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

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.

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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.

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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

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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