Workforce Drug Positivity at Highest Rate in a Decade, Finds Analysis of More Than 10 Million Drug Test Results

Prescription opiate positivity rate drops by double digits, while cocaine rises by double digits in certain states

Methamphetamine positivity skyrockets in Midwestern and Southern United States

Marijuana positivity rises considerably in states that recently enacted recreational use statutes, finds national analysis by Quest Diagnostics 


Secaucus, NJ, May 8, 2018 – Driven by increases in cocaine, methamphetamine and marijuana, drug use by the American workforce remains at its highest rate in more than a decade, according to a new analysis released today by Quest Diagnostics, the world’s leading provider of diagnostic information services.

Nationally, the positivity rate for the combined U.S. workforce held steady at 4.2 percent in 2017, the same as in 2016, but a dramatic increase over the 3.5 percent positivity rate from 2012, which represented a thirty-year low. The analysis of 2017 data also suggests shifting patterns of drug use, with cocaine and amphetamines positivity surging in some areas of the country and marijuana positivity rising sharply in states with newer recreational use statutes. Prescription opiate positivity rates declined dramatically on a national basis.
For an interactive map with positivity rates and trend lines by three-digit zip code in the United States, visit

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DOT 5 Panel Notice

DOT Drug Testing: After January 1, 2018 – Still a 5-Panel

The DOT testing at HHS-certified laboratories is a 5-panel drug test regimen.  As of January 1, 2018, the ‘Opiates’ category was renamed ‘Opioids’:

  • Marijuana (THC)
  • Cocaine
  • Amphetamines
  • Opioids
  • Phencyclidine (PCP)

Under ‘Opioids’, previously ‘Opiates’, DOT testing will continue to include confirmatory testing, when appropriate, for Codeine, Morphine, and 6-AM (heroin).  We added initial and confirmatory testing for the semi-synthetic opioids Hydrocodone, Hydromorphone, Oxycodone, and Oxymorphone to this Opioids group.  Some brand names for the semi-synthetic opioids include OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, Exalgo®.

Under Amphetamines, DOT testing includes confirmatory testing, when appropriate, for Amphetamine, Methamphetamine, MDMA, and MDA.  To this Amphetamines group, we added initial testing for MDA and removed testing for MDEA.

Since January 1st, we have required confirmation testing for 14 drugs under a 5‑panel test.  Broken out, here is what DOT drug testing looks like:

DOT 5 Panel Profile

Marijuana (THC)
~6-AM (Heroin)
Phencyclidine (PCP)

For DOT testing, what does this mean for collectors, laboratories, MROs, and employers after January 1st ,2018?

  • Collectors will continue to check the 5-panel box in Step 1 of the CCF: That is, the box specified for “THC, COC, PCP, OPI, AMP.”
  • Laboratories will:
  • continue to report to MROs the specific drugs / drug metabolites they confirm as positive, and laboratories will add hydrocodone, hydromorphone, oxycodone, and oxymorphone confirmed positives, as appropriate.
  • on their semi-annual reports to DOT and their semi-annual reports to employers add: hydrocodone; hydromorphone; oxycodone; and oxymorphone confirmed positive totals, as appropriate, under Opioids.
  • MROs will continue to report to employers the specific drugs / drug metabolite they verify as positive; and MROs will add hydrocodone, hydromorphone, oxycodone, and oxymorphone verified positives, as appropriate.
  • Employers will continue to provide – on their annual MIS reports – the number of verified positive drug test results in each testing category (i.e., Marijuana, Cocaine, Amphetamines, Opioids, and PCP).
Updated: Tuesday, March 6, 2018

DOT Drug Testing: Part 40 – Employee Notice

On November 13, 2017, the Department of Transportation (DOT) published a final rule which will be effective January 1, 2018.

Here is a notice for transportation safety-sensitive employees regarding the opioids final rule

This is a reminder that the U.S. Department of Transportation (DOT) drug testing program will soon require testing for four semi-synthetic opioids (i.e., hydrocodone, oxycodone, hydromorphone, oxymorphone).

