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.







Most Small Businesses don’t drug test

Running a business is difficult, whether your business is large or small. Having trustworthy and drug free employees should not be a worry for business owners, but unfortunately this is not the case. Most large companies have a drug test policy with 80% of Fortune 500 companies drug testing their employees. This fact can deter drug users from applying with those companies. The alternative to applying to big companies for fear of drug testing, is applying to small businesses. Read More

Pre-Employment Hair Drug Testing

Trucking company, C.R. England, recently published the results of a year long study of the difference between using a urine drug test versus a hair drug test as part of the pre-employment drug screen.  The DOT requires trucking companies to use a urine drug test and the company will continue to do so, however, the results of additionally using a hair drug test are substantially different.

“With hair testing, we are able to detect months of time rather than the handful of days checked with standard urine tests. We found our hair testing positive rate was over three times higher than the required DOT urine test alone.”  Dustin England, vp-safety and compliance for C.R. England

The pilot study was done with 2,000 job applicants that were given the urine drug test and the hair drug test.  Over 150 applicants buy propecia tested positive to the hair drug test while testing negative on the urine drug test.  Overall, 11% of the applicants tested positive to the hair drug test versus only 2.8% testing positive to the DOT required urine drug test.

For employers looking for long term employees, the results of this study show that hair drug testing as part of the job hiring process will help reduce the risk of hiring a person with a drug habit.  Urine drug tests only show drug use in the last few days or weeks compared to a hair drug test which has a ninety day or more history of drug use.

C.R. England is a national trucking company that must comply with DOT regulations regarding drug tests, however, small businesses can also use hair drug tests as part of the pre-employment process and it is no longer cost prohibitive to do so.  Our hair drug test kit for business is less than $80 and there is no minimum purchase so you can test just one potential employee before making that final hiring decision.

Dealing With Federal Laws: Figuring Out How To Drug Test Your Employees

[This is the third in a series of articles by Kim Wilbur, operations manager for a local company.  To view all of Kim’s blogs please visit the Blog Series:  Employee Drug Testing homepage.]

Federal Laws

Now that I want to start drug testing our employees what do I do?  Maybe the question is, “what do I HAVE to do?”  I thought I had better first find out what the laws and requirements are, so I started doing some research.  The federal laws that your business must adhere to will vary depending on the amount of employees you have on staff and the type of business you have.  See below for a brief summary of applicable laws and how they relate to creating a drug-free workplace policy.

Fifteen or More Employees

American with Disabilities Act of 1990

A federal law that protects people with disabilities from discrimination.   The importance of the ADA is to ensure that employers evaluate an individuals’ ability to do the required job tasks and that they make employment decisions based on an individual’s qualifications and performance not the person’s history of drug or alcohol abuse.  For more information see the Department of Labor’s ADA page.

The Civil Rights Act of 1964

This landmark bill prohibits private employers from discriminating against individuals on the basis of race, sex, religion, or nationality.  Employers are required to ensure that their drug free workplace policy and programs treat all workers equally and avoid singling out any particular racial, ethnic, or gender group for drug or alcohol testing or disciplinary action. _____________________________________________________________________________________

Fifty or More Employees

Family and Medical Leave Act of 1993

This act enables employees to take up to 12 weeks of unpaid leave within a 12 month period, due to a serious health problem or a substance abuse problem as long as they have worked for an employer for at least 1 year.   For more information see the Department of Labor’s FMLA page. _____________________________________________________________________________________

Unionized Industries

National Labor Relations Act

This act requires that a drug testing policy that affects union workers, must be negotiated and agreed upon with the union itself.  Even if the employer is mandated to have a policy because of the type of industry it is in, such as a transportation company, the employer must still work closely with the union to determine the specifics of the policy.  For more information see the National Labor Relations Board site here.

Federal Government Contractors and Grantees Drug Free Workplace Act of 1988

This requires Federal contractors and all Federal grantees to agree that they will provide drug-free workplaces as a condition of receiving a contract or grant from a Federal agency.   For more information see this page from the Department of Labor.

Transportation Industry The Omnibus Transportation Employee Testing Act of 1991

States that any employee performing safety-sensitive transportation functions, including ones in the “aviation, trucking, railroads, mass transit, and pipelines industries” are required to be drug and alcohol tested.  Employee drug testing must be done pre- employment, in the event of reasonable suspicion, post-accident, return to duty and follow up, and at predetermined random rates.  For more information see the Department of Transportation’s page.

Department of Defense

All contractors working for the Department of Defense who have access to classified information must create, maintain and enforce a drug free work place policy.  The policies must be consistent with state laws and be agreed to by any relevant labor union.  For more information see this official PDF from the military.

Other Federal Safety Sensitive Organizations

Other organizations that have similar drug testing policies to the US Department of Defense are the U.S. Department of Energy, the National Aeronautics and Space Administration (NASA), and the Nuclear Regulatory Commission.  More information about their policies can be found on each agency’s Web site or in the Code of Federal Regulations.

Again these are basic overviews of the Federal laws that may apply to your business.  To ensure that you are following the appropriate laws and regulations for your business so that you can avoid fines or being sued, you should consult a lawyer.

We hope this helped and that you found it interesting!  Stay tuned for our next installment!