Swedish Workplace Drug Tests Over 25 Years: Positive Results Quadrupled, With Cannabis Driving the Recent Surge | Research

The takeaway

Positive workplace drug tests in Sweden rose from 1.3% in 1994 to 5.6% in 2019, with cannabis becoming the dominant detected substance after 2007.

Anyone interested in workplace drug use trends, drug policy effectiveness, or international comparisons of cannabis use patterns.

1.3% → 5.6%
Positive workplace drug tests in Sweden over 25 years (1994-2019)

What the researchers found

Over 25 years and hundreds of thousands of workplace urine samples from across Sweden, the proportion testing positive for illicit drugs quadrupled — from 1.3% in 1994 to 5.6% in 2019. The increase wasn't steady; it progressed in stepwise phases of linear increase followed by plateaus, with the plateau periods becoming shorter over time.

The drug breakdown shifted dramatically. Cannabis (THC) overtook amphetamine as the most commonly detected substance after 2007 and drove most of the increase in recent years. While amphetamine detections declined, cannabis positives climbed consistently. Other drugs — opiates, cocaine, benzodiazepines — remained relatively stable.

The dataset grew enormously over time (from 3,411 samples in 1994 to 60,315 in 2019), reflecting the expansion of workplace drug testing programs across Swedish industries. Sweden maintained strict drug policies throughout this period, making the increase in positive results notable in a prohibitionist context.

Why it matters

Sweden is one of Europe's most restrictive countries on drug policy — this isn't Colorado or Amsterdam. The fact that positive cannabis tests quadrupled over 25 years despite strict prohibition challenges the assumption that tough drug laws suppress use. Cannabis use increased among the Swedish workforce regardless.

The post-2007 cannabis surge is particularly interesting because it coincided with broader European cannabis potency increases (RTHC-00052) and may reflect cultural shifts in attitudes toward cannabis even in prohibitionist countries. For workplace policy internationally, this data suggests cannabis use among workers is increasing regardless of the legal framework.

The numbers in context

• Positive drug tests: 1.3% (1994) → 5.6% (2019)

• Cannabis: became dominant detected substance after 2007

• Sample volume grew: 3,411 (1994) → 60,315 (2019)

• Cannabis positive rate increased while amphetamine decreased

• Pattern: stepwise increases with shortening plateau periods

How the study worked

Analysis of workplace urine drug testing data from occupational health services across Sweden over a 25-year period (1994-2019). Samples tested for cannabis (THC), amphetamine, opiates, cocaine, and benzodiazepines. Trends analyzed over time by substance.

Who was studied

N=60,315 employees from various workplaces in Sweden over 25 years.

What this study cannot tell us

Workplace drug testing samples are not random population samples — testing intensity and selection criteria changed over time. The dramatic increase in sample volume makes direct trend comparison difficult. Sweden-specific findings may not generalize to other countries. Urine testing detects past use, not impairment. Cannot determine whether positive tests reflect increased use, decreased caution, or changes in cannabis potency affecting detection.

How to read the evidence

Large longitudinal dataset spanning 25 years with hundreds of thousands of samples. Strong for trend identification, limited by non-random sampling and testing protocol changes.

When this study was published

Published in 2022 with data through 2019. Cannabis use trends in Europe have continued shifting.

The bigger picture

This is one of the longest-running workplace drug testing datasets in Europe. Combined with the Canadian workplace study (RTHC-00068) and the NIOSH commentary (RTHC-00061), it shows workplace cannabis use increasing across very different policy environments — from Sweden's prohibition to Canada's legalization. The common thread isn't legal status; it's shifting cultural attitudes toward cannabis.

Replication

Not stated in abstract.

Funding

Not reported in abstract.

Conflicts of interest

Not reported in abstract.

Questions still open

Does the increase in positive tests reflect more cannabis use or just better detection?
Has Sweden's prohibitionist approach failed to prevent workplace cannabis use?
Are the post-2007 cannabis trends related to increasing potency of European cannabis?

Common questions

Are more workers using cannabis?

In Sweden, positive workplace cannabis tests increased substantially from 1994 to 2019, becoming the most detected substance after 2007 — despite Sweden maintaining strict drug prohibition.

Does prohibition prevent workplace cannabis use?

This data suggests not effectively. Cannabis became the dominant substance in Swedish workplace drug tests despite one of Europe's strictest drug policies. Cultural shifts appear to matter more than legal status.

Read the original research

Increasing prevalence of illicit drug use among employees at Swedish workplaces over a 25-year period.

European journal of public health, 32(5), 760-765

The European Journal of Public Health is a reputable journal focusing on public health research and policy.

View on PubMed ↗Publisher’s paper ↗

Citation

Feltmann, Kristin; Villén, Tomas; Beck, Olof; Gripenberg, Johanna. (2022). Increasing prevalence of illicit drug use among employees at Swedish workplaces over a 25-year period.. European journal of public health, 32(5), 760-765. https://doi.org/10.1093/eurpub/ckac105