Drug Test Cheating Surged in 2023

The rate of employees tampering with drug tests reached new highs in 2023, according to a report from health data analytics firm Quest Diagnostics.

The percentage of tests that showed signs of tampering in 2023 was over six times greater than in 2022. Quest Diagnostics reported that the 2023 rate was the highest in 30 years of annual reporting.

Drug Test Cheating Rates

The following summarizes the report’s key findings that indicated drug test tampering in two categories:

General U.S. Workforce

Substituted urine specimens:

2022: 0.015%
2023: 0.11%

Increase: 633% Invalid urine specimens:

2022: 0.31%
2023: 0.45%
Increase: 45.2%

Federally Mandated, Safety-sensitive U.S. Workforce

Substituted urine specimens:

2022: 0.017%
2023: 0.08%

Increase: 370.6% Invalid urine specimens:

2022: 0.3%
2023: 0.41%
Increase: 36.7%

Additional Drug Test Findings

Beyond examining drug test tampering, the Quest Diagnostics report analyzed worker drug use more generally.

In 2022 and 2023, drug test positivity in the general workforce was 5.7%—the highest drug test positivity rate in over 20 years. The report also found a 114.3% increase in post-accident drug positivity between 2015 and 2023 among the same cohort.

The report also highlighted notable drug positivity increases from 2022-23 among “office work” industries:

Real estate and lending: +17%
Professional, scientific and technical services: +9.3% Educational services: +7.9%
Public administration: +5%

Employer Considerations

The Quest Diagnostics report findings are a reminder that organizations should have reliable procedures for ensuring employee compliance with drug policies. An increase in test tampering may indicate an increase in disregard for workplace safety. Employers have the opportunity to improve their support of mental health and substance abuse education in all industries.