Emerging Risks: Drug Test Cheating, Injury Trends

Workplace drug test cheating increases more than six-fold in 2023; marijuana use surges

According to workplace drug testing company Quest Diagnostics Drug Testing Index, the percentage of employees in the general U.S. workforce whose drug test showed substituted urine specimens increased 633 percent from 2022 to 2023 and invalid urine specimens increased 45.2 percent. Similar trends were seen in the federally mandated, safety-sensitive U.S. workforce, with substituted specimens increasing 370.6 percent and invalid rates increasing 36.7 percent.

There are several ways to cheat on a drug test. Employees might substitute a urine sample with urine from someone else, use animal urine or synthetic urines that can be purchased online, or mix the urine sample with an additive designed to hide drug use. Quest classifies substituted or invalid urine samples as a failed drug test.

While the results are disturbing, given the changing societal norms and shifting legal landscape particularly around marijuana, it’s not surprising that more workers are attempting to subvert the drug testing process. The surge in test tampering coincides with the increasing legalization of recreational marijuana. As of April, two dozen states had allowed recreational cannabis use, according to the National Conference of State Legislatures.

Marijuana positivity in the general workforce is surging with a 45.2 percent increase over five years, peaking in 2023 at 4.5 percent. While its use has increased across 13 of 15 industries, the greatest increase has been in white-collar jobs, led by Finance and Insurance, Public Administration, and Real Estate Rental and Leasing.

States that have legalized recreational marijuana have seen the largest increases in positive tests. Some 5.8 percent of tests came back positive in states where recreational marijuana was legal in 2023, up from 2.4 percent in 2015. Notably, in the federally mandated safety-sensitive workforce, marijuana positivity decreased nationally by 3.1 percent from 2022 to 2023. The expectation of drug testing, stiffer consequences, and greater awareness of safety risks could be deterrents.

Post-accident positivity of urine drug tests in the general workforce continued to climb, rising to 7.5 percent in 2023. This data aligns with other reports associating marijuana legalization with workplace injuries. A recent study in the Journal of the American Medical Association found recreational marijuana sales were associated with a 10 percent increase in workplace injuries among employees aged 20 to 34 years.

While ensuring a safe workplace remains the primary aim of employer-mandated drug tests, more employers are rethinking their drug testing policies for non-safety-sensitive jobs to navigate conflicting state laws and employee expectations. A review with your drug testing provider to determine the extent of deceptive testing and possible alternatives and an examination of injury data to assess if there is a correlation between marijuana use and workplace injuries and near misses should be weighed in revisions to drug policies.

Dr. Harwani, a Senior Director at Quest, suggests there could be better ways of testing employees and job candidates for drug use than relying on urine samples when the law allows. The U.S. Department of Transportation approved oral fluid testing to detect drug use, in addition to using urine samples. Whereas urine samples are submitted in a private space, oral fluids are collected directly by lab technicians. While drugs can take time to show up in a donor’s urine sample, they can be detected in saliva immediately after they are used.

If a prospective employee or current worker has a failed drug test, have a conversation to find out if there was a valid medical reason they failed the test. An open dialogue with employees about the impacts of marijuana legalization on the risk of injury and how cheating undermines safety for everyone, enhanced drug education, and mental health support are key to safeguarding workplace safety and productivity. There are no easy or one-size-fits-all solutions to this daunting issue, but it is a call for heightened vigilance and implementing comprehensive strategies that are appropriate for your workplace.

Shifting injury trends by industry

Transportation and warehousing

At the National Council on Compensation Insurance’s (NCCI) annual symposium, it was reported that “Most industries show consistent and steady declines in claim frequency. However, claim frequency increased in the transportation and warehousing sector from 2019- 2022. The couriers and messengers subsector (local delivery drivers) is driving this increase, caused mostly by smaller severity claims.” This is correlated with unprecedented employment growth since 2019. Ankle/foot injuries topped the list with an average annual frequency increase of 37 percent.

A 2023 in-depth study in the American Journal of Industrial Medicine, “Examining injury trends in parcel delivery drivers in the United States: Challenges and opportunities” found most injuries happened while performing delivery or maintenance-related duties, rather than driving. Some of the increased injury propensity stems from the diversity and unpredictability of hazards and repetitive strains encountered by delivery personnel.

Given the wide variety of risk factors, including location, weather, job nature, turnover, route, schedule, and workload, solutions can seem elusive. However, understanding how hazards, injuries, and even fatalities occur is critical to devising solutions. Companies can exercise control with their procedures, scheduling that minimizes fatigue and pressure to rush, diligent equipment maintenance and upkeep, maintaining hiring standards, proper training, including ergonomics when handling heavy packages or lifting items, and use of safety technology, including wearables.

Retail trade

In retail, frequency of injuries is not consistently declining as it is in most industries, but unlike transportation employment is stagnant. NCCI postulates since quits have been higher, the flatter frequency trend may be attributed to losing the “best” employees or the job risk may be changing. Injuries are commonly related to strains. Other studies have highlighted claims related to violent incidents, including physical and psychological injuries.

Companies with unfavorable claim trends should work with their agents to identify if job composition is changing and develop targeted strategies to mitigate risks. While the turnover rate in retail is traditionally high, the NCCI data suggest what the industry has faced over the last few years goes beyond normal retail attrition. Take the time to assess your pay structure, benefits, opportunities for advancement, training, manager effectiveness, flexible work hours, and the safety environment. Exit interviews of valued employees can help identify what areas need improvement.

For the NCCI report, click here.

To learn more about what these emerging risks mean for you in terms of workers compensation, schedule an appointment with a financial professional today.