1 in Every 28 Hair Tests are Positive for Opioids


Drug and alcohol testing is an essential program that increases safety at your workplace and reduces the risk of employees being impaired at your facility. As an industry-leading third-party administrator (TPA) of drug testing, we've seen an increase in medical prescriptions for drugs like marijuana and opioids (Oxycontin, Oxycodone, Hydrocodone, etc.). It's important for employers to understand how these prescriptions affect safety-sensitive employees in the drug testing process, what the process is when an employee has a prescription, and why you may need to implement new procedures to ensure your facility stays as safe as possible.

The rise of the opioid epidemic has led employers to create and implement drug testing policies to deter people from using drugs, but with opioids being legal, prescriptions for opioids being unexpectedly common, and laws varying greatly by state, it complicates the drug testing process for employers.

In 2018, DISA’s vendor partner Psychemedics, a pioneer in using hair for drug testing, saw one out of every 28 drug test samples return lab positive for opioids. After a Medical Review Officer (MRO) reviewed the drug tests, they overturned more than 60% of the tests because the donor had a valid prescription for opioids, like Oxycontin, Oxycodone or Hydrocodone.

When an MRO reviews a drug test that returns positive for opioids, they ask the donor for a valid, medical prescription. If the donor has a valid, medical prescription, then the non-negative drug test is marked as negative. Regardless of a prescription, employees in safety-sensitive positions pose a potential risk for the workplace if they’re using opioids that impair their judgment.In this case, Psychemedics indicated that one out of every 28 employees who took a hair drug test came back positive for opioids at the lab before the MRO reviewed their prescription status.

With MRO’s marking 60% of drug tests that tested positive for opioids as negative because they have a valid prescription, it means that for every two hair drug tests that were reported as positive for opioids, three were reported as negative because the donor had a valid prescription. In 2018, we saw the lab positivity rate drop from one in every 22 tests, to one in every 28 tests. 2016 was a peak usage year, but since then we’ve seen the percentage of MRO overturns due to valid prescriptions increase from 50% to 60% of all positive opioid tests.

How to Protect Your Workplace

Establishing a drug testing policy helps mitigate risk and creates a safer working environment, but that is not the only thing employers should rely on. Prescription drugs are legal, and that makes handling them in the workplace an ongoing challenge. It’s important to educate and train your team on identifying the signs for a reasonable suspicion drug test. Reasonable suspicion drug testing allows employers to maintain a safe working environment by performing a drug test when there is evidence or reasonable cause to suspect an employee of impairment or drug use

Reasons to conduct a reasonable suspicion test include:

  • Physical signs - Bloodshot eyes/dilated pupils, slurred speech, unsteady walk, shakes or tremors, unexplained sweating or shivering, fidgeting/inability to sit still, sleeping at work or difficulty staying awake
  • Behavioral signs - Attendance problems/tardiness, a pattern of absences or excessive absenteeism, a decline in performance/productivity, acting withdrawn from others
  • Psychological signs - Unexplained changes in personality or attitude, sudden mood changes, angry outbursts or inappropriate laughing, inability to focus or concentrate

Establishing and implementing a Medical Disclosure Policy will also help protect your company from legal drug use. Employers must carefully determine which positions should be covered by a Medical Disclosure Policy, as a crane operator using heavy machinery most likely qualifies as a safety-sensitive position, but a receptionist position may not. With a Medical Disclosure Policy, if an employee is using a prescription that could impair them, then they are responsible for notifying their employer. Under these circumstances, if an employee fails to notify the employer, then they can take action on a passed drug test even if the employee has a prescription because they violated company policy.

“It’s imperative that employers understand the risks and costs associated with prescription opioid use in the workplace and decipher and abide by state laws to implement not only a drug testing policy, but a clear and concise Medical Disclosure Policy to further protect their employees and maintain safety and compliance.” – Frank Bernard, VP of Compliance and Administration at DISA Global Solutions.

Why It Should Be A Concern for Your Company

DISA’s 2019 Owner Survey created a report focusing on industry best practices from data collected from more than 60 upstream and downstream owner/operators. From this survey, we established that only 40% of owners say opioids were an issue they were concerned about. What employers don’t understand is just how dangerous and detrimental these drugs can be while under the influence in the workplace, especially with employees in safety-sensitive positions. Opioids are known to cause side effects that can cause users to be less alert, dizzy, nauseous, or, in some cases, to hallucinate. These are all symptoms that can pose a hazard to those in safety-sensitive positions as well as other employees in the workplace.


Employers face many risks when an employee in a safety-sensitive position is under the influence and/or uses prescription opioids. Employers should also be concerned about higher insurance premiums, employee turnover, absenteeism, increase in accidents and workers compensation claims, and reduced employee productivity. DISA recently released a drug testing ‘cost of abuse’ calculator to determine the ‘hidden costs’ employers shoulder from an employee abusing drugs. For the average employee, drug abuse costs employers more than $7,000 for each employee, but in conjunction with a recent whitepaper from Current Consulting, DISA believes safety-sensitive employees abusing drugs add more than $35,000 in hidden costs for employers.

What Can DISA Do?

While drug testing may not be a silver bullet by itself, creating a customized drug testing solution is the best option available to protect your company and ensure safer hiring standards. Our variety of drug testing solutions and professionals can assist you in ensuring that your policies and procedures align with your industry requirements, meet and maintain compliance, follow state laws, and provide employees with a safe working environment.

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About DISA Global Solutions

Founded in 1986, DISA is the industry-leading provider of employee screening and compliance services. Headquartered in Houston, with more than 35 offices throughout the U.S. and Canada, DISA’s comprehensive scope of services includes drug and alcohol testing, background check, occupational health, and transportation compliance. DISA assists employers in making informed staffing decisions while building a culture of safety in their workplace.

DISA Global Solutions aims to provide accurate and informative content for educational purposes only and does not constitute legal advice. The reader retains full responsibility for the use of the information contained herein. Always consult with a professional or legal expert.