Drug abuse is an ongoing issue among the American workforces in 2024 according to the latest Quest Diagnostics Survey.
Marijuana remains the most frequently detected substance, with positivity holding steady at 4.5% in the general U.S. workforce year over year.
Marijuana positivity following workplace accidents also remains high – post-accident positivity was 7.3% in 2024.
Overall Positivity Trends Remain Elevated Despite Modest Declines
In 2024, the combined U.S. workforce urine drug positivity rate declined slightly to 4.4%, down from 4.6% in 2023.
“The overall drug positivity rate continues to reflect persistent trends,” said Sam Sphar, Vice President and General Manager of Workforce Health Solutions at Quest Diagnostics. “When we talk to employers, they tell us the same thing the Quest data tells us – that drug abuse is an ongoing issue among the American workforces.
Amphetamines Positivity Rates Increase; Other Positivity Remains Consistent
In the general U.S. workforce, amphetamines continued their upward climb, with positivity increasing to 1.7%, up from 1.5% in 2023. Cocaine positivity remained unchanged at 0.24%.
Testing Positivity for Suspicion of Drug Use Declines
The 2025 Quest Diagnostics Drug Testing Index reveals that drug test positivity continues to vary significantly depending on the testing circumstance. In the general U.S. workforce, for-cause testing, used when employers have reasonable suspicion of substance use, showed a 33.1% positivity rate in 2024.
Post-accident testing positivity fell slightly from 10.4% to 10.2%, while return-to-duty testing, administered to employees coming back after a violation of a company drug policy, declined from 8.4% to 7.9%.
The Quest data showing that about one in three employees tested for cause were positive for drug use demonstrates opportunities for employers to bolster psychologically safe practices and recovery-supportive programs, enhancing both employee reporting and safety initiatives,” said Claire Bryant, Senior Program Manager of Workplace Wellbeing at the National Safety Council.
About the Quest Diagnostics Drug Testing Index™
The strengths of the DTI analysis include its large, nationally representative sample size, longitudinal monitoring, a testing population that is generally reflective of the U.S. workforce, and the quality of the company’s drug testing services to confirm positive results. Limitations include analysis only of employers that perform drug testing with the company, and a lack of exact cross-specimen comparisons due to variations in substances for which employers test. Quest Diagnostics has analyzed annual workplace drug testing data since 1988 and publishes the findings as a public service. For more information, visit www.QuestDiagnostics.com/DTI.
About Quest Diagnostics Workforce Health Solutions
Through its workforce health solutions, Quest Diagnostics is a leading provider of laboratory testing and other services designed to optimize the health, safety, and wellbeing of employees. Quest workforce health solutions includes population health and biometric and laboratory screening services to identify and act on disease risks in the earliest stages; workplace drug testing services to help identify and pre-empt dangerous workplace drug use; and OSHA-required laboratory screening and vaccination services. Based on the industry-leading diagnostics expertise of Quest Diagnostics, our solutions incorporate the latest science, technology and innovations in laboratory medicine and healthcare management to reveal the actions that will improve workforce health, for better medical care and lower costs. For more information, visit WorkforceHealthSolutions.com.
About Quest Diagnostics
Quest Diagnostics works across the healthcare ecosystem to create a healthier world, one life at a time. We provide diagnostic insights from the results of our laboratory testing to empower people, physicians, and organizations to take action to improve health outcomes. Derived from one of the world’s largest databases of de-identifiable clinical lab results, Quest’s diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors, and improve healthcare management. Quest Diagnostics annually serves one in three adult Americans and half the physicians and hospitals in the United States, and our more than 55,000 employees understand that, in the right hands and with the right context, our diagnostic insights can inspire actions that transform lives and create a healthier world. www.QuestDiagnostics.com.
James P. Randisi, President of Randisi & Associates, Inc., has been helping employers protect their clients, workforce and reputation through implementation of employment screening and drug testing programs since 1999. This post does not constitute legal advice. Randisi & Associates, Inc. is not a law firm. Always contact competent employment legal counsel. To learn more about the rights of employees who test positive for marijuana, Mr. Randisi can be contacted by phone at 410.494.0232 or Email: info@randisiandassociates.com or the website at randisiandassociates.com
