Opinion: When substance abuse impacts the workplace

Prescription drug abuse is a serious issue in the workers' comp arena. Dwight Robertson highlights how agents can help.



Prescription drug abuse has reached epidemic status. The Centers for Disease Control and Prevention (CDC) has reported that more people die from prescription painkillers than from heroin or cocaine1, and that one person is dying every 19 minutes2 in the United States due to this issue. Business owners and managers are rightfully concerned about the adverse effects these increases in substance abuse can have on workplace safety and employee job performance.

A recent study by EMPLOYERS® found that one in 10 small businesses had employees show up for work last year while under the influence of at least one controlled substance. While more than three-quarters of those surveyed agreed it is dangerous for their employees to be under the influence of prescription painkillers, marijuana, alcohol and illicit narcotics (such as heroin and cocaine) while at work, more than half felt that over-the-counter pain medications could also pose a danger to their employees.3

Why Prescription Drug Abuse is a Workers’ Compensation Concern

Research suggests that high doses of heavily addictive prescription drugs (known as Schedule II prescriptions) are often over-prescribed in cases when more mild medications would have sufficed for treatment.4 From public health and workplace safety perspectives, the abuse and over-use of prescription drugs is clearly an issue that must be addressed.

Opioid use is inherently tied to workers’ compensation insurance, since opioid drugs may be part of an appropriate treatment protocol for injuries sustained by workers on the job.  However, opioid drug abuse can prolong an injured worker’s ability to re-enter the workplace at full capacity. It also undermines the culture of the workplace and ultimately threatens the safety of all employees.

When Schedule II drugs are prescribed for minor injuries, the risks of a longer recovery time and a greater chance of addiction increase for the injured employee. Both of these factors negatively affect the employee’s opportunity for a fast and safe return to work.

How to Help Solve This Issue

As state governments across the country continue to debate issues around prescription drug abuse, one thing is abundantly clear; legislation alone cannot solve the problem of prescription drug abuse in the workplace.

At EMPLOYERS, we realized that the best way to address this growing problem is to involve everyone connected to it. That is why we have piloted a proactive program to help better control the flow of narcotics within the workers’ compensation system. This approach involves the workers’ compensation insurance carrier, injured employees, workers’ compensation physicians and pharmacy benefit managers. As part of our approach, we strive to provide education and shed light on issues that can negatively impact patient safety. This includes increasing awareness of safety issues such as when narcotics are used longer than periods of three to six months, when narcotics are used at daily dosing above 50 MEDs (Morphine Equivalent Dose), or when patients obtain drugs from multiple doctors and multiple pharmacies. When involved parties identify and address such potential issues early, outcomes can be improved.

Agents also play an important role. All agents should be encouraging their clients to implement employee drug testing as a normal course of business. Pre-employment and post-accident drug testing have proven to be effective deterrents to drug abuse in the workplace.

While the discussion around prescription drug abuse should continue, only by working together will business owners, employees, insurance carriers, and healthcare providers effectively address the issue of prescription drug abuse in the workplace.

1 CDC, “Policy Impact: Prescription Painkiller Overdoses” (July 2, 2013).
2 CDC, “CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic” (January 13, 2012).
3 EMPLOYERS, “1 in 10 Small Businesses Had Employees “Working Under the Influence” Last Year” (March 20, 2014).
4 California Workers’ Compensation Institute, “Prescribing Patterns of Schedule II Opioids in California Workers’ Compensation” (March 2011).
Dwight Robertson, MD is Medical Director for EMPLOYERS®, America’s small business insurance specialist®, which offers workers’ compensation insurance and services through Employers Insurance Company of Nevada, Employers Compensation Insurance Company, Employers Preferred Insurance Company and Employers Assurance Company. Insurance is not offered in all jurisdictions. For more information, please visit www.employers.com.
Copyright 2014.  EMPLOYERS.  All rights reserved.

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