VALID MEASURE OF A WORSENING OPIOID CRISIS FROM U.S. WORKPLACE RANDOM DRUG SCREENS – SURGING HIGH-RISK OPIOID USE

Consistent with all other measures and trends of high-risk opioid use, results predictably point to a worsening crisis under consensus gold standard medical and expert care

by Clark Miller

Published September 19, 2025

From the WSJ exclusive – 

More Americans are testing positive for fentanyl use in randomized workplace drug tests, highlighting a persistent challenge for employers.

The positive rate for urine tests indicating the presence of the synthetic opioid fentanyl was 1.13% in 2024. That is up from 0.91% in 2023 and double the rate in 2020, according to a recent analysis of more than eight million drug tests by Quest Diagnostics DGX, one of the U.S.’s largest drug-testing labs.

“We’re seeing trends that are outside of the norm that we see for other drugs historically,” said Suhash Harwani, senior director of science for workforce-health solutions at Quest Diagnostics.

That’s no surprise, or shouldn’t be. Evidence has consistently pointed over past decades to a persistently worsening opioid crisis, existing evidence-based treatments not available on any significant scale, displaced by the lethal, expert gold standard practices driving mounting high risk use and deaths. 

By all valid measures including incidence of opioid injection-related infectious disease and of nonfatal overdose, high-risk opioid use continues to increase, a direct indicator of established gold standard treatment failure. Independently measuring a worsening crisis are intensive, desperate public health campaigns to flood communities with overdose reversing naloxone, required as harm reduction against the lethal effects of medical dispensing of opioids fueling the crisis

As explained and summarized in this recent post, incidence of fatal opioid overdoses has never served as valid measure of severity of the crisis. Valid measures include those that accurately measure high-risk opioid use (that use with predicted morbidity, mortality and related costs) including nonfatal overdose (but only when community-level overdoses with unreported revivals are somehow included in the accounting) and incidence of opioid injection-related infectious disease.

Barring cogent reasons to suspect confounding factors affecting the type of random drug screen data compiled by Quest Analytics, those results as well appear to point to what has long become apparent. 

All that remains is for America’s medical/media lethal collusion to bury that result in mystification and celebration of gains against the crisis. 

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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