Workforce Drug Test Positivity Climbs to Highest Level in Two Decades

Today Quest Diagnostics released the latest findings from the Drug Testing Index™ (DTI). The DTI reveals drug use trends among the American workforce and positivity rates by industry sector. It is published annually as a public service for government, employers, policymakers, media, and the general public, and includes workforce drug testing data since 1988.

For 2021, the rate of positive drug test results among America’s workforce reached its highest rate since 2001 and was up more than 30% in the combined U.S. workforce from an all-time low in 2010-2012.

“Our Drug Testing Index reveals several notable trends, including increased drug positivity rates in the safety-sensitive workforce responsible for keeping society safe, as well as higher rates of positivity in individuals tested after on-the-job accidents,” said Barry Sample, PhD, Senior Science Consultant for Quest Diagnostics.

Infographic: 2022 workforce drug testing overview
Infographic: Drug positivity rates for combined workforce
Infographic: Drug positivity rates by industry sector

The study, based on more than 11 million deidentified urine, hair and oral fluid drug test results collected between January and December 2021, offers revealing insights into workforce drug use as employers grapple with creating safe, healthful work environments amid an ongoing recruitment and retention crisis.

Additional Key DTI findings:

  • Positivity for cocaine and marijuana increased for federally mandated, safety-sensitive workers required to test under federal law
  • Drug positivity increased in post-accident tests at a faster rate than pre-employment tests for cocaine, marijuana, opiates and oxycodones
  • Over five years, positivity for marijuana in the general U.S. workforce increased 50% (2.6% in 2017 versus 3.9% in 2021)
  • Urine positivity rates for post-accident testing increased at a greater rate than pre-employment testing over five years, driven by higher positivity on post-accident tests for marijuana, cocaine, and semi-synthetic opiates
  • Retail Trade had highest positivity among key industries

US map with positivity rates

For an interactive map of the Drug Testing Index™ with positivity rates and trend lines by drug categories and three-digit zip code in the United States, visit

DTI resources

Visit our newsroom for the press release and other news from Quest.

Keep an eye out in our DTI Resources page for the full brochure, coming soon.

Media coverage for the Drug Testing Index includes an exclusive story by The Wall Street Journal.

To learn more about employer drug testing with Quest Diagnostics, visit our website or contact us online.