Excerpted from a PR Newswire Blog
The percentage of employees in the general U.S. workforce testing positive for fentanyl in random drug tests far exceeded those in pre-employment testing, according to the 2025 Quest Diagnostics Drug Testing Index.
The new report reveals changing patterns of drug use by the nation’s workforce. While the analysis of more than 8 million drug tests shows that overall workplace urine drug positivity declined slightly last year, to 4.4% from 4.6%, the sharp increase in fentanyl in random drug checks suggests more workers are using the highly addictive opioid after they have passed pre-employment screens.
Random drug testing involves unscheduled and unannounced drug tests of employed individuals after they have presumably passed pre-employment drug screens.
In 2024, the general U.S. workforce positivity for fentanyl was 707% higher in random tests (1.13%) compared to pre-employment tests (0.14%). This is a stark contrast to other categories of drugs, such as marijuana or other opiates, where less variation is seen in random and pre-employment positivity rates.
For example, in the general U.S. workforce, marijuana’s positivity rate in random testing was 42% lower than its positivity rate in pre-employment testing over the past five years. In contrast, the fentanyl positivity rate in random testing has been 400% higher than in pre-employment testing over the past five years.
In addition, 60% of specimens positive for fentanyl in the U.S. general workforce in 2024 were also found to be positive for other drugs. About 22% of fentanyl-positive workforce drug tests were also positive for marijuana, a rate that has doubled since 2020, when only 10% of fentanyl positives were also positive for marijuana. A large percentage of fentanyl positives were also found to be positive for amphetamines – 16% in 2024 compared to 11% in 2020.
A January 2025 CDC report suggests a slight increase in fatal overdoses in January 2025 compared to January 2024 following consecutive years of decline. Fentanyl has since proliferated in the U.S. and most overdose deaths – 7 out of 10 – are estimated to involve illegally manufactured fentanyls (IMFs), according to the CDC. Starting July 7, 2025, the Department of Health and Human Services’ Federal Drug-Free Workplace Program added fentanyl to the authorized drug testing panel. The majority of opioid-related overdose deaths involve multiple substances. Other key findings:
Marijuana Leads Workplace Drug Detections
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, just slightly below the record high of 7.5% in 2023. Among federally mandated, safety-sensitive workers, marijuana positivity declined slightly to 0.87% from 0.95% in 2023.
Overall Positivity Trends Remain Elevated
In 2024, the combined U.S. workforce urine drug positivity rate declined slightly to 4.4%, down from 4.6% in 2023. While the dip marks the first reduction following three years of elevated positivity, the rate remains stubbornly high, with a 4% or higher overall drug positivity rate persisting over the past 10 years.
“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 workforce.”
For the full story, please click here.