In 2013, the number of current heroin users was 289,000 (0.1 percent), which was similar to 2008 through 2012 but higher than 2002 to 2005
were approximately equal in 2005 through 2007, and oral fluid positivity rates have been higher than urine since 2008. In 2013, oral fluid positivity for marijuana stood at 5.1 percent as compared with 2.1 percent in urine drug tests. Tis rate is also higher than hair (4.3 percent) and is all the more remarkable given the shorter detection window of this drug in oral fluid as com- pared with both urine and hair. Presumably a significant driver for these findings is that oral fluid collection is observed while urine drug tests are not. Marijuana remains the second most frequently mentioned illicit substance in ED visits and increased 19 percent between 2009 and 2011. While the NFLIS data shows declines in cannabis/ THC identifications between 2009 and the first half of 2013 in all regions of the country, this substance remains the most commonly reported drug in the Midwest (40 percent), Northeast (34 percent) and South (29 percent). Of increasing interest to employers are
the seemingly relaxing atitudes towards marijuana. Tere are currently 23 states with “medical” marijuana statutes, two of which also permit “recreational” use. An analysis of urine drug test data from the those two states—Colorado and Washington— showed marijuana positivity rates increased 20 percent and 23 percent, respectively, in the general workforce between 2012 and 2013, compared to the 5 percent average in- crease among the U.S. general workforce in all fiſty states. However, both Colorado and Washington experienced dramatic increases in marijuana positivity rates prior to legaliza- tion at the end of 2012. From 2009 to 2010, Colorado experienced a 22 percent increase and Washington a 10 percent decline in positivity. From 2011 to 2012, Colorado experienced a 3 percent increase and Wash- ington an 8 percent increase in positivity. Consequently, it is too early to predict the longer term impact on employer drug test positivity in states with recreational and/or medical marijuana statutes.
12 datia focus
Cocaine Use Cocaine use is down by most measures. Te NS- DUH estimates for current
cocaine use are much lower from 2009 to 2013 (range: 1.4 to 1.7 million or 0.5 per- cent to 0.7 percent) as compared to 2002 to 2007 (range: 2.0 to 2.4 million or 0.8 percent to 1.0 percent). Tis is similar to DTI data, which exhibited declines starting in 2007 in oral fluid and urine and in 2008 in hair tests. Te decline in DTI positivity across all three specimen types is greater than 40 percent. Te only data that runs counter to this is a 33 percent increase in cocaine positivity on federally-mandated tests in 2011 following the lowering of the cutoffs for cocaine. While there was no change in ED mentions of cocaine in 2011, it remains the most frequently mentioned drug. In the MTF, cocaine use by 12th graders has dropped dramatically since 2007; in recent years, has held steady among all grade levels; and is at its lowest level (2.6 percent) among 12th graders with even lower rates among 8th and 10th graders. According to the NFLIS data, cocaine has shown decreasing trends across all four regions of the country since 2004 but is still the second most frequently (15.5 percent) identified drug.
Heroin Use In 2013, the number of current heroin users was 289,000 (0.1 percent),
which was similar to 2008 through 2012 but higher than 2002 to 2005 (range: 119,000 to 166,000) and 2007 (161,000). Specific testing for the heroin metabolite, 6-acetylmorphine (6-AM) is relatively new (since late 2010) in urine drug tests. While it is required for all federal-man- dated tests, approximately 20 percent of general workforce urine tests in 2013 included this substance. In those urine tests, the positivity rate for 6-AM is 0.02 percent. In contrast, oral fluid testing for
winter 2015
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