Fentanyl use on the rise in workplace drug tests nationwide but on the decline in NYS, report finds

The percentage of Americans testing positive for fentanyl in workplace drug tests is on the rise nationwide although rates are significantly lower in New York, according to a new report from Quest Diagnostics, one of the United States' largest drug-testing labs.

The positivity rate for urine tests indicating the presence of the deadly synthetic opioid was 0.55% in 2024, increasing almost 15% from 0.48% one year earlier, according to an analysis of more than 8 million drug tests nationwide.

But the report also revealed a change of patterns in the use of fentanyl by the U.S. workforce.

For example, just 0.13% of employees nationwide tested positive for fentanyl in pre-employment tests — in which the subject can prepare in advance for the test, the report shows. But the positivity rate for fentanyl in random workplace drug tests was more than 700% higher at 1.13%, according to the data.

The figures suggest more workers are using the highly addictive opioid after getting hired, raising concerns about on-the-job accidents and impairments, said Suhash Harwani, senior director of science for workforce-health solutions at Quest Diagnostics.

"It shows there's more drug use going on than you're catching on the pre-employment side, which is a concern with the potency of fentanyl," Harwani told Newsday in an interview Tuesday. " ... The fact that we're seeing it in random testing means there is use going on that undermines safety in the workplace."

'Relief from the crisis'

New York — once at the epicenter of the opioid epidemic — now trails the rest of the country in workplace drug positivity rates.

Only 0.27% of Big Apple workers tested positive in 2024 for fentanyl in pre-employment, random, follow-up, reasonable suspicion, post-accident or return-to-duty screenings — or about half the national average — the report shows.

In pre-employment tests, just 0.05% of New York workers tested positive for fentanyl, Harwani said, adding that data on random testing on Long Island was not available.

Opioids, including fentanyl, have killed thousands of Long Islanders, although the number of fatal overdoses each year has begun to decrease.

In 2023, for example, the number of fatal overdoses in Suffolk County, 463, dropped more than 11% compared with the year before,  Newsday has reported. In Nassau, 209 people lost their lives to overdoses in 2023, down 16% from 2022.

Jeff Reynolds, president and chief executive of Garden City-based Family & Children's Association, which provides drug treatment services, said New York was hit earlier by the fentanyl crisis, in part because of its proximity to major East Coast shipping ports and its previous struggles with prescription opioids and heroin.

"So we may be getting some relief from the crisis sooner than downstream states," Reynolds said. "New York has also made significant strides in prevention, treatment and support for people in recovery, so we may finally be seeing the results of those investments."

In total, the positivity rate for all substances Quest Diagnostics tested for in workplace screenings declined nationwide, from 4.6% in 2023 to 4.4% in 2024, Quest found.

In New York, the overall positivity rate was 3.6% last year, down 12% from 4.1% in 2023, the lab reported.

Marijuana most detected substance

Nationwide, marijuana remains the most frequently detected substance in the workforce, with positivity rates of 4.5%, identical to 2023, Quest said. The number is 3.8% in New York, where cannabis is legal for recreational purposes, data shows.

In addition, about 22% of fentanyl-positive workforce drug tests last year also tested positive for marijuana while 16% also tested positive for amphetamines, the report shows.

Nationwide, drug overdose deaths fell almost 27% last year, from more than 110,000 estimated fatalities in 2023 to just over 80,000 in 2024, according to the Centers for Disease Control and Prevention's National Vital Statistics System. That was the fewest annual overdose deaths since 2019, the agency said.

The CDC estimates roughly 7 in 10 American overdose deaths involved synthetic opioids such as fentanyl.

By Robert Brodsky

robert.brodsky@newsday.com@BrodskyRobert

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.