Testing for Alcohol and Other Drugs

1. Drug Positivity Rates Of US Employees Subjected to Urine Drug Tests, by Worker Category

According to Quest Analytics, the drug positivity rates in 2018 of people in the US who were subjected to urine drug tests as a condition of employment are:
Federally Mandated Safety-Sensitive Workforce: 2.7%
General US Workforce: 5.1%
Combined US Workforce: 4.4%

Click here for the complete datatable of Drug Positivity Rates Of US Employees Subjected to Urine Drug Tests, by Worker Category

"Workforce Drug Testing Positivity Climbs to Highest Rate Since 2004, According to New Quest Diagnostics Analysis," Quest Diagnostics, April 11, 2019.
https://www.questdiagnostics.c...
https://www.questdiagnostics.c...

2. Definition of Drug Metabolite

"A drug’s metabolite is the compound produced when the body processes a particular drug. Identifying these compounds is the focus of workplace drug testing analysis. Marijuana possesses the greatest total number of detectable metabolites at 31 but fewer major components. For amphetamines, no metabolites are identified because these substances normally pass through the body essentially unchanged in chemical structure."

"Drug Retention Times," Prepared for US Dept. of Energy Office of Security Policy, by the Center for Human Reliability Studies (Oak Ridge, TN: Oak Ridge Institute for Science and Education, May 2007), p. 1.
http://www.osti.gov/scitech/bi...
http://www.osti.gov/scitech/se...

3. Prevalence of Employment-Related Testing for Use of Alcohol or Other Drugs

"While almost two-thirds of respondents drug test all candidates, the remainder of companies drug test only candidates for specific positions. The percentage of companies with a policy to test all candidates dropped by 12% since our 2018 survey."

Companies That Subject Workers to Tests for Alcohol or Other Drugs:
All job candidates: 62%
Candidates for safety/ security concerned roles: 10%
Candidates for non-exempt/ hourly positions: 10%
Candidates for director and manager positions: 7%
Candidates for positions dealing with finances: 6%
Candidates for C-suite/ executive positions: 5%
Temporary or contingent workers: 5:
Independent contractors: 3%
Interns: 2%
Volunteers: 1%
Vendors: 1%
Other: 21%

"Employment Screening Benchmark Report, 2019 Edition," HireRight, Inc., 2019, p. 25.
https://www.hireright.com/asse...

4. Positivity Rate for Marijuana Use Among US Workers Subjected to Drug Testing

"Marijuana positivity continued its upward climb in both the federally-mandated, safety-sensitive and general U.S. workforces. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75 percent, from 5.1 percent in 2013 to 8.9 percent in 2016 in the general U.S. workforce. Marijuana positivity also increased in both urine testing (2.4% in 2015 versus 2.5% in 2016) and hair testing (7.0% in 2015 versus 7.3% in 2016) in the same population.
"Among the federally-mandated, safety-sensitive workforce, which only utilizes urine testing, marijuana positivity increased nearly ten percent (0.71% in 2015 versus 0.78% in 2016), the largest year-over-year increase in five years.
"In Colorado and Washington, the first states in which recreational marijuana use was legalized, the overall urine positivity rate for marijuana outpaced the national average in 2016 for the first time since the statutes took effect. The increase was more pronounced in Colorado, which increased 11 percent (2.61% in 2015 versus 2.90% in 2016), than in Washington, which increased nine percent (2.82% in 2015 versus 3.08% in 2016). The national positivity rate for marijuana in the general U.S. workforce in urine testing increased four percent (2.4% in 2015 compared to 2.5% in 2016).
"'We have been tracking the trends in marijuana positivity in states that have passed medical and recreational marijuana use statutes for several years now. 2016 is the first year since Colorado and Washington approved recreational use that the rates of year-over-year change were sharply higher than the national average,' said Dr. Sample."

"Quest Diagnostics Drug Testing Index™ Full year 2016 tables," Quest Diagnostics, Table 2, last accessed Nov. 13, 2017.
http://www.questdiagnostics.co...
http://www.questdiagnostics.co...
"Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years, Quest Diagnostics Analysis Finds," Quest Diagnostics, May 16, 2017.
http://newsroom.questdiagnosti...

5. What Urine Drug Testing Can and Cannot Measure

"Urine drug tests, which are the least expensive and most frequently used form of drug test, can generally detect marijuana use within the past week; cocaine, heroin and other 'hard' drugs used within the past two days; and alcohol use within the past several hours (though alcohol is not often included in drug screens). Drug tests cannot measure frequency of use, nor do they indicate the severity of impairment or whether an individual has a substance use disorder that requires treatment. In addition, without medical review and confirmation testing on initial positive results, 20 urine screens also cannot distinguish between the illicit use of street drugs and the legitimate use of certain prescription and over-the-counter drugs. For instance, a drug test cannot distinguish between prescribed Tylenol with codeine and illicit opiates. Improper testing procedures and mishandling of samples can also produce inaccurate results."

"ASPE Issue Brief: Drug Testing Welfare Recipients: Recent Proposals and Continuing Controversies," Dept. of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (Washington, DC: October 2011), p. 4.
http://aspe.hhs.gov/hsp/11/Dru...

6. Drug Test Positivity Rates for Cocaine Among Workers in the US Subjected to Drug Testing

"The positivity rate in urine testing for cocaine increased for the fourth consecutive year in the general U.S. workforce and for the second consecutive year in the federally-mandated, safety-sensitive workforce. Cocaine positivity increased 12 percent in 2016, reaching a seven-year high of 0.28 percent, compared to 0.25 percent in 2015 in the general U.S. workforce, and seven percent among federally-mandated, safety-sensitive workers to 0.28 percent, compared to 0.26 percent in 2015."

