Drug-Free Workplace

Marijuana, Cocaine, Meth Use in the Workplace Climbs as Opioid Use Falls

The decline of opioids is encouraging, but increased positive tests in methamphetamine and cocaine should be seen as a wake-up call for public safety.
By: | May 9, 2018 • 4 min read
Topics: Safety | Workers' Comp

While communities and health care providers work to drive down opioid usage, drug use by the American workforce remains at its highest rate in more than a decade, thanks to increases in the use of cocaine, methamphetamines and marijuana, according to Quest Diagnostics.


2018 marks the 30th year that the company published its national Drug Testing Index™, analyzing workplace drug positivity trends.

According to the analysis, drug test positivity for the combined U.S. workforce held steady at 4.2 percent in 2017. But rising figures related to certain substances may prompt employers to review their drug testing and prevention programs.

Cocaine Use Is Increasing

The positivity rate for cocaine increased for the fifth consecutive year in the general U.S. workforce across every specimen type. In urine testing, the most common drug test specimen type, the

Kim Samano, PhD, scientific director, Quest Diagnostics

positivity rate for cocaine increased 7 percent in the general U.S. workforce.

In the federally-mandated, safety-sensitive workforce, for which only urine testing is permitted, cocaine positivity increased by 11 percent, the third consecutive year of increases in this segment.

A new pattern emerged in this year’s analysis, with cocaine positivity in urine testing increasing significantly in certain states among the general U.S. workforce. Double-digit, year-over-year increases in at least four of the five past years were seen in the states of Nebraska (91 percent increase between 2016 and 2017), Idaho (88 percent increase), Washington (31 percent), Nevada (25 percent), Maryland (22 percent increase), and Wisconsin (13 percent).

Methamphetamine Rise Is Cause for Concern

From 2016 to 2017, the percentage increase in methamphetamine positivity rates ranged from 9 percent to 25 percent in certain regions. But the current year’s figures alone don’t tell the full story of the alarming rise of the drug’s use. Quest reports that between 2013 and 2017, methamphetamine positivity increased:

  • 167 percent in the East North Central division of the Midwest (Illinois, Indiana, Michigan, Ohio, Wisconsin);
  • 160 percent in the East South Central division of the South (Alabama, Kentucky, Mississippi, Tennessee);
  • 150 percent in the Middle Atlantic division of the Northeast (New Jersey, New York, Pennsylvania); and
  • 140 percent in the South Atlantic division of the South (Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia).

Marijuana positivity increased 4 percent for the general U.S. workforce. For safety-sensitive workers, including pilots, rail, bus and truck drivers, and workers in nuclear power plants, for whom routine drug testing is required by the DOT, that increase was 8 percent.

States with recently enacted recreational use statues saw notable increases:

  • Nevada (43 percent)
  • Massachusetts (14 percent)
  • California (11 percent)

Whether those numbers indicate an actual trend remains to be seen.

Opioid Positivity Rates Continue to Decline

The good news is that significant progress has been made in the battle against opioid abuse. Quest Diagnostics’ Scientific Director Kim Samano noted in the report, “The depth of our large-scale analysis supports the possibility that efforts by policymakers, employers, and the medical community to decrease the availability of opioid prescriptions and curtail the opioid crisis is working to reduce their use, at least among the working public.”

“While there is encouraging data regarding prescription opiates, increased workplace test positives in methamphetamine and cocaine is troubling. This data should serve as a wake-up call to regulators and employers that drugs other than opioids require attention to effectively combat workplace substance abuse and maintain public safety.” — Kim Samano, PhD scientific director, Quest Diagnostics.

Nationally, the positivity rate for opiates in the general U.S. workforce in urine drug testing declined 17 percent between 2016 and 2017. Positivity for oxycodones (oxycodone and/or oxymorphone) declined 12 percent between 2016 and 2017, while hydrocodone positivity dropped by 17 percent and hydromorphones declined 22 percent.


For opiates other than codeine, positivity rates were at their lowest in more than a decade, a trend that mirrors the CDC’s figures on the decline of opioid prescribing over the past decade.

Test results for heroin also reached a three-year low, down 11 percent from 2016 to 2017.

Those figures are positive, but the fact remains that shifting patterns of usage across geographies will continue to make it more difficult for employers to effectively focus their prevention programs and drug-free workplace efforts.

