Cocaine Positives Spike 33% After New Government Rule for Safety-Sensitive Workers
Amphetamines Positives Jump Nearly 26% After New Rule, Continuing Upward Trend, Shows Quest Diagnostics Drug Testing Index™
MADISON, NJ, March 13, 2012 — Safety-sensitive workers have been subject to more stringent government drug testing rules over the past year, and the crackdown may be paying off, according to annual Drug Testing Index™ data released today by Quest Diagnostics (NYSE: DGX), the world's leading provider of diagnostic testing, information and services. New data reveal a 33% jump in cocaine positives in the safety-sensitive workforce, largely driven by new, lower cutoff rules implemented by the U.S. Department of Transportation (DOT) and the U.S. Department of Health and Human Services (DHHS). Amphetamines positives among this group also rose by nearly 26%, continuing an existing upward trend, but also likely boosted by better detection related to the new, lower, Federally-mandated cutoffs, Quest Diagnostics experts say. The findings are based on 1.6 million federally mandated, safety-sensitive workforce drug tests performed by Quest Diagnostics between January and December 2011.
"We all know how devastating a single accident can be when an impaired driver gets behind the wheel," said Dr. Barry Sample, Director of Science and Technology for Quest Diagnostics Employer Solutions. "The risk to public safety can heighten dramatically when that person is flying the plane we're boarding, operating the train or bus we take to work, taking our children to school, or transporting the products we buy across the country."
"The individuals who hold these jobs are in a category called 'safety-sensitive' workers, and they carry a tremendous responsibility each time they perform their duties. Our data suggest that new Federal requirements may be helping employers ensure that the workers they put behind the wheel are those ready to perform their duties safely."
On October 1, 2010, the U.S. Department of Transportation (DOT) harmonized with the U.S. Department of Health and Human Services (DHHS) decision to institute lower initial and confirmation cutoff levels for amphetamines and cocaine, and added other substances, such as heroin and ecstasy, to the required drug testing panel. Workers subject to these new requirements include private-sector workers for whom routine drug testing is mandated by the DOT as well as those Federal employees in testing-designated positions.
Dr. Donna Smith, a principal architect of the regulations for the DOT's drug and alcohol testing programs during her DOT tenure from 1989-1994 commented on the findings, "Amphetamines, including prescribed medications that also carry a reputation for diversion for illicit use, and cocaine, well known as an illegal drug of abuse, are powerful stimulants. Identifying their use is an important safety issue in the workforce subjected to Federally mandated testing. The Quest Diagnostics data show increased detection of cocaine use not identified by the previous cut-off levels, and increased identification of the use of amphetamines." After the implementation of the new cutoff requirements, Federally mandated safety-sensitive workers tested positive for cocaine at the highest level (0.32%) since 2008 and methamphetamine positivity was at the highest level (0.14%) since prior to 2007. This increase suggests that the new requirements may have played a role in identifying more than 1,300 additional cocaine positives and more than 1,400 additional amphetamines positives in the 1.6 million Federally mandated safety-sensitive tests performed by Quest Diagnostics in 2011, which may shed light on potential use among the estimated 12 million transportation workers in the U.S. subject to the new rule.
The increase in amphetamines positives — which continues an upward trend in recent years — likely reflects both an increase in the use of prescribed amphetamine drugs (such as those used in medical treatment for attention deficit hyperactivity disorder, or ADHD) and more drug positives identified owing to the lower cutoff in drug testing. Identifying amphetamine use in safety-sensitive positions — whether prescribed or illicit — is important for ensuring worker and public safety.
Cocaine and amphetamines (amphetamine and methamphetamine) are stimulants, typically used to increase alertness and relieve fatigue. Stimulants are also used for euphoric effects or may be used to counteract the "down" feeling of tranquilizers or alcohol. Possible side effects of stimulants include increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite. High doses may cause irregular heartbeat, loss of coordination or collapse. Indications of possible misuse may include excessive activity, talkativeness, irritability or nervousness. Amphetamines are derived from a chemical compound that is structurally a sympathomimetic amine, considered a psychostimulant, and approved by the FDA to treat narcolepsy and ADHD. Amphetamines act primarily by triggering the release of norepinephrine, dopamine, and serotonin from presynaptic neurons. Because of their potential for abuse, they are scheduled by the FDA in the most restrictive classification for a drug with medical usefulness.
U.S. General Workforce Key Findings
Among the 4.8 million tests in the general U.S. workforce from January to December 2011, amphetamines positives are up 16.7% from 2010 (0.66% vs. 0.77%) and up 75% since 2007. Cocaine positivity is up 8% from 2010 (0.25% vs. 0.27%) in the general workforce, also partially driven by some private sector employers adopting the new Federal standard.
