Recent data from Quest Diagnostics reveals a significant rise in workplace fentanyl positivity — especially in random testing. This has, in turn, led some employers to increase the regularity of testing for the drug. In 2024, fentanyl appeared in 1.13% of random urine tests, compared with just 0.14% during pre-employment screening — a staggering 707% increase. Sixty percent of fentanyl-positive tests also showed co-use with other substances.
This has implications for both security clearance holders and employees in general.
Drug Screening at Work
Private-sector employers typically may screen for drugs, including fentanyl. In the past, testing for fentanyl was not done often. However, given the increasing usage and related safety issues associated with such use, along with the increasing positive test results, it is becoming more common. Traditionally, Department of Transportation-regulated industries (like trucking, aviation, and railroad) had specific drug panels that historically excluded fentanyl. This is in the process of changing, and the DOT is seeking to have employees tested for fentanyl use through a change in regulation that appears to be imminent. In other words, most employers will be testing for improper fentanyl use in the future.
Testing Accuracy and Reliability an Issue
Another issue with drug testing for fentanyl is that some opioid screenings do not reliably detect fentanyl. Some tests are better than others. In the past, Opioid drug tests were not always accurate because of several factors, including false-positive results from cross-reacting medications (e.g., ibuprofen) or impurities, false-negative results due to dilution or low drug concentrations, and issues with sample integrity. However, many of these issues have been cleared up. In short, testing accuracy for fentanyl is increasing in reliability.
Security Clearance Implications
In terms of security clearance issues, testing positive for fentanyl usage can lead to security concerns under Guideline H, Drug Involvement and Substance Misuse. While there very well could be situations where fentanyl use might be appropriate (e.g., cancer pain) when following a medical professional’s prescription, any abuse or misuse could cause potential security clearance issues. I expect that more of these types of issues will be more common in the future. Potential issues can arise where clearance holders don’t take fentanyl exactly as prescribed, let others borrow pills, or use older pills that have expired. Some issues involving usage were covered in an earlier ClearanceJobs article.
Employment Implications
From an employment perspective, testing positive at work for fentanyl use, especially where the employer is unaware of any authorized purpose for the use (i.e., medical conditions), could lead to the loss of your position. Many employers may require follow-up testing after a positive result. Others may opt for a Fitness-for-Duty examination. There are several laws governing this, and employers will need to be careful. Issues involving disability discrimination could be raised. Also, there are differences in testing between private sector and federal employees.
Final Thoughts
The uptick in workplace fentanyl detection — especially in random testing — reflects broader public health and safety challenges. Employers are seeing a shifting legal environment where concern for the issue is causing increased testing. I see this also as affecting security clearances under Guideline H, given the increased usage and testing. If you encounter these issues, consult security clearance or employment counsel for assistance.
This article is intended as general information only and should not be construed as legal advice. Although the information is believed to be accurate as of the publication date, no guarantee or warranty is offered or implied. Laws, regulations and government policies are always subject to change, and the information provided herein may not provide a complete or current analysis of the topic or other pertinent considerations. Consult an attorney regarding your specific situation.
