The Dangers of Opioid Use Disorder in the Workplace
Opioid use disorder (OUD), also known as opioid abuse, opioid dependence, or opioid addiction, is a pattern of problematic opioid consumption which often results in significant impairment or distress.1 Opioids target the brain’s reward center with feel-good neurotransmitters, which creates a temporary sense of contentment.2 The use of opioids often leads to fatal consequences, as individuals can develop dependence within mere weeks.1
Drivers of Opioid Use Disorder
At various times, studies have shown that approximately 21-29 percent of patients prescribed opioids for chronic pain ultimately misuse them,3 and 65 to 85 percent of workers may be prescribed narcotic painkillers (opioids) for pain relief.4
From 2010 to 2017, the rate of illicit opioid deaths increased 364 percent.5 Two illicit opioids are heroin and fentanyl. Both drugs bind to opioid receptors in the brain to reduce pain sensations and increase pleasure and relaxation. They are extremely potent, fast-acting, and can be lethal in a single dose.6 Heroin is a Schedule 1 drug with no accepted medical use and a high potential for abuse. Fentanyl is a Schedule II drug, which also is considered dangerous with a high potential for abuse; use of fentanyl can lead to severe psychological or physical dependence.7
How OUD Affects Employees
The National Safety Council reports that approximately two-thirds of people affected by OUD are contributing members of the workforce.8 Although it can be difficult to detect employees who are struggling with OUD, some of the most commonly observed signs of opioid abuse include:
- Weight loss
- Frequent flu-like symptoms
- Isolation from work friends
These effects have been linked to impaired thinking and reaction time.4 Not only does this put employees at greater risk for accidents and injuries, but it can also compromise their performance of safety-sensitive job functions. A recent study by the Massachusetts Department of Public Health found that professions with physically demanding working conditions and high injury rates are more at risk for opioid-related overdose deaths.9 Employees in industries such as construction, transportation, and material moving occupations have been hit particularly hard by the opioid epidemic.10 Employers have been significantly impacted by this as well.
Employer-facing Impacts of OUD
One of the biggest setbacks employers face from OUD is diminished productivity levels. This typically appears in the form of heightened absenteeism, excessive missed workdays, and high turnover rates.11 Beyond decreased productivity, OUD can result in several other significant financial burdens. According to a recent study from Johns Hopkins University, employees with as little as one opioid prescription had an average total workers’ compensation claim cost more than three times that of similar claimants who did not receive opioids.12 Altogether, employers expend about $25.6 billion yearly due to the implications of the historic opioid epidemic.13
Eliminating OUD in the Workplace
Employers can play an important role in preventing OUD in the workplace by choosing an occupational health provider with safe prescription practices. Partnering with a provider that uses evidence-based prescription and alternative treatment techniques can help reduce the need for prescribing opioids. This is evident in Concentra’s FReSH approach to injury care, which helped decrease the percent of closed cases with opioid prescriptions by over 60 percent in just two years.14 Further research has found that alternative treatment approaches have impacted occupational health at a national level as well. A recent study from the Workers Compensation Research Institute reported that all 27 study states saw a decrease in opioid dispensing among injured employees.15
Treatment options are available to help reduce OUD in the workplace, sometimes through employee assistance programs (EAP). In fact, research shows treatment is more effective when initiated by employers rather than friends and family.10 Other modern treatment methods include medication-assisted treatment (MAT) and the administration of naloxone, a reversal agent for opioid overdose. Treatment initiatives such as these have helped to reduce the fatal effects of the opioid epidemic across the country, which reportedly fell by 9.6 percent from January 2017 to May 2019.6 By working with a qualified occupational health provider, such as Concentra, employers can make an important impact in reducing workplace OUD.
- Opioid Use Disorder. (2018, November). Retrieved from psychiatry.org: https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder
- How Opioid Addiction Occurs, Mayo Clinic, February 16, 2018. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
- Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569-576. doi: 10.1097/01.j.pain.0000460357. 01998.f1.
- 2016 WCRI Annual Report + Research Review, Workers Compensation Research Institute, 2016. http://www.wcrinet.org/images/uploads/files/2016_WCRI_ANNUAL_REPORT_-_FINAL_03_23_17.pdf
- Economic Report of the President, The White House, February 2020. https://www.whitehouse.gov/wp-content/uploads/2020/02/2020-Economic-Report-of-the-President-WHCEA.pdf
- Marisa Crane, B. (2019, November). Fentanyl vs. Heroin: The Similarities and Differences Between Two Powerful Opioids. Retrieved from American Addiction Centers: https://americanaddictioncenters.org/fentanyl-treatment/similarities
- Drug Scheduling, United States Drug Enforcement Administration, https://www.dea.gov/drug-scheduling
- Opioids and the Workplace, National Safety Council, 2019. https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/RxKit/2019/Opioids-in-the-Workplace.pdf?ver=2019-03-27-161805-350
- Opioid-related Overdose Deaths in Massachusetts by Industry and Occupation, 2011-2015, Massachusetts Department of Public Health, August 2018. https://www.mass.gov/files/documents/2018/08/15/opioid-industry-occupation.pdf
- Opioids at Work Employer Toolkit, National Safety Council, 2019. nsc.org/opioidsatwork
- Implications of Drug and Alcohol Use for Employers, National Safety Council. https://www.nsc.org/work-safety/safety-topics/drugs-at-work/substances
- Wang D, Hashimoto D, Mueller K. (2012) Longer Term Use of Opioids. Cambridge: Workers Compensation Research Institute.
- Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States, The American Academy of Pain Medicine, 2017.https://www.asam.org/docs/advocacy/societal-costs-of-prescription-opioid-abuse-dependence-and-misuse-in-the-united-states.pdf
- FReSH: A New Alternative to the Pain Scale, Concentra, 2020
- Thumula, V. (2020, March 5). Opioid Dispensing Trends & Alternatives for Pain Management. Retrieved from Workers Compensation Research Institute