Additional findings from the Drug Testing Index data collected between January–December 2011 include:
- Positivity rates for oxycodone from more than 500,000 tests in the general U.S. workforce are 10% higher than in 2010 (1.0% vs. 1.1%) and up 25% since 2007.
- Positivity for opiates in the general workforce is up nearly 7.7% from 2010 (0.39% vs. 0.42%) and up 20% since 2007.
- Positivity for propoxyphene in the general workforce was down 84.7% from 2010 (0.38% vs. 0.06%). Propoxyphene was pulled off the market in November 2010 because the drug was found to put patients at risk for potentially serious or even fatal heart rhythm abnormalities.
About the Quest Diagnostics Drug Testing Index
The Quest Diagnostics Drug Testing Index is published as a public service for government, media and industry and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates - the proportion of positive results for each drug to all such drug tests performed - among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce.
About Quest Diagnostics
Quest Diagnostics is the world's leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative new diagnostic tests and advanced healthcare information technology solutions that help improve patient care. Additional company information is available at: www.QuestDiagnostics.com.
The Drug Testing Index © 2012 Quest Diagnostics Incorporated. All rights reserved.
Tables Follow
Table 1. Annual Positivity Rates - Urine Drug Tests
(For Combined U.S. Workforce)
(More than 6.4 million tests from January to December 2011)
| Year | Drug Positive Rate |
|---|
| 1988 | 13.6% |
| 1989 | 12.7% |
| 1990 | 11.0% |
| 1991 | 8.8% |
| 1992 | 8.8% |
| 1993 | 8.4% |
| 1994 | 7.5% |
| 1995 | 6.7% |
| 1996 | 5.8% |
| 1997 | 5.0% |
| 1998 | 4.8% |
| 1999 | 4.6% |
| 2000 | 4.7% |
| 2001 | 4.6% |
| 2002 | 4.4% |
| 2003 | 4.5% |
| 2004 | 4.5% |
| 2005 | 4.1% |
| 2006 | 3.8% |
| 2007 | 3.8% |
| 2008 | 3.6% |
| 2009 | 3.6% |
| 2010 | 3.5% |
| 2011 | 3.5% |
Table 2. Positivity Rates By Testing Category - Urine Drug Tests
| Testing Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Federally Mandated, Safety-Sensitive Workforce | 1.8% | 1.6% | 1.5% | 1.5% | 1.7% |
| General U.S. Workforce | 4.4% | 4.2% | 4.2% | 4.2% | 4.1% |
| Combined U.S. Workforce | 3.8% | 3.6% | 3.6% | 3.5% | 3.5% |
Table 3. Positivity Rates By Testing Reason - Urine Drug Tests
(For Federally Mandated, Safety-Sensitive Workforce)
(More than 1.6 million tests from January to December 2011)
| Testing Reason | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Follow-Up | 2.8% | 2.2% | 2.5% | 2.4% | 2.8% |
| For Cause | 11.1% | 9.9% | 11.1% | 9.7% | 7.5% |
| Periodic | 0.8% | 0.7% | 0.8% | 1.0% | 1.6% |
| Post-Accident | 2.6% | 2.3% | 2.2% | 2.2% | 2.3% |
| Pre-Employment | 2.0% | 1.7% | 1.5% | 1.6% | 1.8% |
| Random | 1.5% | 1.4% | 1.4% | 1.4% | 1.5% |
| Returned to Duty | 3.3% | 3.1% | 3.0% | 3.3% | 2.5% |
Table 4. Positivity Rates By Testing Reason - Urine Drug Tests
(For General U.S. Workforce)
(More than 4.8 million tests from January to December 2011)
| Testing Reason | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Follow-Up | 7.7% | 7.6% | 7.5% | 6.5% | 6.6% |
| For Cause | 19.2% | 22.0% | 26.8% | 26.9% | 26.8% |
| Periodic | 1.4% | 1.4% | 1.5% | 1.3% | 1.3% |
| Post-Accident | 5.8% | 5.6% | 5.3% | 5.3% | 5.3% |
| Pre-Employment | 3.9% | 3.6% | 3.4% | 3.6% | 3.5% |
