Quest Diagnostics’ 25th Anniversary Drug Testing Index reports a deep drop in drug use among American workers in the quarter century the Index has been published. Based on over 125 urinalysis drug tests, the laboratory network and provider of diagnostic information said use had plummeted 75% since its data assessment initiative began shortly after passage of the 1988 federal Drug Free Workplace Act through 2012. Among the more significant findings announced by Quest: The positivity rate for the combined U.S. Workforce dropped from 13.6% in 1988 to 3.5% in 2012 (74%); The positivity rate for the Federally Mandated Safety-Sensitive Workforce declined by 38% from 2.6% in 1992 to 1.6% in 2012; The positivity rate for the U.S. General Workforce declined by 60%, from 10.3% in 1992 to 4.1% in 2012. Despite the overall decline, the positivity rate for certain drugs such as amphetamines and prescription opiates rose during this period. A 2012 report by Quest Diagnostics found that the majority of Americans misused their prescription medications, including opioids and amphetamine medications. The data suggests, in our opinion, that workplace drug testing, with its threat of disclosure and risk of disciplinary action and termination, has helped reduce markedly the positivity rates for illegal drugs over the last 25 years, but that employers’ testing programs must be reviewed periodically and revised to address the abuse of new and different drugs and controlled substances, and changes in laws and regulations.