When an employee injures themselves at work, a whole new danger begins for them; the potential for addiction. It is no secret that the United States is going through an opioid crisis. According to the Centers for Disease Control and Prevention, from 1999-2017, almost 400,000 people died from an overdose involving any opioid, and that includes prescription medication.
What many people may not realize is that a portion of that crisis has been started due to workplace injuries. Obviously, the best way to keep your workers safe is to prevent workplace injuries from happening, but when they do, there are steps you can take to help prevent injuries from morphing into drug addiction.
According to the National Safety Council (NSC), more than 25 percent of workers' compensation prescription drug claim costs were for opioid pain medications, which can lead to drug addiction, overdose and death. Courts have consistently ruled these instances of addiction and death are also compensable under the employers' compensation program.
Some of the factors that increase the risk of an opioid overdose for injured workers are:
Taking high doses of opioid pain medications or for an extended period of time.
Taking multiple forms of opioids or mixing them with other drugs.
Suffering from sleep apnea, obesity, chronic obstructive pulmonary disease (COPD) or respiratory conditions.
To help ensure that injured workers don't end up getting sucked into an addiction that can threaten their lives, follow these six steps for workplace injuries:
1. Use opioid prescribing guidelines.
Companies can require their workers' compensation and network providers to use the opioid prescribing guidelines of the American College of Occupational and Environmental Medicine (ACOEM). These guidelines make opioid prescribing safer and more responsible by establishing thresholds and precautions to take when doses exceed the threshold amounts.
Companies can also use a Pharmacy Benefit Manager (PBM) to help identify dangerous drug combinations and suspicious prescribing patterns. State prescription drug monitoring programs can also help healthcare providers be fully informed about all drugs that are prescribed to an individual by other medical providers.
2. Require prior approval for the use of methadone to treat chronic pain.
Methadone is a powerful pain reliever and has been linked to as many as a third of opioid related fatalities, the SNC says. That is why the organization recommends against prescribing the drug for any kind of pain that is not cancer related or that does not involve end-of-life care. If it is prescribed, it should have to be approved first.
3. Screen injured workers for depression, mental health conditions and current or prior substance use.
As part of the ACOEM guidelines, workers who need to undergo treatment for injuries should be screened for depression and prior substance abuse at the initiation of new workers' compensation claims. Because depression is often treated with benzodiazepines (powerful stimulants), if people are taking these drugs to help them with depression, they might inadvertently overdose if they are also prescribed opioids (powerful depressants).
Furthermore, people who are living with depression, other mental health issues or prior drug abuse history may also be more susceptible to addiction. If any of these conditions are found, non-opioid pain management alternatives should be considered and the workplace injury should be co-treated with the existing condition rather than treated separately.
4. Know and identify the signs of drug abuse.
Drug abuse itself is often done in private, but the signs are public. If you know what to look for, you can help spot it in your employees. Inform yourself about what to look for and keep an especially close eye on anyone who has recently come back from an injury. Since many overdoses will happen during the injury time away from work, you may also want to stop in and visit injured employees at home.
5. Revisit your drug testing policy and make sure safety sensitive positions are being screened regularly.
Drug testing can be done before you hire, but for positions that pose any kind of risk, it should also be done randomly so any employee in these positions is tested at least once per year. And, if any safety incidents occur, you should test immediately afterward.
6. Educate all workers about the hazards associated with prescription pain medication use.
Key educational messages to all workers -- especially injured ones -- should include:
Risks of opioid pain medication use, especially for workers with sleep apnea, COPD or other respiratory problems.
Hazards with using multiple forms of opioid pain medications together.
Dangers of using other drugs with opioid pain medications.
Potential for addiction and drug overdose.
Caring for employees goes beyond the workplace, especially when it comes to injuries. If you were not able to prevent someone from getting hurt, you can still prevent them from becoming a victim of opioid painkillers.