| Random | 5.7% | 5.3% | 5.4% | 5.3% | 5.2% |
| Returned to Duty | 5.6% | 5.3% | 4.6% | 5.2% | 5.2% |
Table 5. Positivity Rates By Drug Category - Urine Drug Tests
(For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests)
(More than 1.6 million tests from January to December 2011)
| Drug Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Overall | 1.8% | 1.6% | 1.5% | 1.5% | 1.7% |
| 6-Acetylmorphine | | | | 0.011%1 | 0.012% |
| Amphetamines | 0.25% | 0.26% | 0.29% | 0.35% | 0.44% |
| Cocaine | 0.44% | 0.32% | 0.24% | 0.24% | 0.32% |
| Marijuana | 0.88% | 0.77% | 0.69% | 0.69% | 0.64% |
| MDMA | | | | 0.005%1 | 0.003% |
| Opiates | 0.18% | 0.20% | 0.21% | 0.17% | 0.18% |
| PCP | 0.04% | 0.04% | 0.04% | 0.04% | 0.04% |
Table 6. Positivity Rates By Drug Category - Urine Drug Tests
(For General U.S. Workforce, as a percentage of all such tests)
(More than 4.8 million tests from January to December 2011)
| Drug Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Overall | 4.4% | 4.2% | 4.2% | 4.2% | 4.1% |
| 6-AM | | | | 0.013%1 | 0.015%2 |
| Amphetamines | 0.44% | 0.48% | 0.57% | 0.66% | 0.77% |
| Barbiturates | 0.24% | 0.25% | 0.26% | 0.25% | 0.26% |
| Benzodiazepines | 0.67% | 0.70% | 0.74% | 0.69% | 0.68% |
| Cocaine | 0.58% | 0.41% | 0.29% | 0.25% | 0.27% |
| Marijuana | 2.3% | 2.1% | 2.0% | 2.0% | 1.9% |
| MDMA | 0.020% | 0.015% | 0.015% | 0.009% | 0.003%3 |
| Methadone | 0.23% | 0.22% | 0.23% | 0.22% | 0.20% |
| Opiates | 0.35% | 0.38% | 0.45% | 0.39% | 0.42% |
| Oxycodones | 0.88%4 | 0.83%4 | 1.0%4 | 1.0%4 | 1.1%4 |
| PCP | 0.02% | 0.02% | 0.02% | 0.01% | 0.01% |
| Propoxyphene | 0.58% | 0.56% | 0.48% | 0.38% | 0.06% |
Table 7. Positivity Rates By Drug Category - Urine Drug Tests
(For Combined U.S. Workforce, as a percentage of all such tests)
(More than 6.4 million tests from January to December 2011)
| Drug Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Overall | 3.8% | 3.6% | 3.6% | 3.5% | 3.5% |
| 6-AM | | | | 0.011% | 0.013% |
| Amphetamines | 0.40% | 0.43% | 0.50% | 0.58% | 0.69% |
| Barbiturates | 0.24% | 0.25% | 0.26% | 0.25% | 0.26% |
| Benzodiazepines | 0.67% | 0.70% | 0.74% | 0.69% | 0.68% |
| Cocaine | 0.55% | 0.39% | 0.28% | 0.25% | 0.28% |
| Marijuana | 2.0% | 1.8% | 1.7% | 1.7% | 1.6% |
| MDMA | 0.020% | 0.015% | 0.015% | 0.007% | 0.003% |
| Methadone | 0.23% | 0.22% | 0.23% | 0.22% | 0.20% |
| Opiates | 0.32% | 0.34% | 0.39% | 0.34% | 0.36% |
| Oxycodones | 0.88%4 | 0.83%4 | 1.0%4 | 1.0%4 | 1.1%4 |
| PCP | 0.02% | 0.02% | 0.02% | 0.02% | 0.02% |
| Propoxyphene | 0.58% | 0.56% | 0.48% | 0.38% | 0.06% |
Table 8. Non-Negative Rates By Specimen Validity Test (SVT)5 Category - Urine Drug Tests
(For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests)
(More than 1.6 million tests from January to December 2011)
| SVT Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Acid-Base | 0.01% | 0.02% | 0.03% | 0.03% | 0.03% |
| Invalid | 0.11% | 0.11% | 0.09% | 0.09% | 0.09% |
| Oxidizing Adulterants | 0.000% | 0.000% | 0.000% | 0.000% | 0.000% |
| Substitution | 0.05% | 0.05% | 0.06% | 0.06% | 0.06% |
Table 9. Non-Negative Rates By Specimen Validity Test (SVT)5 Category - Urine Drug Tests
(For General U.S. Workforce, as a percentage of all such tests)
(More than 4.8 million tests from January to December 2011)
| SVT Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| Acid-Base | 0.002% | 0.002% | 0.001% | 0.001% | 0.001% |
