I’ve been at the Louisiana Association of Self-Insured Employers (LASIE) conference this week and one of the hot topics is drug use. It is a topic you hear about a lot in workplace health and safety, but opioid use and abuse is especially important in Louisiana, which leads the nation in the number of pills prescribed per patient.
Nationally, more and more workers are testing positive for drugs and alcohol, according to the testing company Quest. It says about four percent of the U.S. workforce tested positive, the highest level in 10 years. Given the number of states legalizing pot and the shift in public opinion on its use, it is no surprise that a big part of the increase in positive tests is from marijuana.
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But it is the opiate use that is sparking so much interest. the National Safety Council has called overdoses a national epidemic. In Northern Kentucky, for example, emergency medical personnel run on an average of seven drug-related calls a day. According to officials, “One person in Northern Kentucky died from a drug overdose every 40 hours last year — nearly five times the number of people killed in car crashes.”
What should employers do? The answers aren’t clear. Drug testing is important, but there are limits on what tests alone can accomplish. Don’t forget that we are already testing millions of employees, but drug use appears to be on the rise and drugs like heroin are threatening whole regions of the country. The other factor is that the motivation for an employee taking recreational drugs and those addicted to opioids because of chronic pain are two very different things. That impacts the drug testing program.
Beyond the reasons why an employee may use the drug, discovery of its use may also be different. Heroin often takes no more than 2 days to leave the system. Oxycodone and hydrocodone don’t show up in commonly used five-panel tests, which the standard DOT-required test (at least for now). According to a very good article from the Society for Human Resources Management, the bigger problem may be that the the employee is likely to have a valid prescription for painkillers. That means the employer may never even be informed of the use, unless the Medical Review Officer determines that the use doesn’t match the prescription.
Testing is still a necessary part of an employer’s program, but it needs to be just one part of a multi-pronged approach that both ensures that no one is impaired while working a safety-critical job and removes the stigma that often keeps employees from seeking treatment.
A good starting place for companies is the National Safety Council’s report, The proactive role employers can take: opioids in the workplace. It lists five steps employers should take:
- A clear, written policy
- Employee education
- Supervisor training
- An employee assistance program
- Drug testing
One important point that comes from the report is the potential for pain management programs to actually increase chronic pain. The best time to address the problem appears to be at the point of injury when more options may be available.