The percentage of employees testing positive for marijuana following an on-the-job accident increased to its highest level in 25 years in 2022, according to a recently released analysis from Quest Diagnostics.

The company’s annual Drug Testing Index report is based on more than 10.6 million de-identified urine, hair and oral-fluid drug test results reported between January and December 2022. The index is aimed at providing insights into behavior seen in workers across the combined United States workforce by industry and drug type. The samples include mostly company-policy testing by private employers as well as the federally mandated, safety-sensitive workforce, which includes federal employees and the transportation and nuclear power industries.

“Intoxicating cannabis products, including marijuana, can have a major impact on safety at work and have been proven to slow reaction time, impact memory and impair skills essential to driving. State legalization of the drug creates new challenges for employers,” said Katie Mueller, a senior program manager at the National Safety Council focusing on cannabis safety, said in a statement

According to Quest Diagnostics, the increases in post-accident marijuana test positivity correspond with the legalization of marijuana in certain states. In 2012, Colorado and Washington became the first states to legalize marijuana for recreational use. Since then, 19 additional states and the District of Columbia have legalized the recreational use of marijuana, and 38 states (plus Washington, DC) have legalized medical use, although either kind of use remains illegal under federal law.

“The Quest data provide compelling evidence that increased use of cannabis products by employees can contribute to greater risk for injuries in the workplace. It is imperative employers take the proper steps to create and maintain a policy that addresses cannabis use, build a safety-focused culture and educate the workforce to keep all workers safe on and off the job,” said Katie Mueller, a senior program manager at the National Safety Council focusing on cannabis safety.

In addition to marijuana, positivity for amphetamines use also has increased in recent years, according to the report. Positivity for marijuana in the general workforce increased 10.3% (4.3% positivity in 2022 versus 3.9% positivity in 2021) and amphetamines positivity increased 15.4% (1.5% positivity in 2022 versus 1.3% positivity in 2021). The data does not differentiate between prescribed amphetamine medications and illicit drug use. 

The analysis “shows that the overall US workforce positivity rate continued to be at a historically elevated level in 2022, even as much of the nation’s workforce returned to the office post-pandemic,” said Keith Ward, general manager and vice president for employer solutions at Quest Diagnostics. “This historic rise seems to correspond with sharp increases in positivity for marijuana in both pre-employment and post-accident drug tests, suggesting that changing societal attitudes about marijuana may be impacting workplace behaviors and putting colleagues at risk. The increase in amphetamines positivity is also notable, given the addictive potential and health risks associated with this class of drugs.