The change is effective January 1, 2018.

What does this mean for the employees?

Beginning January 1, 2018, in addition to the existing DOT drug testing panel (that includes marijuana, cocaine, amphetamines, phencyclidine (PCP), and opiates), you will also be tested for four semi-synthetic opioids (i.e., hydrocodone, oxycodone, hydromorphone, oxymorphone).  Some common names for these semi-synthetic opioids include OxyContin®, Percodan®, Percocet®, Vicodin®, Lortab®, Norco®, Dilaudid®, Exalgo®.

If you test positive for any of the semi-synthetic opioid drugs, then as with any other drug test result that is confirmed by the laboratory, the Medical Review Officer (MRO) will conduct an interview with you to determine if there is a legitimate medical explanation for the result.  If you have a valid prescription, you should provide it to the MRO, who will determine if the prescription is valid.  If a legitimate medical explanation is established, the MRO will report the result to your employer as a ‘negative’.  If not, the MRO will report the result to your employer as ‘positive’.

As it has been the requirement in the past, when your employer receives a ‘positive’ drug test result, your employer is to immediately remove you from performing safety-sensitive functions and provide you with a list of qualified Substance Abuse Professionals (SAP) available in your area.  In order to return to performing safety-sensitive functions for any DOT-regulated employer, you must complete the return-to-duty process that will include an evaluation by a SAP, who will require education and/or treatment.  The SAP will determine if you successfully completed the prescribed education and/or treatment.  Before an employer could return you to safety-sensitive work, the employer must get a negative result on a directly observed return-to-duty drug test.  After you return to safety-sensitive work, you must be subject to directly observed follow-up testing for 12-60 months depending on the SAP’s recommendations.

Do I need to tell anyone about my prescribed medications?

Your employer may have a policy that requires you to report your prescribed medications to them.  So check with your employer.  If your job function has DOT-regulated medical standards (truck/bus driver, airline pilot, mariner), the DOT agency regulation may require you to report your prescribed medications to those who approved your medical qualifications.

What should I tell my prescribing physician?

If you are taking any prescription medications, consider this to be a reminder to have a conversation with your prescribing physician to discuss your safety-sensitive work.  Be proactive in ensuring that your prescribing physician knows what type of transportation-related safety-sensitive work you currently perform.  For example, don’t just provide a job title but describe your exact job function(s) or ask your employer for a detailed description of your job function that you can give to your prescribing physician.  This is important information for your prescribing physician to consider when deciding whether and what medication to prescribe for you.  It is important for you to know whether your medications could impact your ability to safely perform your transportation-related work.

Will the MRO report my prescribed medication use/medical information to a third party?

Historically, the DOT’s regulation required the MRO to report your medication use/medical information to a third party (e.g. your employer, health care provider responsible for your medical qualifications, etc.), if the MRO determines in his/her reasonable medical judgement that you may be medically unqualified according to DOT Agency regulations, or if your continued performance is likely to pose a significant safety risk.  The MRO may report this information even if the MRO verifies your drug test result as ‘negative’.

As of January 1, 2018, prior to the MRO reporting your information to a third party you will have up to five days to have your prescribing physician contact the MRO.  You are responsible for facilitating the contact between the MRO and your prescribing physician.  Your prescribing physician should be willing to state to the MRO that you can safely perform your safety-sensitive functions while taking the medication(s), or consider changing your medication to one that does not make you medically unqualified or does not pose a significant safety risk.

NOTE:   This document informally summarizes some of the effects of recent changes to the Procedures for Transportation Workplace Drug and Alcohol Testing Programs that are important for transportation employees, but it should not be relied upon to determine legal compliance with those procedures.

