Fentanyl use in US workplaces rises, study finds: report

More American workers are testing positive for fentanyl in randomised workplace drug screenings, a report by The Wall Street Journal said, which brings to the fore the persistent challenges the opioid epidemic poses for employers.

The rate of positive urine tests for fentanyl reached 1.13% in 2024, up from 0.91% in 2023 and more than double the rate seen in 2020, according to new data from Quest Diagnostics cited by WSJ.

The analysis reviewed more than eight million drug tests, making it one of the most comprehensive workplace drug-use studies in the country.

“We’re seeing trends that are outside of the norm that we see for other drugs historically,” said Suhash Harwani, senior director of science for workforce-health solutions at Quest Diagnostics.

The findings indicate that random tests reveal opioid use more accurately than pre-employment screenings, where candidates have time to prepare.

Fentanyl-positive results were more than seven times higher in random tests than in initial hiring screenings.

Overall drug positivity shows a decline

While fentanyl use is rising, Quest found that overall workplace drug positivity fell slightly in 2024, to 4.4% from 4.6% in 2023.

That decline follows three consecutive years of increases.

The continued prevalence of fentanyl use comes as the US grapples with an opioid crisis that has claimed hundreds of thousands of lives.

Deaths involving synthetic opioids fell slightly last year, down 2% to about 74,700, according to preliminary data from the Centres for Disease Control and Prevention.

Still, fentanyl accounted for roughly seven in 10 US overdose deaths.

Source: Statista

Fentanyl use results versus marijuana use results

Employers in industries such as construction, mining and transportation have been particularly vulnerable to substance misuse in the workforce.

Unintentional overdoses from nonmedical drug and alcohol use in the workplace rose for the 10th straight year in 2022, according to the Bureau of Labor Statistics.

The new findings suggest some workers may begin using fentanyl after passing pre-employment screenings, raising risks of on-the-job accidents, absenteeism, and overdoses.

In contrast, marijuana use trends lower in random tests compared to hiring screenings, with a 42% lower positivity rate in surprise testing over the past five years.

Why fentanyl slips through screenings

Experts note that fentanyl’s short lifespan in the body allows it to evade standard pre-employment detection more easily than other drugs.

“Fentanyl is shorter-lived than cannabis; it doesn’t stay in the bloodstream or remain detectable nearly as long,” said Alexandria Macmadu, assistant professor of epidemiology at Brown University.

“The drug can disappear from the system within hours versus up to three days for other substances.”

This means job candidates can abstain for a short period before interviews or tests and still pass screenings.

In some cases, candidates have reportedly attempted to substitute specimens to avoid detection.

Employers respond with expanded testing

The growing prevalence of fentanyl use has led more corporate clients to request that Quest Diagnostics include the drug in their testing panels.

"We're starting to see a bit more of a shift into reasonable suspicion, random-type testing and post-incident testing," said Janet LaQuintano, vice president of growth and strategic initiatives at staffing agency ManpowerGroup.

Human-resource professionals also report a shift away from narrow testing strategies.

“Companies are increasingly requesting a full suite of tests for all drugs rather than just marijuana,” said Julie Schweber, knowledge adviser at HR trade group SHRM.

As fentanyl continues to pose unique risks in the workplace, experts warn that employers may need to adopt even stricter monitoring and support programs to address the health and safety challenges stemming from the nation’s opioid epidemic.