NSC Alcohol, Drugs and Impairment Division news Drugs

Drug test cheating surges to highest rate ever, annual index shows

Photo: Sundry Photography/iStockphoto

Secaucus, NJ — The percentage of U.S. workers whose drug test showed signs of tampering skyrocketed in 2023 to its highest level in over 30 years, according to Quest Diagnostics’ annual Drug Testing Index.

Researchers from the lab services provider examined the results of nearly 9.8 million samples taken last year. The samples were from both the general workforce and employees in safety-sensitive jobs who undergo federally mandated drug testing (including pilots, truck drivers and train conductors).

Substituted urine specimens in the general workforce soared 633% (0.11% in 2023 vs. 0.015% in 2022). Invalid urine specimens among this group rose 45.2% (0.45% in 2023 vs. 0.31% in 2022).

The increased rate of invalid or substitute drug test samples, which Quest Diagnostics says suggest an attempt to conceal drug use, coincides with historically high rates of both drug positivity in the general workforce (5.7%) and post-incident positivity, which has gone up 114% from 2015.

Among the federally mandated, safety-sensitive U.S. workforce, substituted specimens increased 371% (0.08% in 2023 vs. 0.017% in 2022) and rates of invalid tests rose 37% (0.41% in 2023 vs. 0.3% in 2022).

Other findings:

  • Marijuana positivity in the general workforce rose 4.7% (4.5% in 2023 vs. 4.3% in 2022) and has jumped 45% since 2019.
  • Cocaine positivity among the general workforce saw a 9.1% increase (0.24% in 2023 vs. 0.22% in 2022), while amphetamine positivity (1.5%) remained steady.
  • The positivity rates of codeine/morphine, hydrocodone/hydromorphone and oxycodone/oxymorphone all fell.

“Organizations must have sound policy and procedures to ensure employee drug testing programs have efficacy,” said Katie Mueller, a senior program manager at the National Safety Council whose work focuses on cannabis safety. “Cheating on drug tests not only undermines workplace safety but also jeopardizes the safety of society as a whole.”

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