December 11, 2017

Updated: Monday, December 11, 2017

Facing an Everyday Killer

Opioid Users Face Those Who’ve Lost Loved Ones to Overdose

One in four Americans has been directly impacted by the opioid crisis, but 40% still do not consider it to be a threat to their family, according to National Safety Council poll results. In an attempt to end this persistent indifference, the Council released a powerful short film that brings opioid users face to face with those who have been personally impacted by the worst drug crisis in recorded U.S. history.

The video, Facing an Everyday Killer, is part of the Council’s Stop Everyday Killerscampaign, a public awareness initiative to help educate about the risks of taking opioids and encourage people to explore other pain treatment options.

Facing an Everyday Killer illustrates the potential for a well-intentioned opioid user to become a statistic – a trend that is much too common. Far too many opioid addictions begin with valid prescriptions following an injury or surgery.

“The most important thing to know about this crisis is not the numbers and statistics, but the faces,” said NSC President and CEO Deborah A.P. Hersman. “The data speak to our head but the individual stories speak to our hearts. The Facing an Everyday Killer video not only puts an image on the scope of the problem, but also encourages actions that will help us eliminate these preventable deaths.”

Facing an Everyday Killer includes sweeping footage of the Council’s Prescribed to Death Memorial that launched in Chicago Nov. 9 and drew hundreds of visitors who came to remember, learn and act. The Memorial includes a wall with 22,000 engraved pills, each carved with the image of someone who fatally overdosed last year. It will travel across the country, with a stop planned in Pittsburgh in late January.

As part of this campaign, NSC is distributing Opioid Warn-Me labels patients can stick on their insurance and pharmacy cards to prompt a conversation with their prescribers about the risks of taking opioids and possible alternatives. Pharmaceutical disposal company Stericycle is providing pre-paid Seal&Send envelopes for disposing of unused medications

The short film can be downloaded via YouTube, accessed at stopeverydaykillers.organd shared on social media using the hashtag, #StopEverydayKillers.




Educate Your DOT Employees Now

DOT Publishes Drug Testing Rule…will included semi-synthetic opioids

The new HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs took effect October 1st, 2017 and now the Department of Transportation is following suit, effective January 1st, 2017. This will expand the drug testing panel for all DOT-mandated drug testing programs. The time to educate your personnel regarding the proposed rule changes is now NOT later. The proposed change will include the following opioids to be added to the age old DOT panel; oxycodone, oxymorphone, hydrocodone, and hydromorphone.

With the addition of these opioids the positivity rate will surely increase and estimates have been placed at 1% but there is potential for a higher increase. Without mentioning safety concerns being submitted by medical review officers after reviewing a positive test for commonly over prescribed synthetic opioids. The DOT is also proposing the addition of MDA as an initial analyte and removing MDEA as a confirmatory test analyte.

Contact the professionals at Aegis Alliance to schedule a brief discussion for your next safety meeting in order to educate your workforce for the upcoming  rule changes!

(337) 484-1466 /  

The following is a representative sampling of information provided by various organizations who have reported on prescription opioid use trends over the past few years:

  • CDC data from 2012 indicates that 259 million prescriptions were written for prescription opioids, which is more than enough to give every American adult their own bottle of pills.[2]
  • According to the SAMHSA National Survey on Drug Use and Health 2014 data, almost 2 million Americans misused or were dependent on prescription opioids.[3]
  • As posted by the Office of National Drug Control Policy, according to the National Center for Health Statistics, the number of overdose deaths involving opioids rose from 28,647 in 2014 to 33,091 in 2015.[4]
  • National Center for Health Statistics [5data indicates that every year since 2002 more than 40 percent of the total number of overdose deaths in the United States have been related to prescription opioids.

In light of this compelling information regarding opioid use (and the national attention being focused on this issue), we propose to modify the DOT drug-testing regimen not only to meet our statutory obligation under OTETA to do so, but also to raise the level of safety for the transportation industry and the public.

11/13/2017 – Final Rule (Effective 01/01/2018)

Part 40 DOT – Summary of Changes

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