"Quest Diagnostics Drug Testing Index™ Full year 2016 tables," Quest Diagnostics, Table 2, last accessed Nov. 13, 2017.
http://www.questdiagnostics.co...
http://www.questdiagnostics.co...
"Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years, Quest Diagnostics Analysis Finds," Quest Diagnostics, May 16, 2017.
http://newsroom.questdiagnosti...

7. Drug Test Positivity Rates for Methamphetamine Among US Workers Subjected to Drug Testing

"Amphetamines (which includes amphetamine and methamphetamine) positivity continued its year-over-year upward trend, increasing more than eight percent in urine testing in both the general U.S. and federally-mandated, safety-sensitive workforces compared to 2015. Throughout the last decade, this rise has been driven primarily by amphetamine use which includes certain prescription drugs such as Adderall®.
"Although methamphetamine positivity in urine testing declined between 2005 and 2008, the positivity rate plateaued between 2008 and 2012, and has increased steadily since. Between 2012 and 2016, it climbed 64 percent in the general U.S. workforce and 14 percent among federally-mandated, safety-sensitive workers. In oral fluid, methamphetamines positivity increased 75 percent between 2013 (0.24%) and 2016 (0.42%)."

"Quest Diagnostics Drug Testing Index™ Full year 2016 tables," Quest Diagnostics, Table 2, last accessed Nov. 13, 2017.
http://www.questdiagnostics.co...
http://www.questdiagnostics.co...
"Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years, Quest Diagnostics Analysis Finds," Quest Diagnostics, May 16, 2017.
http://newsroom.questdiagnosti...

8. Drug Test Positivity Rates for Heroin and Other Opiates Among US Workers Subject to Drug Testing

"After four straight years of increases, in 2016, urine testing positivity for heroin, indicated by the presence of the 6-acetylmorphine (6-AM) metabolite, held steady in the general U.S. workforce and declined slightly among federally-mandated, safety-sensitive workers.
"Prescription opiate positivity – including hydrocodone, hydromorphone and oxycodones – declined in urine testing among the general U.S. workforce. Oxycodones have exhibited four consecutive years of declines, dropping 28 percent from 0.96 percent in 2012 to 0.69 percent in 2016. Hydrocodone and hydromorphone both showed double-digit declines in both 2015 and 2016 (0.92% in 2015 to 0.81% in 2016) and (0.67% in 2015 to 0.59% in 2016), respectively.
"In recent years, state and federal authorities have instituted efforts to more tightly control opiate prescribing in order to address the opioid crisis."

"Quest Diagnostics Drug Testing Index™ Full year 2016 tables," Quest Diagnostics, Table 2, last accessed Nov. 13, 2017.
http://www.questdiagnostics.co...
http://www.questdiagnostics.co...
"Increases in Illicit Drugs, Including Cocaine, Drive Workforce Drug Positivity to Highest Rate in 12 Years, Quest Diagnostics Analysis Finds," Quest Diagnostics, May 16, 2017.
http://newsroom.questdiagnosti...

9. Drugs Screened for Under Federal Mandatory Guidelines

"The Federal mandatory guidelines recommended that the initial screening test identify the presence of the following commonly abused drugs or their metabolites (SAMHSA, 2008):
• Amphetamines (amphetamine, methamphetamine)
• Cocaine metabolites
• Marijuana metabolites
• Opiate metabolites (codeine, morphine)
• Phencyclidine (PCP)
"These substances are generally called the “Federal 5,” but over the years they have also been called the 'NIDA 5' and 'SAMHSA 5.'"

"Clinical Drug Testing in Primary Care," Technical Assistance Publication (TAP) 32, Substance Abuse and Mental Health Services Administration, Clinical Drug Testing in Primary Care (Rockville, MD: US Department of Health and Human Services, 2012), HHS Publication No. (SMA) 12-4668, p. 4.
http://www.kap.samhsa.gov/prod...

10. Possible Masking Agent: Zinc Found to Produce False Negatives in ELISA [Enzyme-Linked Immunosorbent Assay] Tests

"We conclude that zinc ion (Zn2+) is a potential adulterant in urine samples tested for drugs in routine workplace drug screening under the NIDA-5 panel using ELISA. Its effect in causing potential false-negative results in drug testing is robust and reproducible. This effect appears independent of the mode by which zinc is made available in urine. Although the exact mechanism by which zinc interacts with different components of the ELISA assay is unknown, the enhanced ELISA signal increases in a dose-dependent fashion. As a consequence, it is our conjecture that zinc ion increases the binding of drug conjugate to which the active horseradish peroxidase enzyme is attached, thereby increasing the final output signal.
"Although some urine samples containing added zinc sulfate may show signs of abnormal levels of chromate ions when tested using Adultacheck10 urine test strips, urine samples containing zinc by ingesting zinc supplements do not show any sign of adulteration whatsoever. In addition, such samples do not exhibit turbidity as observed with urine samples to which zinc sulfate has been directly added. Thus, we are aware of no suitable test to determine zinc adulteration in urine and conclude that zinc supplements are effective at subverting routine drug testing and undetectable by standard means."

Abhishek Venkatratnam and Nathan H. Lents. Zinc Reduces the Detection of Cocaine, Methamphetamine, and THC by ELISA Urine Testing. Journal of Analytical Toxicology (July/August 2011) 35(6):333-340 doi:10.1093/anatox/35.6.333.
http://jat.oxfordjournals.org/...
http://jat.oxfordjournals.org/...

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