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Fentanyl Spikes in Random Workplace Tests: What Employers Should Do? 

The latest data from Quest Diagnostics’ Drug Testing Index shows a troubling trend: fentanyl positives in random workplace drug tests climbed to 1.13% in 2024, up from 0.91% in 2023 and double the rate seen in 2020. According to a recent analysis by the Wall Street Journal, this sharp increase highlights how fentanyl use is slipping past traditional pre-employment screening and surfacing later in the workplace (WSJ, Quest Diagnostics Report).

What’s Really Going On

Random screenings reveal the truth.
Quest’s report found that fentanyl positivity is more than seven times higher in random tests (1.13%) compared to pre-employment screenings (0.14%). This suggests employees may either develop use patterns after hiring or find ways to avoid detection during initial screening (Quest Diagnostics Report).

Polydrug use is rising.
Roughly 60% of fentanyl-positive results included at least one additional substance. Co-detection with marijuana doubled from 10% in 2020 to 22% in 2024, while amphetamine co-positives climbed from 11% to 16%. NJBIZ reports this shift is increasing the complexity of workplace safety risks (NJBIZ).

Overall positivity may be down, but fentanyl isn’t.
While overall workplace drug positivity slipped from 4.6% to 4.4%, Quest noted that fentanyl’s steady rise makes it one of the most pressing issues facing employers in 2025 (PR Newswire).

Why Employers Should Care

  • Safety Risks: fentanyl is ~50–100× more potent than morphine and ~25–50× more potent than heroin. Combined with other substances, the risk of on-the-job accidents and overdoses multiplies.
  • Compliance Exposure: If fentanyl isn’t part of your test panel, your program could miss it entirely, leaving gaps during audits or post-incident reviews. We explained in detail why most workplace drug tests miss fentanyl (and what to do about it).
  • Evolving Risk Landscape: Marijuana positivity is flattening, but fentanyl is rising. Employers must adapt quickly to new realities.

Immediate Steps for Employers

1. Expand Test Panels Now

Ensure your drug testing panels include fentanyl and norfentanyl where possible. Employers across industries are already adopting expanded panels to address this blind spot (WSJ).

2. Strengthen Post-Incident & Random Testing

Put more weight on random and post-accident testing, where fentanyl positivity is most likely to show up. This is especially critical in safety-sensitive roles like trucking, construction, and energy.

3. Update Drug-Free Workplace Policies

Adjust your written policies to reflect fentanyl risks. This should include: 

  • Incident response steps
  • Return-to-duty protocols
  • How employees are educated on new testing procedures

4. Train Supervisors & Safety Teams

Your team should be able to spot signs of fentanyl impairment, know when to call for reasonable suspicion testing, and follow DOT documentation rules correctly. For guidance, check out our article on common drug testing challenges under DOT’s Part 40 regulations.

5. Partner with QuickScreen for Proactive Solutions

QuickScreen supports employers with:

  • Expanded fentanyl-inclusive panels
  • Random and post-incident testing programs.
  • Supervisor training and policy development
  • MRO-reviewed lab confirmations for defensibility

TL;DR What Employers Should Do Now

Action 

Why It Matters 

Upgrade Panels 

Catch fentanyl that standard panels miss 

Boost Random Testing 

Target the stage where positivity rates are highest 

Update Policies 

Keep your drug-free program compliant and defensible 

Train Supervisors 

Ensure impairment signs are caught early 

Leverage QuickScreen 

Access expertise, expanded testing, and compliance support 

Fentanyl’s rise in the workplace is more than a statistic; it’s a safety and compliance challenge employers must confront immediately. QuickScreen helps businesses stay prepared, protected, and compliant in this new testing landscape.