Fentanyl in the Workplace: A Hidden Threat Employers Can’t Afford to Ignore

Rising Positives in Workplace Drug Tests

Fentanyl, the synthetic opioid fueling the nation’s overdose crisis, is increasingly showing up in U.S. workplaces. According to Quest Diagnostics’ 2025 Annual Drug Testing Index, the positive rate for fentanyl in urine drug tests climbed to 1.13% in 2024, up from 0.91% in 2023 and nearly double the rate from just four years earlier. These figures come from an analysis of more than eight million drug tests conducted across industries.

Unlike marijuana or other substances, where pre-employment testing may filter out users before they are hired, fentanyl is surfacing in random workplace tests—a strong signal that some employees are continuing use after securing jobs. Quest’s data showed fentanyl-positive results were more than seven times higher in random testing compared to pre-employment screening.

That gap highlights a serious blind spot: fentanyl use is not being fully detected through standard hiring protocols, creating hidden risks for employers.

The Scale of the Crisis

Fentanyl is up to 50 times more potent than heroin and 100 times stronger than morphine. The Centers for Disease Control and Prevention (CDC) estimates that nearly 74,700 deaths involved synthetic opioids in 2024, a slight decline from 2023 but still staggeringly high. While the modest dip reflects expanded access to naloxone (Narcan) and better public awareness, the availability of fentanyl on U.S. streets remains at record levels.

In fact, U.S. Customs and Border Protection intercepted over 27,000 pounds of fentanyl in 2023, almost double the prior year’s record seizures. The sheer volume underscores how deeply the drug has penetrated the market, often laced into heroin, cocaine, methamphetamine, and counterfeit pills without the user’s knowledge.

The potency of fentanyl means even microgram quantities can be lethal. For employers, the implications are severe: a worker unknowingly or intentionally under the influence of fentanyl can endanger themselves, coworkers, and the public.

Why the Standard DOT 5-Panel Isn’t Enough

One of the most dangerous misconceptions among employers is the belief that fentanyl is already covered under “opioids” in workplace drug tests. In reality, the Department of Transportation’s (DOT) mandated 5-panel test does not include fentanyl.

The DOT 5-panel tests for:

• Marijuana (THC)
• Cocaine
• Amphetamines
• Phencyclidine (PCP)
• Opioids (codeine, morphine, 6-AM from heroin, hydrocodone, hydromorphone, oxycodone, oxymorphone)

Synthetic opioids like fentanyl and its analogs are excluded unless employers specifically request their inclusion. This means that many safety-sensitive organizations—transportation companies, construction firms, healthcare providers—may be operating under a false sense of security.

Unless explicitly added to a drug testing panel, fentanyl use will go undetected.

DISA’s Response: Closing the Gap

Recognizing the urgent threat, DISA Global Solutions has begun adding fentanyl to tests across its drug testing consortium, ensuring greater protection for employers and employees alike.

By integrating fentanyl testing, DISA aims to:

• Close a dangerous compliance gap
• Improve safety outcomes for safety-sensitive workplaces
• Educate employers about emerging drug trends and evolving risks

“Employers can no longer assume their current panels are sufficient,” said Brendon Brown, Vice President, Account Management at DISA Global Solutions. “Fentanyl is reshaping the drug landscape, and organizations need to proactively adjust their testing programs.”

The Employer Risk Equation

The presence of fentanyl in workplaces isn’t just a public health concern; it’s a workplace liability issue. Employers who fail to test for fentanyl may face:

• Safety hazards: Impaired coordination, confusion, and drowsiness increase the likelihood of accidents in high-risk jobs.
• Legal exposure: Ignoring fentanyl testing can weaken an employer’s defense in the event of workplace incidents.
• Productivity losses: Substance misuse drives absenteeism, turnover, and healthcare costs.
• Reputation damage: Companies tied to drug-related accidents or fatalities face long-term brand harm.

The Bureau of Labor Statistics reported that unintentional workplace overdoses from nonmedical drug or alcohol use rose for the 10th straight year in 2022, a trend driven in part by synthetic opioids. Employers who delay updating their testing strategies risk falling behind both compliance standards and real-world threats.

Regulatory Momentum Is Building

While DOT testing panels currently exclude fentanyl, momentum is building for regulatory updates. In January 2025, the Department of Health and Human Services (HHS) announced a rule requiring laboratories to include fentanyl and its primary metabolite, norfentanyl, in federal workplace drug testing programs. Enforcement began July 7, 2025, and although the rule directly applies to labs, it signals broader changes ahead.

If DOT adopts similar updates, fentanyl screening will eventually become standard across transportation and other safety-sensitive industries. But waiting for mandates could leave employers vulnerable in the meantime.

The Misconceptions Employers Must Overcome

1. “Opioid testing covers fentanyl.” False. Unless requested, fentanyl is not part of the standard opioid panel.
2. “We’ve never had an incident, so the risk must be low.” With fentanyl often hidden in counterfeit pills, many users may not know they’ve consumed it. The absence of past incidents doesn’t eliminate future risks.
3. “Testing is too costly to expand.” The cost of adding fentanyl testing is minimal compared to the potential financial and reputational fallout of a workplace accident or fatality.
4. “Overdose deaths are declining, so the problem is improving.” Declines are tied to naloxone use and treatment, not to a decrease in fentanyl prevalence. The supply remains strong.

Real-World Implications: Post-Hire Use

Quest’s data suggests many employees begin or continue using fentanyl after being hired. Unlike cannabis, which stays in the system for days or weeks, fentanyl clears within hours. That makes it possible for job applicants to avoid detection during pre-employment testing but still use regularly afterward.

This dynamic highlights the importance of random, post-incident, and reasonable-suspicion testing—not just pre-employment screens. Employers relying solely on front-end testing are missing the majority of fentanyl cases.

Why Employers Should Act Now

Forward-thinking organizations aren’t waiting for federal rulemaking, many companies and DISA’s consortium partners are already adding fentanyl testing to their panels. Acting now helps employers close a dangerous gap, prevent accidents, and reduce liability while demonstrating a commitment to workforce safety.  

Practical steps employers can take include:  

• Reviewing testing policies to ensure fentanyl is included  
• Expanding beyond pre-employment testing with random or post-incident screens
• Educating HR and safety teams on the difference between traditional opioids and synthetic opioids  
• Framing testing as a safety measure when communicating with employees  

Staying ahead of HHS and DOT updates not only prepares organizations for evolving compliance standards but also provides opportunities to support employees who may be struggling with fentanyl misuse.

The fentanyl epidemic is the deadliest drug crisis in American history, and it is showing up in workplaces at alarming rates. Standard panels, including the DOT 5-panel, leave employers vulnerable to hidden risks. By proactively adding fentanyl to testing programs, companies protect employees and the public, align with emerging regulations, and strengthen their reputation for safety. DISA’s decision to expand consortium testing with fentanyl emphasizes that workplace safety depends on anticipating risks rather than reacting to them. Employers who follow this lead won’t just improve compliance; they could save lives.