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Workers on opioids, employers must navigate legal


NEW ORLEANS — An occupation medicine doctor told an audience of the workplace health and safety professionals at the Volunteer Protection Program Participants Association’s Safety +, Integrated Safety & Health Management Systems Symposium in New Orleans on Tuesday a story about a worker coming to him complaining of pain in her stomach.

Mysterious, indescribable pain, said Dr. Thomas Hysler, chief medical officer for the Houston Area Safety Council, as he relayed his story, and follows up with what he says is not unheard of in his line of work. She tells him, “I need an opioid.”

“Scary but we see it,” he said, just after showing a public service commercial from, which shows a worker in a jumpsuit and gear slamming his arm in a door — injuring himself to get opioids, he explained.

“This epidemic is not just on the streets, it’s in our workplaces,” he said.

The National Safety Council recently revealed a survey that showed that 70% of employers are affected by drug misuse, he said, urging health and safety professionals to understand that they may have workers on drugs and “not even know it.”

He cited statistics from the National Institute on Drug Abuse, which collects data on opioid deaths and provides information on the how and why of an epidemic that has taken the lives of 42,249 Americans: one-third of the U.S. population has taken opioids, usually prescribed after something minor like a tooth extraction, or back pain, for which opioids are no longer recommended, he added. Dr. Hysler showed the audience pie charts: how many are using opioids; who is now on heroin, as 80% of heroin users started with a legitimate prescription for the legal version of opioids.

“These are not little pieces,” Dr. Hysler said, referring to a set of pie charts. “It’s a lot of us.”

How can an employer know a worker is taking opioids? “Oftentimes you will not be aware,” he said. Drug tests are not as reliable as employer think, and doctors are not always required to inform a patient’s employer if he or she have been prescribed an opioid, he said. A medical review officer, who reviews a worker’s file after an injury, is supposed “to tell you if they are taking a medication that is a safety risk,” he said.

Employers are also legally allowed to ask all employees — as a companywide policy — to disclose medications they are taking, he said. He also recommends legal pre-employment medical examinations known as “fit for duty” tests to gauge whether a worker is in good health, or may have a drug problem, he said. 

On the legal front, an employer with an employee who is taking opioids does not have to accommodate the worker taking a drug that may cause impairment, under the federal Americans With Disabilities Act, unless the opioid is prescribed to treat an illness that is considered a permanent disability, such as multiple sclerosis or cerebral palsy, he said.

An employer who has an employee who admits to a drug problem can provide opportunity for that worker to take leave — either paid vacation time or unpaid leave — for treatment, but is not required to accommodate, or provide that worker a job that is not safety sensitive, he added.

Dr. Hysler urged employers to “treat every case differently” and to engage a worker with a substance abuse problem in the interactive process, a legal proceeding in which both the worker and the employer agree to a solution regarding work, leave, and medications, he said.






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