What to do About Suspected Painkiller Addiction

Question: I recently read that prescription painkiller overdoses have reached epidemic proportions and that abuse is rampant throughout North America. I am concerned about the possibility that some of my workers may be working while under the influence of opioid drugs (narcotics), either for pain or for non-medical reasons. What should I do?

Answer: Opioid painkillers are medications for treating pain that can be very addicting. Most people who are prescribed these medications do not develop a problem. Some, however, can become addicted even when these drugs are taken for a legitimate pain problem.

Prescription painkiller abuse costs employers almost $42 billion annually because employees are less productive while at work or are not at work at all. Employees who abuse drugs are two to five times more likely to take unexcused absences, be late for work, quit or be fired within one year of employment, be involved in workplace incidents, and file workers’ compensation claims.

Many people who have become addicted to opioids did not feel high when they took them, but did feel that they:

Had more energy.
Were more confident.
Were smarter.
Were more relaxed.
Were less depressed.

The effects of opioid medications can create serious risks at work. Your employees need to be clear on your workplace’s policy regarding potential impairment from opioid prescription medications.

Opioids can negatively affect a person’s ability to drive or operate heavy equipment. These drugs can also alter a person’s judgment, create tremors, reduce muscle strength, impair coordination and cause confusion. Employers can and should:

Educate employees about the health and productivity issues related to prescription drug abuse. Warning signs of abuse include thinking about taking more medication than is being currently prescribed; continuing to use opioids even when pain is no longer present; or trying to access more painkiller medication from another source beside one’s physician.
Incorporate information about substance abuse in workplace wellness programs or strategies.
Offer health benefits that provide coverage for substance abuse disorders.
If you have a drug-testing policy in place, consider expanding it to include prescription drugs.
Publicize drug-free workplace policies and incorporate guidelines regarding prescription drugs. Research has shown that for types of pain related to common workplace injuries, including soft-tissue injuries and musculoskeletal problems, opioids are no more effective than non-opioid alternatives such as Tylenol, Advil or generic ibuprofen. Although opioids are widely prescribed for back injuries and chronic back pain, they should not be the first line of treatment. Non-steroidal anti-inflammatory drugs offer a more affordable and safer alternative to opioids.
Provide employee assistance programs (EAPs), wellness and work-life programs that include information and services related to substance abuse prevention, treatment and return-to-work issues.
Provide training to managers so that they can recognize and respond to substance abuse issues so problems can be addressed in uniform, cost-effective and business-sensitive ways.

(The source of information in this column was the National Safety Council’s report entitled The Proactive Role Employers Can Take: Opioids in the Workplace.)