% of employees tested were positive, but look at the rates (dark green) in the these states – all above the national average:

Drug Use in Southeast States

If you want to know more about what drugs are showing up in your own area, go to the Interactive Drug Map and click on the drug list at the bottom left and you will see how your area compares to the rest of the country.

drug List


For example, here is where positive cocaine tests are the highest

cocaine Map


The interactive map is useful for determining the drug culture of your own area and gives any small business the ability to determine the best drug testing policies for your business and workforce.







Drug Test for Prescription Drugs

Alere Toxicology just released a brand new CLIA waived 5 Panel Rx Drug Screen with specimen validity test. The new I-RXA-157-01 tests for:

  • Benzodiazepines (300 ng/mL)
  • Buprenorphine (10 ng/mL)
  • Methadone (300 ng/mL)
  • Opiates (300 ng/mL)
  • Oxycodone (100 ng/mL)

This new test targets the most commonly prescribed and misused prescription drugs and will provide instant results for clinicians. The integrated cups are easy to use since they are self contained and are ideal for sending preliminary positive specimens to a lab for confirmation.

A temperature strip and specimen validity test are built in to check for specimen tampering checking Creatinine (CR), Nitrites (NI), Oxidants (OX), pH (PH), and specific gravity (SG).

The urine drug screen for prescription drugs are available at POCTestSupply in boxes of 25 tests.

I-RXA-157-01 5 panel test

How long does oxycodone stay in your system?

The world’s largest consumer of oxycodone is the United States with hydrocodone with acetaminophen being the most frequently prescribed drug according to SAMSHA, the Substance Abuse and Mental Health Services Administration. This being the case, many people want to know how long these drugs will stay in your system. The truth is that there are no exact timetables that will give you a definitive answer. However, there are some general guidelines that may help.

There are a couple of factors that determine the duration of a drugs’ presence in the body. Firstly is metabolism. The quicker your body processes what you ingest, the quicker it also leaves the system. Second is hydration and body mass. Fatty tissue has a tendency to store chemicals longer then lean tissue and staying hydrated means less fluid retention. Finally, there is the amount and frequency of use. A first time user can pass a drug through their system generally quicker than a frequent user whose body has built up a tolerance to the drug. Similarly, someone who takes a lower dosage of the drug will test lower sooner than someone who took a higher dosage.

Different types of tests call for different detection times. Oxycodone is detectable in blood tests for roughly 24 hours, in saliva tests for 1-4 days, urine tests 3-4 days and hair tests up to 90 days. This is backed up by findings done in a 2014 study by Ron R. Flegal for SAMSHA.


The study took two groups of 12 healthy, drug-free people and gave one group a single 20mg dose oxycodone and the other group a single two tablet dose of 10mg hydrocodone with 325mg acetaminophen each. They then measured the detection times of the dose through blood, saliva and urine tests over a 50 hour time period. The results show that both oxycodone and hydrocodone showed up in blood and saliva within 15-30 minutes and showed positive in urine within 0-2 hours. For the blood test, the two drugs were out of the detection range in under 25 hours and out of detection range on the saliva test in roughly 35-50 hours. The urine test took the longest as the drugs were detectable up to hour 50.

It is extremely important to note that these are not guarantees that oxycodone will be out of your system in the time frames mentioned. The only way to know for sure is to be tested.

Alcohol Testing with your iPhone

Are you leaving a party after having a few glasses of wine or beer and feeling anxious about getting behind the wheel? Are you afraid of getting pulled over and failing a police officer’s breathalyzer test? You can now test your blood alcohol content (BAC) using your iPhone. Three different iPhone apps have been developed to measure the effect of the amount of alcohol you have consumed. The user must be at least seventeen years of age in order to download and install any of these iPhone apps. Read More