“While there is encouraging data regarding prescription opiates, increased workplace test positives in methamphetamine and cocaine is troubling. This data should serve as a wake-up call to regulators and employers that drugs other than opioids require attention to effectively combat workplace substance abuse and maintain public safety,” said Kim Samano, PhD, scientific director, Quest Diagnostics.

Risk and safety managers can view positivity rates and trend lines by zip code on Quest Diagnostics’ interactive Drug Testing Index map. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

The risk manager for Boyd Gaming Corp. says curiosity keeps him engaged, and continual education will be the key to managing emerging risks.
By: | May 1, 2018 • 4 min read

R&I: What was your first job?

I was trained as an accountant, worked in public accounting and became a CPA. Being comfortable with numbers is helpful in my current role, and obviously, the language of business is financial statements, so it helps.

R&I: How did you come to work in risk management?

Working in finance in the corporate environment included the review of budgets and the analysis of business expenses. I quickly found the area of benefits and insurance — and how “accepting risk” impacted those expenses — to be fascinating. I asked a lot of questions. Be careful what you ask for — I soon found myself responsible for those insurance areas and haven’t looked back!

R&I: What is the risk management community doing right?


I have found the risk management community to be a close-knit group, whether that’s industry professionals, risk managers with other companies or support organizations like RIMS and other regional groups. The expertise of the carriers and specialty vendors to develop new products and programs, along with the appropriate education, will continue to be of key importance to companies going forward.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?

As I’m sure many in the insurance field would agree, Hurricanes Katrina and Rita in 2005 changed our world and our industry. It was a particularly intense time and certainly a baptism by fire for people like me who were relatively new to the industry. This event clearly accelerated the switch to the acceptance of more risk, which impacted mitigation strategies and programs.

Bob Berglund, vice president, benefits and insurance, Boyd Gaming Corp.

R&I: What emerging commercial risk most concerns you?

The fast-paced threat that cyber security represents today. Our company, like so many companies, is reliant upon computers, software and IT expertise in our everyday existence. This new risk has forged an even stronger relationship between risk management and our IT department as we work together to address this growing threat.

Additionally, the shooting event in Las Vegas in 2017 will have an enduring impact on firms that host large gatherings and arena-style events all over the world, and our company is no exception.

R&I: What insurance carrier do you have the highest opinion of?


With the various types of insurance programs we employ, I have been fortunate to work with most of the large national and international carriers — all of whom employ talented people with a vast array of resources.

R&I:  How much business do you do direct versus going through a broker?

We use brokers for many of our professional coverages, such as property, casualty, D&O and cyber. We are self-insured under our health plans, with close to 25,000 members. We tend to manage those programs internally and utilize direct relationships with carriers and specialty vendors to tailor a plan that works best for team members.

R&I: Who is your mentor and why?

I have been fortunate to have worked alongside some smart and insightful people during my career. A key piece of advice, said in many different ways, has served me well. Simply stated: “Seek to understand before being understood.”

What this has meant to me is try everything you can to learn about something, new or old. After you have gained this knowledge, you can begin to access and maybe suggest changes or adjustments. Being curious has always been a personal enjoyment for me in business, and I have found people are more than willing to lend a hand, offer information and advice — you just need to ask. Building those alliances and foundations of knowledge on a subject matter makes tackling the future more exciting and fruitful.

R&I: What have you accomplished that you are proudest of?

Our benefit health plan is much more than handing out an insurance card at the beginning of the year. We encourage our team members and their families to learn about their personal health, get engaged in a variety of health and wellness programs and try to live life in the healthiest possible way. The result of that is literally hundreds of testimonials from our members every year on how they have lost weight, changed their lifestyle and gotten off medications. It is extremely rewarding and is a testament to [our] close-knit corporate culture.

R&I: What’s the best restaurant you’ve ever eaten at?


Some will remember the volcano eruption in Iceland in spring of 2010. I was just finishing a week of meetings in London with Lloyd’s syndicates related to our property insurance placement when the airspace in England and most of northern Europe was shut down — no airplanes in or out! Flights were ultimately canceled for the following five days. Therefore, with a few other stranded visitors like myself, we experimented and tried out new restaurants every day until we could leave. It was a very interesting time!

R&I: What is the riskiest activity you ever engaged in?

I am originally from Canada, and I played ice hockey from the time I was four years old up until quite recently. Too many surgeries sadly forced my recent retirement.

R&I: What do your friends and family think you do?

That’s a funny one … I am a CPA working in the casino industry, doing insurance and risk management, so neighbors and acquaintances think I either do tax returns or they think I’m a blackjack dealer at the casino!

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]