Fentanyl At Work
A new report shows fentanyl is increasingly appearing in workplace drug tests, particularly among employees who have already passed pre-employment screening. Understanding what’s going on and taking proactive steps can help protect your team, your reputation, and your bottom line.
A recent study by Quest Diagnostics provides a clear picture of the issue. Quest analyzed over eight million workforce drug tests across the U.S. In 2024, random and unannounced drug tests (tests not tied to hiring) found fentanyl more than seven times as often as pre-employment screenings.1 Even more concerning, nearly 60% of fentanyl-positive tests also involved other substances, such as marijuana and amphetamines.1 Fentanyl use on the job, especially when combined with other substances, increases the risk of accidents, impairment, and even overdose.
The impact on small businesses can be serious. Fentanyl exposure in the workplace can lead to accidents and injuries, particularly in roles involving machinery, vehicles, or other safety-sensitive tasks.2 Beyond immediate safety risks, there are potential legal and financial consequences. If an employee under the influence causes harm, your business could face liability, workers’ compensation claims, or insurance complications. Incidents also create operational disruption, affecting productivity, morale, and your overall reputation. Substance misuse can reduce performance, increase absenteeism, and contribute to higher employee turnover, which can be especially challenging for small businesses.3
Small business owners can take practical steps to reduce these risks. Reviewing and updating your drug-free workplace policy is a critical first step. Policies should clearly outline expectations, consequences, and testing procedures, while staying compliant with state laws. Random or periodic testing can help detect fentanyl use that pre-employment screenings might miss. Employee education is equally important; staff need to understand the dangers of fentanyl, especially when combined with other substances.
Providing support is also key. Offering Employee Assistance Programs, connecting employees with treatment services, and fostering a culture where staff feel safe seeking help can make a major difference. Training supervisors to recognize signs of impairment and respond appropriately is critical to preventing accidents. Additionally, preparing for emergencies with overdose reversal tools, like naloxone, and clear response protocols can save lives. Check out this Overdose Emergency Planning Tool from the National Safety Council for help! Additionally, reviewing test data and incidents periodically will help you adapt policies and safety measures as needed, ensuring your workplace remains safe and productive.
Even one case of fentanyl exposure can have devastating consequences, but small business owners can take action now. By combining clear policies, employee education, and supportive measures, you can reduce risk, protect your employees, and maintain a safe and productive workplace.
Citations:
- Fentanyl Positivity Is More Than Seven Times Higher in Random Tests vs. Pre-Employment Drug Screening, Finds 2025 Quest Diagnostics Drug Testing Index. (2025, September 2). Quest Diagnostics Newsroom. https://newsroom.questdiagnostics.com/2025-09-02-Fentanyl-Positivity-Is-More-Than-Seven-Times-Higher-in-Random-Tests-vs-Pre-Employment-Drug-Screening,-Finds-2025-Quest-Diagnostics-Drug-Testing-Index
- Hegmann, K. T., Weiss, M. S., Bowden, K., Branco, F., DuBrueler, K., Els, C., Mandel, S., McKinney, D. W., Miguel, R., Mueller, K. L., Nadig, R. J., Schaffer, M. I., Studt, L., Talmage, J. B., Travis, R. L., Winters, T., Thiese, M. P., & Harris, J. S. (2014). ACOEM practice guidelines: Opioids and safety-sensitive work. Journal of Occupational and Environmental Medicine, 56(7), e46–e53. https://doi.org/10.1097/JOM.0000000000000237
- The effects of substance abuse in the workplace. (2025, March 28). American Addiction Centers. https://americanaddictioncenters.org/workforce-addiction