Workplace Suicides, Opioid Overdoses Increase

Allen Smith, J.D. By Allen Smith, J.D. December 19, 2019
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A bottle of opioids

​The fallout of the opioid epidemic continues to be felt at work, and the number of workplace suicides is increasing at an alarming rate. But steps are being taken to fight both problems.

Despite national attention given to the opioid epidemic, the number of opioid overdoses at work rose by 12 percent in 2018, the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries report announced Dec. 17. This is the sixth consecutive annual increase in drug overdoses at work, which rose to 305 last year from 272 in 2017.

Employers can help reduce the number of drug overdoses by having naloxone, an over-the-counter spray (under the brand names Evzio and Narcan) on their premises that trained employees can use to revive someone who has overdosed on opioids, said Nancy Delogu, an attorney with Littler in Washington, D.C.

Suicides at work increased 11 percent in 2018, from 275 to 304. The Federal Communications Commission (FCC) proposed on Dec. 12 designating 9-8-8 as a nationwide, three-digit phone number for a suicide-prevention and mental health crisis hotline.

Overall Work Fatalities Rose Slightly

There were 5,250 fatal work injuries in the United States in 2018, a 2 percent increase from the 5,147 in 2017, BLS stated. Transportation incidents remained the most frequent type of fatality at 2,080, accounting for 40 percent of all work-related fatalities.

Incidents involving contact with objects and equipment rose 13 percent, from 695 to 786, including a 39 percent increase in workers getting caught in running equipment or machinery and a 17 percent increase in workers being struck by falling objects or equipment.

Fatal falls, slips and trips decreased 11 percent to 791 after reaching a high of 887 in 2017.

Drivers, sales workers and truck drivers had the most fatalities of any broad occupation group at 966.

'Discouraging Statistic'

The rise in opioid overdose deaths at work is a "discouraging statistic" and shows that the opioid epidemic isn't going away, Delogu said.

Surgeon General Jerome Adams recommended at an April 2018 conference that employers train employees on how to administer naloxone to help save lives.

Naloxone can help reverse an opioid overdose. After it's administered, someone who has overdosed typically is immediately revived, but a co-worker still should call for emergency medical help. Good Samaritan laws generally protect employers from being held liable if something goes wrong when supplying naloxone to an employee who has overdosed, Delogu added.

"Employers shouldn't ignore their instincts when something seems wrong at work," she said. They're not overstepping if they notice someone is not appearing well, or is drowsy or having work problems. Employers can ask the employee about these issues as they pertain to performance problems.

If someone is abusing opioids, there probably will be signs of the abuse. Even if an employer doesn't have a drug-testing policy, a manager can ask what's going on and send the employee home for the day, she noted.

If the worker is in a safety-sensitive role, there may be more urgent conversations about perceived alertness, Delogu added.

Post-Accident Testing Limited

Employers can't always prevent opioid overdose deaths or injuries resulting from opioid abuse.

When there are accidents, employers often want to test for drug use. The anti-retaliation provisions of the Occupational Safety and Health Administration's (OSHA's) electronic record-keeping rule limit when post-accident drug testing can be conducted, which has been a source of frustration for employers, according to Eric Conn, an attorney with Conn Maciel Carey in Washington, D.C.

"OSHA has softened its approach to challenging workplace drug testing," Conn said. Nonetheless, employers remain vulnerable to OSHA's challenges of post-accident drug testing.

To comply with OSHA, an employer must have a reasonable suspicion to believe drugs or alcohol were involved in an incident before a post-accident drug test can be administered. OSHA also permits drug testing at random and if there is reasonable cause, Conn said.

[SHRM members-only HR Q&A: What might be considered reasonable suspicion for drug testing?]

However, state laws on drug testing run the gamut, from employers being able to test whenever they want under state law in Virginia to being allowed to test in only limited circumstances in Rhode Island, Delogu said. If an employer is unionized, there may be additional restrictions on drug testing.

Even if an employer conducts drug tests after an accident, it might not realize the person involved is addicted to opioids. That's because while the drug test may be positive, the medical review officer who examines the test results may conclude that a prescribed drug can't be reported to the employer.

Delogu noted that in 2018, the U.S. Department of Transportation (DOT) started requiring employers regulated by the department to conduct opioid testing. Many employers emulate the DOT in their drug testing. If employers are not testing for opioids, "they may be missing an opportunity to detect and deter abuse of prescribed drugs."

If someone tests positive, consider offering medical leave to get treated for opioid addiction rather than firing him or her, said Kathryn Russo, an attorney with Jackson Lewis in Melville, N.Y. Many employers in hard-hit areas are doing that, recognizing that opioid addiction is a "horrific epidemic" and wanting to help people, she added.

Suicide Crisis

In addition to the opioid crisis, the rate of suicide has risen a shocking amount in recent years.

"The suicide rate in the United States is at its highest level since World War II," said FCC Chairman Ajit Pai. "In 2017, more than 47,000 Americans died by suicide, and more than 1.4 million adults attempted suicide."

He added that the crisis is disproportionately affecting at-risk populations. "More than 20 veterans die by suicide every day, and more than half a million LGBTQ [lesbian, gay, bisexual, transgender or queer] youth will attempt suicide this year alone."

He said that an easy-to-remember three-digit phone number—9-8-8—could help facilitate access to services that could prevent suicide attempts. The proposal must go through review and comment periods. The number is not in use yet.

"It'll reduce the stigma surrounding suicide and mental health conditions," he said. "And it'll ultimately save lives."

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