Marijuana positivity rates aren’t going down. They’re going up. Could this statistic be problematic for your workforce? Well, let’s analyze.
What the Numbers Tell Us
Quest Diagnostics recently released its Drug Testing Index (DTI), and the data is eye-opening. For those unfamiliar, the DTI is derived from nearly 10 million workforce drug tests (urine, hair, and saliva).
In 2024, the overall drug positivity rate was 4.4 percent, slightly down from 4.6 percent in 2023. While positives did experience a dip, the rate stubbornly remains above 4 percent, where it has persisted for the past 10 years.
Amphetamine positivity continues to increase while opioid positivity remains somewhat consistent. However, it is marijuana that comfortably leads workplace drug detection. While the implications of this fact may not be clear accross the board, what is clear is that post-accident marijuana positivity was 7.3 percent in 2024– a statistically significant figure that indicates a correlation between marijuana use and accidents.
The Federal vs. General Workforce Gap
When you dig further into the numbers, some interesting patterns emerge. Employees in federally mandated safety-sensitive positions had a positivity rate of 2.3 percent. The general workforce? 5.6 percent. That’s more than double.
What could be the reason for this? Well, there are likely many. However, Dr. Jason Hudson, Scientific Director at Quest Diagnostics Workforce Health Solutions, seems to believe one of the primary reasons is workforce drug policy structure. Federal drug testing programs are comprehensive, including pre-employment, random, reasonable-suspicion, and post-accident screening. Employees know they can be tested at any time.
Many private sector programs are less rigorous. While pre-employment drug testing is common, candidates can often predict this process and prepare. Once they are hired, testing is less common.
The message is clear: structured, consistent drug testing programs work as a deterrent.
The Matrix Matters
Here’s where things get interesting. Quest’s data shows marijuana positivity in oral fluid samples was 10.4 percent—more than double the 4.4 percent seen in urine.
Dr. Hudson believes a key difference lies in the collection logistics. Oral fluid collections are observed, which means no opportunity for tampering. Most urine collections are not observed, which is likely why this DTI noted a 600 percent increase in tampered urine specimens.
Why Marijuana Positivity Is Increasing
The primary reason, of course, is legalization. Legalization is changing perceptions. As more states legalize marijuana, the perceived risk of harm is diminishing.
Quest’s data shows an 11.8% increase in marijuana positivity between 2021 and 2022 in states that legalized recreational use. Medical marijuana states saw an 8.3 percent increase. Even non-legal states saw a 3.3 percent increase.
Perhaps more concerningly, an increasing number of individuals are admitting to marijuana use on the way to work or during breaks.
The Safety Connection
When Current Consulting Group surveyed employers in 2025, 78 percent said their number one reason for drug testing was to promote a safe workplace. And their number one concern about marijuana legalization? Safety.
The data backs up their concerns. A 7.3 percent post-accident marijuana positivity rate, compared to a 4.8 percent pre-employment marijuana positivity rate (between urine, hair, and oral fluids), is significant. That’s a 52 percent difference. And this gap has persisted since 2016.
The Workers Compensation Research Institute found a 7.7 percent increase in workers comp claims within the first year and a half after a state legalizes recreational marijuana. Over five years, that increase jumps to 15%—primarily in safety-sensitive industries.
What Employers Are Doing
Despite the data, some employers are dropping marijuana from their testing panels. According to Current Consulting Group’s 2025 survey, the number of THC drug testing programs is steadily decreasing year over year, at a rate of about 2-4 percent.
In some states where marijuana is legal, THC testing could be seen as a barrier to entry for employees. Candidates may want to pursue work where marijuana use is better tolerated.
Despite this reality, employers in all 50 states still have the right to maintain drug-free workplaces. Under DOT regulations, testing for marijuana is still mandated. Employers can prohibit employees from bringing marijuana into the workplace, using it during work hours, or being impaired while working.
Recommended Best Practices
- Update policies annually. State laws are changing constantly—over 500 bills related to drug testing were introduced at the state level last year. Current Consulting Group’s survey found that 32% of employers haven’t updated their policies in over 2 years, or have never done so.
- Choose your testing matrix wisely. Urine, oral fluid, and hair testing all have different detection windows and strengths. Understand what you’re trying to accomplish, then choose accordingly.
- Consider the data: marijuana use is increasing. More people are using it daily. More people are admitting to using it before and during work. Post-accident positivity rates are significantly higher than pre-employment rates.
Takeaways
Marijuana legalization is impacting workplace decisions. This, however, doesn’t change the current reality that marijuana use correlates with increased workplace accidents and workers’ compensation claims.
We’re seeing increases in post-accident positivity rates, particularly among companies that have dropped marijuana from their pre-employment testing. We’re seeing more tampering and the use of synthetic urine. And we’re seeing legitimate safety concerns from employers across all industries. For this reason, we would urge careful consideration as you determine whether to include or exclude THC from your drug-free workplace policy.