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It’s a trend that puts addiction treatment access back in the spotlight for workers and the employers who screen them.
The Scope of Worker Drug Use
Clinical laboratory Quest Diagnostics found that close to one in five tested workers had a positive result for drug use in its 2025 workforce report, based on hair analysis across its US client base.
The company screens for marijuana, cocaine, opiates, amphetamines and methamphetamine, using both hair and urine testing.
Hair testing has a 90 day detection window, a wider net than standard urine screening, and Quest said this method points to a pattern of long term, recurring drug use rather than occasional use among many of the workers who tested positive.
Year over year, positive drug tests rose 46 percent since 2021, even as fentanyl specific positives declined over the same period.
Which Industries Reported the Most Drug Use
Quest’s breakdown of 2024 data, its most recent full year on record, found the highest positive rates concentrated in a handful of sectors.
Retail trade led at 5.9 percent, followed by health care and social assistance at 5.6 percent, administrative support and remediation services including waste management at 5.2 percent, and construction at 5.1 percent.
The substances involved varied by field. Cocaine use was highest among construction workers, opiate use was highest among health care workers, and amphetamine use was highest among workers in educational services and health care.
Addiction Treatment and the Workplace Testing Debate
The data lands amid an unsettled policy environment for drug testing. Following the federal rescheduling of marijuana, employers have had to weigh legal changes against workplace safety and liability.
A former Disability Management Employer Coalition executive has told HR Dive that many employers still test primarily for opioids, cocaine and heroin rather than marijuana, and has suggested employers consider impairment based testing instead of blanket drug panels, since some employees use THC or CBD for documented medical reasons.
Despite the marijuana rescheduling, the federal government has kept marijuana testing in place for its own workforce, a sign of how unevenly drug policy is shifting even as legalization spreads at the state level.
A positive test does not always signal a substance addiction. But the chronic, recurring use patterns captured by hair testing can be an early sign that addiction treatment, not disciplinary action alone, is the more useful next step for an employee.
What This Means for Treatment Seekers
Workers in high positive rate industries such as construction, retail and health care may want to understand what addiction treatment actually involves before a testing issue turns into a job loss.
Evidence based options range from outpatient counseling to medication assisted treatment (MAT) for opioid use disorder, which combines FDA approved medications like buprenorphine with behavioral therapy.
Employees concerned about job security while pursuing care should also know that federal job protection exists in some circumstances for people who need leave to seek treatment, a detail that is often overlooked in the middle of a crisis.
Exploring Treatment Options
Anyone affected by this data, whether an employee facing a workplace drug test or a family member worried about a loved one’s use, has options to consider:
- Comparing rehab centers that treat the specific substance involved, whether that is cocaine, opiates or stimulants.
- Understanding insurance coverage for addiction treatment, including employer sponsored plans.
- Asking about evidence based therapies such as cognitive behavioral therapy alongside medication assisted treatment where appropriate.
- Verifying a facility’s credentials and treatment approach before enrolling.
Rehab.com’s directory connects people to verified treatment centers nationwide. Call to speak with a treatment advisor about options that fit a specific job, industry or insurance situation.
