Curb Prescription Drug Abuse at Work with Six Proactive Steps

By Roy Maurer Oct 22, 2014
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Prescription medications contribute to favorable treatment outcomes and quality of life when used correctly. However, the abuse of opioid painkillers has become a disturbing trend and a threat to workplace safety, according to a National Safety Council (NSC) report.

The number of prescriptions for opioid pain relievers such as Vicodin, OxyContin and Percocet shot up from 76 million in 1991 to 213 million in 2013, a 176 percent increase, according to the National Institute on Drug Abuse. In 2010, almost half of drug overdose fatalities in the U.S., 16,651 deaths, were tied to prescription medications, exceeding the overdose deaths from both heroin and cocaine combined.

The prescription painkiller epidemic poses a unique challenge for employers. “These medications are powerful, highly addictive drugs that have the potential to cause impairment [and] increase the risk of workplace incidents, errors and injury even when taken as prescribed,” said Dr. Don Teater, medical advisor for the NSC, in the report.

Prescription painkillers also profoundly increase workers’ compensation costs, length of worker disability and work time lost, according to the Workers Compensation Research Institute.

Quest Diagnostics, which provides drug testing services, said in 2010 that workers who had been in accidents tested positive for the narcotic opioid hydrocodone nearly five times more often than the general population of workers. Positive tests for hydrocodone and oxycodone have risen 172 percent and 71 percent, respectively, since 2005, according to Quest’s Drug Testing Index.

But there are legitimate checks on what employers can do in this area, such as legal concerns about privacy, protection of personal medical information and possible violations of the confidential doctor-patient relationship.

So what can you do about this growing problem?

“Most employers understand how detrimental illegal drugs can be in the workplace, but few recognize the toll of the prescription painkiller epidemic,” said Deborah Hersman, NSC president and CEO in a press release. “Strong drug-free workplace programs, comprehensive benefits packages, easily accessible employee assistance programs and companywide education are risk reduction efforts every employer must undertake to help protect the health and well-being of their employees as well as company bottom lines.”

Employers have the legal right to provide a drug-free workplace, including drug testing, in order to establish that job tasks are performed in a safe and effective manner, according to the NSC.

Here are six steps employers can take to maintain a safe work environment:

Re-evaluate your company’s drug policy. Drug-free workplace policies were more easily enforced when illegal drugs were the only drugs banned under the policy, Teater said. “Now, the increased use of prescription medicines, especially opioid painkillers, has created an important need to revisit these policies.” The NSC says this should be overseen by the HR and safety departments and legal counsel. “A clear, written policy has never been more important,” Teater said. “Unlike blood-alcohol levels, proving an objective measure of unsafe impairment is difficult. The involvement of legal counsel in tandem with human resources and employee relations is critical to ensure the policy includes protections for risk management, injury prevention and liability.”

Educate employees about the dangers of prescription painkiller use and misuse. According to the NSC, employees should know:

  • To discuss their concerns about taking prescription opioid painkillers as soon as their doctor recommends taking these drugs. “Employees then should work with their prescriber to determine if a non-opioid prescription can be used,” said Teater. The NSC recently produced a report that asserts over-the-counter pain medications can be more effective than opioid painkillers for most pain.
  • What state law says about driving while using prescription drugs. “In the majority of states, an individual can receive a driving under the influence citation, even if he or she is driving under the influence of a legitimately prescribed medication,” Teater said.
  • The risks of taking painkillers while performing safety-sensitive tasks.
  • How to safely store and dispose of opioid drugs.
  • Not to mix opioids with certain other types of drugs or alcohol, and not to take someone else’s prescribed painkillers or share theirs with anyone else.

Train supervisorsso they can act as your company’s first line of defense. Supervisors should know:

  • The company’s current drug-free workplace and drug-testing policies and any updates as they’re made.
  • The potential signs of drug impairment. Managers need to know that the Americans with Disabilities Act may protect an employee’s use of prescription drugs to treat a disability. However, “prescription drug abuse is considered illegal drug use. Employers may test employees for such abuse based on a reasonable suspicion. If an employee notifies a manager that his or her medication may impair job performance, managers should be coached on how to engage and offer reasonable accommodations, up to or including modifying job responsibilities,” said Teater.
  • How to communicate with their workers about prescription painkillers.

Promote your employee assistance program. Seventy percent of all U.S. companies and 90 percent of Fortune 500 companies purchase employee assistance programs (EAPs) because research shows that EAPs have positive returns on investment, according to the NSC. “It is in an employer’s best interest to identify opioid abuse and to support confidential access to treatment. Employer-sponsored treatment is a cost-effective solution,” Teater said.

But few employees use EAPs, he added. “Many employees don’t understand the value or may fear negative ramifications if they seek help. Employee education on the company’s EAP services needs to clearly state who an employee may talk to, how they can communicate with that resource and where.”

Include prescription medications in your drug-testing program. Drug tests can be perceived as being highly intrusive, but they can be invaluable tools for preventing drug-related incidents and reducing risk, according to the NSC. Workplace drug-testing programs can curb drug abuse through the apprehension of getting caught and the possibility of the consequences.

“The structure of the drug-testing program largely determines its effectiveness,” Teater said. Some programs require mandatory testing for all employees, some test only after an incident and some only test at the pre-employment stage.

Before performing any drug test or adopting a drug-testing policy, employers should obtain expert legal advice that is current with both state laws and federal guidelines, the NSC advised.

Additional advice regarding drug testing:

  • Use a lab certified by the U.S. Department of Health and Human Services or an equivalent state agency.
  • Use a testing format that respects employees’ privacy and dignity.
  • Have a clear written policy explaining testing procedures and disciplinary actions. Employees should understand how the test will be given, when it will be given and what drugs the test can detect.
  • Require employees to read the policy and sign an acknowledgment that they have done so.
  • Document why each drug test was administered and how it was performed.
  • Ensure test results are absolutely confidential.
  • Know what drugs to test for. “It is important to know the drugs that are commonly abused in your area,” said Teater. Many companies still use a standard five-panel test that covers opiates/heroin, cocaine, marijuana, PCP and amphetamines but will miss oxycodone (a semi-synthetic opioid) and most other abused prescription drugs, he said.

Partner with your health care and workers’ compensation insurance providers.

Working closely with these important partners helps employers understand the extent of opioid use and the need for programs to prevent and manage opioid abuse, the NSC said.

Roy Maurer is an online editor/manager for SHRM.

Follow him @SHRMRoy

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