OSHA Urges Employers to Prepare for Opioid Overdoses at Work

The Occupational Safety and Health Administration (OSHA) is urging employers to prepare their workplaces for potential opioid overdoses, including by keeping medications such as naloxone readily available and training employees to recognize and respond to an overdose.

On Sept. 24, the Department of Labor (DOL) released new OSHA guidance aimed at helping employers and workers respond quickly to opioid-related emergencies. The fact sheet, Opioid Overdose Rescue with Reversal Medications, recommends treating overdose medications much like other workplace emergency equipment, with supplies stored in visible and easily accessible locations.

The guidance does not create new OSHA compliance requirements. Instead, it offers employers a framework for preparing for an emergency that the agency says can occur in any workplace.

“Opioid overdose in the workplace can be a serious health and safety issue,” OSHA says in the fact sheet, adding that managers, supervisors and employees should know how to respond.

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What OSHA Recommends

Central to OSHA’s guidance are opioid overdose reversal medications, or OORMs. The two FDA-approved medications are naloxone and nalmefene, which work by blocking opioid effects and allowing normal breathing to resume. Some naloxone nasal sprays are available without a prescription, while other naloxone and nalmefene products require one.

Employers can obtain naloxone through pharmacies, wholesalers, manufacturer programs and, in some cases, state or local health departments that distribute it at low or no cost.

Once acquired, OSHA recommends storing the medication according to its labeling, monitoring expiration dates, and assigning someone, such as a safety officer, to manage supplies. Kits should be placed in easily accessible locations near first-aid kits or automated external defibrillators, and larger workplaces may want supplies in multiple locations.

OSHA also recommends that employers consider voluntary employee training. Workers can be taught to recognize overdose warning signs, including slowed or stopped breathing, blue lips, pinpoint pupils, unresponsiveness, and gurgling or snoring sounds. Training can also cover administering reversal medications, placing an individual in the recovery position, and understanding applicable state Good Samaritan laws.

Administration of naloxone or nalmefene is not a substitute for emergency medical treatment, OSHA emphasized. Their effects can be temporary, meaning an additional dose may be necessary, and employers should instruct workers to call 911 even if the individual regains consciousness.

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Opioids Remain a Workplace Issue

The guidance builds on years of federal efforts to address the opioid crisis in the workplace. In 2018, the National Institute for Occupational Safety and Health (NIOSH) published guidance to help employers determine whether to establish workplace naloxone programs.

More recent NIOSH data underscores why employers remain part of the response. Workplace deaths from unintentional drug overdoses increased nearly 500% between 2012 and 2020, and certain industries — particularly those involving physically demanding or hazardous work — have experienced higher rates of substance-use disorders and overdose deaths. 

The new OSHA guidance is part of the Trump administration’s Great American Recovery Initiative, a government-wide effort focused on addiction treatment and recovery. For employers, the fact sheet adds overdose preparedness to the broader workplace emergency-planning conversation while emphasizing that reversal medication, training, and rapid access to professional medical care can work together when an emergency occurs.