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

Post-accident marijuana positivity of urine drug tests in the general U.S. workforce was 7.3% last year, compared to 6.7% in 2021. The new peak follows a steady increase in post-accident marijuana positivity every year from 2012 to 2022.

In that 10-year time frame, post-accident marijuana positivity increased 204.2%. From 2002 to 2009, post-accident marijuana workforce positivity declined.

Quest said the rise in post-accident marijuana positivity corresponds with 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 the District of Columbia) have legalized medical use.

In 2022, the combined U.S. workforce urine drug positivity for all drugs persisted at 4.6% – the highest level in two decades. The 2021 and 2022 positivity rates were the highest since 2001, up more than 30% from an all-time low in 2010-2012.

While marijuana was the main driver of positive drug tests in the general U.S. workforce, amphetamines positivity also contributed to the increase, the report said.

“U.S. 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.

“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,” Ward said. “The increase in amphetamines positivity is also notable, given the addictive potential and health risks associated with this class of drugs.”

Marijuana, cocaine and amphetamines showed widespread increases across industry sectors, the report said. Positive marijuana tests were highest in the retail trade and food services industry (8.1%) in 2022. Positive cocaine tests increased in 12 of 15 industries and was highest in the construction industry (0.33%). Positive amphetamine tests were up in 14 of 15 industries and highest in education services (2.1%)

Positivity for marijuana in the general U.S. workforce increased to 4.3% positivity in 2022 versus 3.9% in 2021 and amphetamines positivity increased to 1.5% in 2022 versus 1.3% in 2021. The amphetamines data does not differentiate between prescribed medications and illicit drug use.

The 2023 Quest Diagnostics Drug Testing Index report, based on more than 10.6 million deidentified urine, hair and oral-fluid drug test results reported between January and December 2022, is aimed at providing insight into behavior seen in workers across the combined U.S. workforce by industry and drug type. The data was presented at the National Drug & Alcohol Screening Association 2023 Conference last week.