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Policies can counter safety hazards from prescription misuse

Prescription drugs

Employers should take a proactive approach in mitigating safety hazards stemming from employees who abuse prescription drugs by implementing workplace policies that address drug misuse and outlining procedures for supervisors to follow if they’ve identified a worker who is potentially impaired.

The Itasca, Illinois-based National Safety Council developed these and other recommendations for employers following a study released last week that found 70% of workplaces have been impacted by employee misuse of prescription drugs. These impacts include absenteeism, lost productivity and, in some cases, overdoses and arrests, the survey found.

Workplace policies can help employers accommodate legitimate use of prescription medications to keep employees safe and navigate situations where prescription drug use may be crossing into addiction, said Tess Benham, senior program manager for prescription drug misuse at the National Safety Council. For example, employers might ask employees to disclose if they are using a prescription that has a warning label about possible impairment — not necessarily which drug in order to protect privacy — so they can create a plan around not operating vehicles or machinery while the prescription is in use.

In workers compensation cases, employers can work with claims managers to make sure prescriptions for painkillers aren’t being refilled too frequently or at high doses, or that employees aren’t on those prescriptions for extended periods of time, all of which can signal potential abuse, she said.

Employers should be concerned about prescription drug misuse because, along with decreased productivity, it can lead to workplace safety hazards, such as cognitive impairment and reduced response times, said Dr. Susan Murray, a professor of engineering management and chair of the psychological sciences department at Missouri University of Science and Technology in Rolla, Missouri.

From an ergonomics and workers comp standpoint, employees taking opioids and other potent medications may go back to work too quickly after an injury and re-injure themselves, possibly permanently, Dr. Murray said.

“Cognitive impairments and physical pain being masked by prescription drugs could make it more likely for employees to engage in riskier behaviors and overexert themselves,” Dr. Murray said. “They may end up going back on workers compensation, having done more severe damage than whatever was causing pain in the first place, and be out of work longer or suffer permanent damage.”

Many employers believe prescription drug abuse should be regarded similarly to heart disease, diabetes and other medical conditions with genetic or behavioral elements, said Ms. Benham of the National Safety Council. She said there is some evidence that employer interventions are often more effective at convincing people to seek help than interventions by family, friends and the criminal justice system. Intervention is critical not only for workplace safety but also because legitimate use of opioid painkillers can lead to misuse, addiction and eventually heroin use, Ms. Benham said.

Employers can encourage the use of medications other than opioids to address pain management for injured workers and ask their insurers to cover alternative therapies, such as physical therapy, cognitive behavioral therapy and massage. Training also is an underused tool that companies can implement to make employees aware of the risks and signs of prescription drug misuse, along with company policies that address it, Ms. Benham said.

The National Safety Council is also encouraging companies to re-examine their post-incident drug testing policies, which has been an area of some confusion following language discouraging blanket drug testing in the U.S. Occupational Safety and Health Administration’s recently implemented electronic recordkeeping rule.

“We recommend companies look at identifiable triggers for drug testing, such as operation of equipment, severity of injury or fatality,” Ms. Benham said. “Rather than saying every time something happens we’re going to test, identify the situations where testing makes the most sense and will give good information back to the employer as they investigate the incident.”

While most companies perform pre-employment drug screens, and many conduct post-incident and random drug tests, many do not screen for commonly misused synthetic opioid painkillers, the National Safety Council study found.

Tim Thoelecke Jr., president of Morton Grove, Illinois-based InOut Labs, which provides employee drug testing services nationwide, said the cost to test for such drugs isn’t prohibitive. He believes companies likely aren’t doing the expanded tests because they don’t know about them, they aren’t required to do them, or they are reluctant to deal with the complexities of positive test results that might occur with prescription medications.

“A lot of companies don’t like idea of telling employees we don’t trust you,” said Mr. Thoelecke, who noted companies increasingly don’t view misuse of prescription drugs as a zero-tolerance issue. “If they approach it as an employee health issue, that makes it a little bit easier.”




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