| Invalid | 0.13% | 0.12% | 0.12% | 0.13% | 0.14% |
| Oxidizing Adulterants | 0.000% | 0.000% | 0.000% | 0.000% | 0.000% |
| Substitution | 0.01% | 0.01% | 0.02% | 0.02% | 0.01% |
Table 10. Non-Negative Rates By Drug/SVT Category - Urine Drug Tests
(For Federally Mandated, Safety-Sensitive Workers, as a Percentage of All Non-Negatives)
(More than 29 thousand non-negative test results from January to December 2011)
| Drug/SVT Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| 6-AM | | | | | 0.62% |
| Acid/Base | 0.47% | 0.86% | 1.7% | 1.7% | 1.6% |
| Amphetamines | 12.7% | 14.4% | 17.4% | 21.3% | 24.6% |
| Cocaine | 22.2% | 17.7% | 14.8% | 14.4% | 17.5% |
| Invalid | 5.5% | 6.4% | 5.5% | 5.3% | 4.9% |
| Marijuana | 45.2% | 44.3% | 41.7% | 41.2% | 35.6% |
| MDMA | | | | | 0.14% |
| Opiates | 9.2% | 11.0% | 12.6% | 10.5% | 9.7% |
| Oxidizing Adulterants | 0.00% | 0.00% | 0.01% | 0.00% | 0.00% |
| PCP | 2.1% | 2.3% | 2.5% | 2.2% | 2.1% |
| Substituted | 2.7% | 3.0% | 3.8% | 3.6% | 3.2% |
Table 11. Non-Negative Rates By Drug/SVT Category - Urine Drug Tests
(For General U.S. Workforce, as a Percentage of All Non-Negatives)
(More than 210 thousand non-negative test results from January to December 2011)
| Drug/SVT Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| 6-AM | | | | | 0.06% |
| Acid/Base | 0.04% | 0.04% | 0.02% | 0.03% | 0.03% |
| Amphetamines | 9.2% | 10.7% | 12.6% | 14.7% | 17.5% |
| Barbiturates | 2.8% | 3.3% | 3.5% | 3.5% | 3.7% |
| Benzodiazepines | 6.9% | 8.2% | 9.0% | 8.5% | 8.7% |
| Cocaine | 12.2% | 9.2% | 6.4% | 5.6% | 6.1% |
| Invalid | 2.8% | 2.6% | 2.7% | 2.9% | 3.2% |
| Marijuana | 48.8% | 46.3% | 44.0% | 45.4% | 44.3% |
| MDMA | | | | | 0.01% |
| Methadone | 2.2% | 2.5% | 2.7% | 2.7% | 2.6% |
| Methaqualone | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Opiates | 7.4% | 8.4% | 10.0% | 8.8% | 9.5% |
| Oxidizing Adulterants | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Oxycodones | 1.5% | 1.8% | 2.7% | 2.7% | 3.1% |
| PCP | 0.35% | 0.38% | 0.34% | 0.33% | 0.32% |
| Propoxyphene | 5.6% | 6.3% | 5.6% | 4.5% | 0.71% |
| Substituted | 0.26% | 0.26% | 0.40% | 0.40% | 0.26% |
Table 12. Non-Negative Rates By Drug/SVT Category - Urine Drug Tests
(For Combined U.S. Workforce, as a Percentage of All Non-Negatives)
(More than 240 thousand non-negative test results from January to December 2011)
| Drug/SVT Category | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|
| 6-AM | | | | | 0.12% |
| Acid/Base | 0.09% | 0.12% | 0.20% | 0.22% | 0.23% |
| Amphetamines | 9.6% | 11.1% | 13.1% | 15.4% | 18.4% |
| Barbiturates | 2.5% | 2.9% | 3.2% | 3.1% | 3.2% |
| Benzodiazepines | 6.1% | 7.4% | 8.0% | 7.6% | 7.6% |
| Cocaine | 13.2% | 10.0% | 7.3% | 6.6% | 7.5% |
| Invalid | 3.0% | 3.0% | 3.0% | 3.2% | 3.4% |
| Marijuana | 48.4% | 46.1% | 43.7% | 44.9% | 43.3% |
| MDMA | | | | | 0.03% |
| Methadone | 2.0% | 2.3% | 2.4% | 2.4% | 2.3% |
| Methaqualone | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Opiates | 7.6% | 8.7% | 10.3% | 9.0% | 9.5% |
| Oxidizing Adulterants | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Oxycodones | 1.4% | 1.6% | 2.4% | 2.4% | 2.7% |
| PCP | 0.53% | 0.57% | 0.56% | 0.54% | 0.54% |
| Propoxyphene | 5.0% | 5.7% | 5.0% | 4.0% | 0.62% |
| Substituted | 0.51% | 0.54% | 0.76% | 0.76% | 0.62% |
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