Opioid Addiction on the Job
Opioid abuse in the workplace exacts a considerable toll in the United States.
Missed time, impaired performance, injuries, and even death can result from substance use disorders. There’s no easy fix for the problem, but some changes in policies and outlooks can save both dollars and lives.
More Americans now die each year from accidental opioid overdoses than car crashes. In 2017, the National Safety Council (NSC) announced that the odds of a fatal overdose were one in 96, outpacing the one in 103 likelihood of dying in a motor vehicle accident. That same year, more than 72,000 people perished from drug abuse, and more than 47,000 died from opioid overdoses.
Over 2 million people in the United States have an addiction to opioids. Feeling the sting is the American workplace.
Opioids in the Workplace
The NSC reported that 70 percent of employers experienced some sort of negative effect from prescription drug abuse.
Forty-three percent of drug overdose deaths, according to the Bureau of Labor Statistics, happened in three industries:
- Transportation and warehousing
- Health care and social assistance
Industries with physically demanding work conditions or higher injury rates tend to be most affected by opioid abuse at work. Also, fields with high demands and job insecurity, such as mining or fishing, are at higher risk for their workers developing an addiction to opioids or pain relievers.
Risks of Opioids in the Workplace
It’s estimated that opioid abuse at work cost the U.S. economy $78 billion in 2013. Despite the toll, in 2016 approximately 80 percent of individuals who could have benefited from substance use disorder treatment did not receive any. That number improved slightly for 2017, when 28 percent received help.
Employed individuals with a substance use disorder (SUD) miss work an average of 14.8 days every year. Those with a pain medication use disorder miss 29 days annually. In comparison, the average employee misses 10.5 days, and workers in recovery from a SUD take off 9.5 days.
While some may balk at the idea of getting a worker into rehab, it actually has some positive side effects, almost working like preventive medicine. Opioid use at work costs companies money via absenteeism, injuries, accidents, and overdoses. There’s also the price of lowered morale that comes with working with opioid abusers.
Employers could save $2,600 per worker each year by getting them into treatment. A few policy changes could make a significant difference to help employees receive such assistance.
Cost of Addiction
The cost of addiction is high. While it may not always be appealing to treat the condition as a long-term chronic illness, that may be a better strategy for everyone. Playing the long game can improve outcomes for both employee and employer.
Instead of seeking a quick fix, sorting through behaviors that brought on or nurtured the substance abuse can help with recovery and prevent relapse. (In the case of relapse, it’s best not to view the recovery as a failure, but rather as a therapy that needs adjustment.)
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) for opioid use disorder has proven highly beneficial for many people. Typically MAT is paired with behavioral therapy or other forms of support, and it can reduce overdoses and relapses. Carefully administered, the treatments make quitting the addictive substance less painful.
Three successful options are:
- Methadone: Methadone works similarly to other opioids such as heroin, morphine, or fentanyl but acts more slowly, so the euphoric effect is muted and the symptoms of withdrawal are reduced.
- Buprenorphine: Buprenorphine is long-acting, so it keeps cravings in check. It can be paired with naloxone, a drug that reverses or stops the effects of opioids.
- Naltrexone: Naltrexone blocks the euphoria and sedative effects produced by heroin, morphine, and other opioids. It also helps with cravings for drugs.
In addition, having Narcan (naloxone) on hand is a good idea when there is an opioid-addicted individual (or one suspected of having a SUD) in the workplace. It can be given as a nasal spray or injected, and can quickly reverse an overdose.
The latest Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has a list of criteria to determine if a person has a SUD. Depending on how many items apply on the checklist, a person can have a mild, moderate, or severe disorder.
Signs of addiction include strong cravings, poor performance at work, excessive time spent using or obtaining the substance, tolerance to the drug, and withdrawal when attempting to quit or cut back. For a full list of criteria, visit the National Institute on Drug Abuse.
What Employers Need to Know
Companies can play a major part in cutting costs related to the use of opioids in the workplace or outside of work. Promoting the health and safety of workers, offering preventive health benefits, training managers in workplace policies, and creating a safer workplace while not stigmatizing addiction — these can all work to improve outcomes for individual employees and the company as a whole.
When employers initiate treatment, for example, it tends to have a better result than when sobriety is insisted upon by family and friends.
Companies that institute employee assistance programs (EAP) can provide much-needed support to SUD workers. EAPs typically help workers when they have personal problems (such as addiction or mental health issues) by offering assessments, counseling, referrals, and follow-ups. Written policies and educational materials also can prove helpful in such situations.
According to the NSC, workplaces may want to consider implementing drug-free workplace policies that include:
- Written plans
- Employee education
- Supervisor training
- EAPs (including having someone available to discuss insurance specifics with employees)
- Drug testing
The NSC says that 70 percent of U.S. companies and 90 percent of Fortune 500 companies already have EAPs in place.
A company culture that encourages employees to seek help can make it easier for addicted employees as well as for employees working with opioid abusers. Treating a worker for a substance use disorder is also more economical than replacing them and training someone new. The costs of addiction are high, but the savings of recovery can be even higher.
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- nsc.org – For the First Time, We’re More Likely to Die from Accidental Opioid Overdose Than Motor Vehicle Crash
- injuryfacts.nsc.org – Odds of Dying
- nsc.org – Opioids at Work: Employer Toolkit. Opioids and the Workplace
- cdc.gov – Opioids in the Workplace
- nsc.org – The Proactive Role Employers Can Take: Opioids in the Workplace
- drugabuse.gov – The Science of Drug Use and Addiction: The Basics
- samhsa.gov – Workplace Policies and Programs Concerning Alcohol and Drug Use
- cdc.gov – Workplace Solutions: Medication-Assisted Treatment for Opioid Use Disorder