The Opioid Epidemic: It’s Everywhere
If you follow the news, you already know that opioid disorders and overdoses are a growing problem in the United States. Even if your company has not had to deal directly with an employee who has an opioid disorder, there is good chance your business is still being impacted.
According to the New York Times, workplace insurers spend approximately $1.4 billion annually on opioid medications (Meier, 2012). Additionally, opioids feature prominently in workers’ compensation claims, particularly given the high prevalence of musculoskeletal injuries in the workplace. So, it is likely that someone on your workforce, or someone on a jobsite working alongside your employees, is taking opioids. With as many as one in four people who take opioids developing an opioid disorder, this phenomenon is bound to impact your company.
Where Does the Problem Stem From?
According to the CDC, more people died from drug overdoses in 2014 than in any previous year on record. The majority of these drug overdose deaths (more than six out of ten) involved an opioid (including prescription opioid pain relievers and heroin). Since 1999, the rate of overdose deaths involving opioids has nearly quadrupled. From 2000 to 2014 nearly half a million people died from drug overdoses. Sources report that between 78 and 94 Americans die every day from an opioid overdose.
Increased availability, over-prescription, and intentional overuse of prescription opioid pain relievers are driving factors in the 15-year increase in opioid overdose deaths. Between 1999 and 2013, the amount of prescription opioids sold in the U.S. nearly tripled. As the amount of opioids prescribed increased, so too did the number of people using heroin—an illicit opioid that works similarly in the brain to prescription opioids. In fact, heroin use has increased sharply across the U.S. among men and women, most age groups, and all income levels. Recent deaths from heroin use are also tied to two other drugs that are mixed with heroin to produce a stronger “high.” Fentanyl is a drug that is 15-20 times stronger than heroin, and Carfentanil—marketed primarily as a tranquilizer for elephants and other large animals—is in turn 100 times stronger than Fentanyl.
We now know that 75% to 80% of people using heroin in the U.S. misused prescription opioids prior to using heroin. Some of the greatest increases in heroin use have occurred in demographic groups with historically low rates of use: women, the privately insured, and people with higher incomes. This has led to an increase in heroin-related overdose deaths. Between 2002 and 2014, the rate of heroin-related overdose deaths more than quadrupled, and more than 10,500 people died of heroin-related overdoses in 2014.
Anyone who takes prescription opioids is at risk of developing an opioid use disorder. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid misuse. In 2015, more than 2 million Americans had an opioid use disorder involving prescription opioids or heroin.
The risk for overdose is very real for individuals using prescription opioids or heroin. Taking prescription opioids in a manner inconsistent with a doctor’s instructions, or using heroin, can cause the user to stop breathing—leading to death.
What Can Employers Do?
The human and monetary costs associated with opioid use by employees are clear but can be potentially offset by implementation of substance abuse programs for employees, including education, employee assistance program (EAP) services, as well as access to confidential treatment. The National Safety Council (2014) recommends that companies consider taking the following actions:
- Revisit drug-testing policies and the scope of testing to detect prescription medications;
- Manager training should include examples of typical behavioral and performance-related signs of opioid impairment. Instruct managers to focus employee communication on the shared goal of ensuring that work can be done safely and effectively at all times.
- Educate employees on the risk of opioid use. Employers can help mitigate stigma associated with substance use disorders by educating employees about the biological nature of addictions. Substance use disorders are brain-based illnesses; they are not the consequence of failed willpower or character weakness.
- Encourage employees to seek help for dependency and addiction.
- Encourage your health plan to exploit opportunities for intervention through Prescription Benefit Managers (PBMs).
- Share information on available EAP services with your employees. Such information should clearly state who an employee can talk to, and how they may communicate with that resource and where. Employees also need to be provided with details about their benefit plan coverage and aftercare.
- Create a tolerant, understanding work environment to help increase the likelihood that employees will feel comfortable seeking assistance.
Contractors should consult legal counsel knowledgeable in labor and employment law when reviewing their internal policies and procedures.
Look for a session on substance abuse intervention at the upcoming Partners in Progress Conference, February 13 & 14, 2018 in Orlando, Florida.