Cannabis Up! Opioids down! The Drug War Goes Sideways in 2019

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DTN (Aug. 30, 2019) The rate of positive drug tests in the American workplace shot up to a 14-year high in 2018, according to long-spinning industry weathervane, the Quest Diagnostics Drug Testing Index™. The most-current version, released last spring, revealed a sharp increase in positive results across all three major drug test platforms: urine, saliva and hair. 

Positive results for urine tests in general rose nearly five percent. Marijuana remained the most commonly detected drug across all three worker categories including the General Workforce, the federally mandated Safety-Sensitive Workforce and the all-inclusive Combined Workforce. Quest found that in the Combined Workforce the rate of marijuana positives in urine testing increased nearly eight percent, representing an almost seventeen percent jump since 2014 in that category. For the urine-test-only, safety-sensitive Feds and their contractors, marijuana positives rose nearly five percent in 2018 for a total jump of 24 percent over the last four years.

In stark contrast, the positive test rates for opiates in urine testing decreased significantly within the General Workforce.  The traditional “Opiates” category – mostly codeine and morphine – dropped almost 21 percent between 2017 and 2018. That’s nearly a 37 percent plunge from a historic peak in 2015. But the traditional opiates was just collateral damage; they were really gunning for the synthetics. Positive results for synthetic opiates in the hydrocodone family were knocked down only two percent in 2018, but that number rides in on the tail end of a very impressive 43 percent decline since 2014. There was a dramatic downward shift in positive results in the oxycodone family too (which includes America’s beloved Oxycontin). The Oxys fell more than 29 percent in 2018 and more than 46 percent from a five-year high that peaked in 2014. These significant reductions in opiate positives correspond directly to a well-publicized public outcry followed by a government demand that doctors stop writing so many goddamn opiate prescriptions! In 2017 prescription opioid dosage volume – an indicator measured in morphine milligram equivalents (MME) – decreased 12 percent, the largest annual drop in more than 25 years.

So what does all that mean? Cannabis is up and opioids are down… but not for the reasons you might suspect. Quest continues to cite marijuana as an “illicit drug” even though cannabis is now medicalized in most of the country, legalized in eleven states and decriminalized in fifteen. These are differences without distinction for as long as marijuana is federally illegal, all use will be “illicit” to Quest Diagnostics. 

On the other hand the opiate issue is the first drug war crisis to spring not from the squalid streets but from inside your doctor’s office. Prescriptions have spread so rapidly and the addicted number so many that in 2017 alone, more than 47,000 Americans died from opioid overdose. Faced with increasing public awareness, the medical community and Big Pharma were forced to act. And, lo and behold, they found all those impressive opiate reductions to be easily to achieve in a relatively short time. How? They just had to walk into your doctor’s office and turn off the spigot. 

Quest Diagnostics is the world’s leading provider of drug testing services. Its trademarked Drug Test Index, now in its 30th year, reflects an analysis of approximately ten million workplace drug tests that Quest labs perform each year. No one knows for sure how many total drug tests are conducted in the U.S. every year – there are too many companies and too many kinds of customers to make an accurate count – but 50 to 70 million drug test per annum can be taken as a reasonable guess. Whatever the real number may be, Quest’s ten million data points represent a lion’s share of the larger market, and its results – setting self-serving illicit skews aside – are considered to be the industry standard.