Study: Drug use among workforce means big cost for some employers in Eastern Iowa

New study shows Eastern Iowa workers testing for drugs at higher rate than national average

Kevan Bakewell

Holmes Murphy
Kevan Bakewell Holmes Murphy

A new nationwide analysis has found drug use among the U.S. workforce remains at its highest rate in more than a decade, increasing concern for many employers.

Not only could it be dangerous for workers, but drug use can spell a greater financial loss for local employers, said one Cedar Rapids expert.

“It’s really having a huge impact on employers,” said Kevan Bakewell, vice president of loss control services for Holmes Murphy and Associates, an insurance brokerage in Cedar Rapids.

The Quest Diagnostics Drug Testing Index, which issued its 2017 analysis last month, is a diagnostic information service that releases an annual report on workplace drug testing data, cultivated from laboratories around the country. These include five different types of drug tests — urine, blood, hair, saliva and sweat, with urine being the most common and most cost-efficient for employers.

Based on the data from these tests, the Index found the positive drug test rate for the combined workforce across the country in 2017 held at 4.2 percent, the same as in 2016. However, this rate is “a dramatic increase” from 3.5 percent in 2012, the lowest positivity rate — that, with low results for drugs in the worker’s system — in a 30 year period, the analysis stated.

Iowa’s overall positivity rate was below the national average, rating at 3.8 percent in 2017, according to the data.

However, Eastern Iowa saw some of the highest rates throughout the state. In Iowa ZIP codes 52400 to 52499 — which includes Cedar Rapids — and ZIP codes 52200 to 52299 — which takes in Iowa City — the positivity rate was between 4.5 percent and 5.5 percent.


Pramod Dwivedi, director of Linn County Public Health, said the most concerning rate “is the difference in positivity for cocaine in Eastern Iowa as well as marijuana positivity in the Cedar Rapids area compared to the United States and Iowa.”

“However, the percent positive across all categories is relatively small particularly for our area,” he said. “Without additional information on their methodology, an accurate conclusion cannot be ascertained.”

Dwivedi pointed out not all companies require drug screening. Only about 63 percent of U.S. employers report any form of drug or alcohol test for job candidates, according to a 2018 Employment Screening Benchmark report.

The drug tests reported in the analysis are also limited to employers who perform drug screenings through Quest Diagnostics.

‘Ever-evolving threat’

“Thirty years in, this year’s results again demonstrate the ever-evolving threat that substance abuse poses to workplace safety,” the analysis stated.

While the study looked at positive test results for cocaine, prescription opioids, marijuana and methamphetamine, Bakewell said the largest concern for employers he works with should be prescription drug abuse.

“Employers are pretty aware and know illegal drugs are a bit of an issue. That’s pretty well known,” he said.

“What’s not really as well known is all the employees that are working for a company that are using legal drugs — prescription drugs, such as hydrocodone or Vicodin or something. They may not even know (employees) are abusing it.”


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Bakewell oversees 10 consultants at the insurance brokerage firm Holmes Murphy, who work with about 450 companies around the country but mostly in the Midwest, developing safety and risk management strategies.

The opioid crisis — blamed for the 146 opioid-related deaths statewide in 2016, according to the Iowa Department of Public Health — can create a domino effect of greater losses for employers, Bakewell said. He listed the financial payouts of workers’ compensation claims, property damage or even lawsuits from third parties from outside the company.

Absenteeism could be five times higher for employees abusing a prescription, and turnover could be as much as four times higher, Bakewell said. that high turnover can lead to nearly 60 percent reduction in production.

Moreover, that means your current employees likely are working harder, increasing the likelihood of accidents and workplace injuries, Bakewell said.

This can be seen across industries, but there is a correlation with labor-intensive work settings, he said.

To prevent these losses, Bakewell said employers must implement specific strategies not only to prevent drug use in the workplace, but also to address the issue

Recommended strategies

One of the most effective method for preventing drug-related accidents are hazard controls initiatives, but in particular, pre-employment drug exams. Most employers conduct these tests when hiring, but historically these tests have not included capabilities to measure opiate use.

Those companies that do test for opioids are seeing reductions in their injury rates, Bakewell said.

“It’s going to cost a little bit more, but you really need to make sure you’re testing for more things to include those opioids,” Bakewell said.


Another strategy for current employees centers on effective employee assistance plans, which entails training employees and supervisors to detect potential abuse — signs such as mood changes, production decreases or absenteeism.

It can be extremely hard to detect opioid abuse, Bakewell said, so it’s also important for the company to create an environment in which the employee feels comfortable going to management for help.

“Sometimes people don’t want to report that, so hopefully the company leadership can create a culture where it’s treated not as a bad thing, but almost like a disease,” Bakewell said. “When employees report it, it’s not thought of as a negative thing, so the employer can help them as much as possible.”

Drug testing index findings

The 2017 data “suggests shifting patterns of drug use,” the analysis stated, connecting this trend with the increased prevalence among the general public in use of cocaine, marijuana and methamphetamine — but not in prescription opioids. In fact, the study has found decreases in opioid use among this population.

Prescription opiate positivity rates “declined dramatically on a national basis.” According to the Index, the positive urine drug results in the general U.S. workforce declined 17 percent between 2016 and 2017.

A contributing factor could be the decline in prescription opioids given to American patients in recent years. In 2016, there were 66.5 prescriptions dispensed per 100 people, compared to 2006’s rate of 72.4, according to the Centers for Disease Control and Prevention.

The analysis also stated heroin use among American workers may be abating, with positive drug test results down about 11 percent between 2017 and 2016.

On the other hand, the positivity rates for cocaine and methamphetamines surged in some parts of the country. Between 2013 and 2017, methamphetamine positivity “skyrocketed” 167 percent throughout the Midwest, the analysis stated.


Cocaine positive test results for the general U.S. workforce also increased in 2017, for the fifth consecutive year, up seven percent from 2016.

Positive test results for marijuana use rose sharply in states that had enacted laws in 2016 allowing recreational use, such as California, Massachusetts and Nevada.

“These increases are similar to the increases we observed after recreational marijuana use statues were passed in Washington and Colorado,” the Index stated. “While it is too early to tell if this is a trend, our data suggests that the recreational use of marijuana is spilling into the workforce.”

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