The Advantages of Adding Fentanyl Testing To Employer Drug Panels

On July 7, 2025, a U.S. Department of Health and Human Services ruling went into effect, authorizing all federal workplace drug testing panels to check for fentanyl. Although private employers aren’t mandated to include it in their drug testing panels, checking for fentanyl can be a proactive way for companies to address the nationwide opioid crisis.

Fentanyl, a synthetic opioid, is 50 times more potent than heroin. It’s a highly addictive substance that causes more overdose deaths than any other drug in the United States. More than 72,000 Americans died of fentanyl overdose in 2023, the year with the most recent data available.

Employers who include fentanyl testing in their panels may lower the risk of overdose among their employees while improving workplace safety.

“You want to identify a potential risk that will cause liability, resulting in injury to the employee and others around them, and damage to the company physically and possibly financially,” says Robert Pedowitz, D.O., Vice President and Chief Medical Officer of Occupational Health and Safety at Hackensack Meridian Health. “Fentanyl is the most prevalent drug abused, so this is worth looking into.”

Companies that do their employee drug testing at Hackensack Meridian Health can choose to add fentanyl to their panels. It may increase an employer’s testing costs by about $10 per employee, but companies may determine that the financial investment is worthwhile.

“It’s estimated that American companies lose more than $81 billion annually due to alcohol and drug misuse,’” Dr. Pedowitz says. Employers may pay about twice as much in healthcare expenses for workers who abuse opioids. And employees with substance use issues are five times more likely to file workers' comp claims than other workers.”

At the moment, mandatory fentanyl testing only affects federal workers. However, the practice could become more widespread if, for example, the U.S. Department of Transportation (DOT) adds fentanyl testing to its panels for commercial drivers.

“For employers with people who drive vehicles who need a DOT license, fentanyl testing could be in their future,” Dr. Pedowitz says. “And if the DOT does adopt it, other agencies may start to do so, as well.”

The majority of private employers that have drug- and alcohol-free workplace policies only screen for drug use during the employee onboarding process and in circumstances when an employee is suspected of substance use.

After an employee goes for testing, negative test results are usually reported within 48 hours. If a drug screening test is positive, the sample is tested again to confirm the result, which can take approximately an additional five days. A positive or negative test (without specific findings) is reported to the employer.

Most employers will offer assistance to an employee who becomes addicted to opioids, recognizes that it’s impairing their ability to do their job, and asks their employer for help, even if the company has a zero-tolerance policy for drugs and alcohol. But drug testing panels aren’t intended for employees who are forthcoming about a problem.

“There are many options and services available, such as counseling, working with your private physician, and getting treatment at addiction facilities,” Dr. Pedowitz says. “For individuals who have problems with addiction and are not sure about fentanyl use, they may purchase and use fentanyl test strips. If an employee reports that they don’t use any drugs, but then they’re intoxicated or impaired and have a positive test, this becomes a violation of the drug-free workplace.”

The death toll from opioid overdose has risen substantially in the U.S. since 1999. Beginning in 2013, overdose deaths caused by synthetic opioids (including fentanyl) increased significantly for a decade, but the number of opioid-related deaths decreased in 2023. Employers that add fentanyl to their drug testing panels may help that number continue to drop.

“It’s a public health problem that everyone wants to tackle,” Dr. Pedowitz says.

For information about adding fentanyl to your company’s drug testing panel, contact us at hmworks@hmhn.org.