Illegal drugs are not the only substance abuse employers must guard against. The misuse and abuse of prescription drugs are on the rise and also contribute to workplace accidents and lost productivity.

And the misuse and abuse of legally prescribed drugs has increased during recent years, according to speakers at an annual Disability Management Employer Coalition conference held recently in San Diego.

Greater misuse of prescribed drugs by employees has increased because medicine has improved, said Marcia Scott, a physician, instructor at Harvard Medical School, and a consultant to the Boston Police Department. Improved medicine means more employees are working today with chronic illnesses that once forced people out of the workplace.

The increased use of medicines to treat chronic illness and any accompanying symptoms and discomfort also means there is greater opportunity for misusing or abusing legally prescribed drugs, Ms. Scott added.

There is also a greater sense today that people shouldn’t have to feel bad because of their physical or mental health conditions while there is an increased belief that drugs can easily alleviate problems without consumers having to make any lifestyle changes.

Misdiagnosis by doctors and a failure to follow-up and monitor how patients are using prescriptions is also a contributing factor, Ms. Scott said.

So it’s not just the stereotypical ‘druggie” that employers need to concern themselves with, but also long-term employees that may eventually develop a health condition requiring prescription treatments, Ms. Scott said.

A White House study released in July provided insight into the growing problem of prescription drug abuse, added Ronn Johnson, a medical doctor and associate professor at the University of San Diego’s School of Leadership and Educational Sciences.

The study found hospital emergency room visits due to the misuse of prescription pain killers increased 400% between 1998 and 2008, Mr. Johnson told DMEC.

A news story on the White House report is available here.

So employers have to help manage the problem, Ms. Scott advised.

Employers can do that by using their “benefit structure,” Ms. Scott said.

Case managers reviewing claims can call doctors who are treating employees if the doctors do not appear to be following established prescription treatment guidelines. A pharmacy benefit manager can also include protocols in their programs to flags potential problems and then place a call to the doctor.

Doctors will likely respond and change the treatment pattern, but supervisors must be trained to act early when they notice things such as unusual employee behavioral changes or an uncommon increase in absences, Ms. Scott advised.

But steps must be taken early.

“Down the road when things have fallen apart is too late,” Ms. Scott said.

Post injury drug tests showing the use of prescription drugs also provide an opportunity for employers to act, Ms. Scott said.