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Prescription opioid abuse is a public health epidemic in the United States. Since 1990, drug overdose death rates have tripled due to extended abuse of prescription medications, according to the Center for Disease Control and Prevention (CDC).

The CDC defines prescription opioids as medications typically used to treat moderate-to-severe pain. They are often prescribed following surgery or injury, or for health conditions such as cancer. When used according to prescription, prescription opioids are meant to reduce the intensity of pain signals by attaching to opioid receptors in the brain, spinal cord and other organs. The National Institute on Drug Abuse states the effects of opioid use include drowsiness, mental confusion, nausea, constipation and, in some cases, reduced respiration.

Common prescription opioids include hydrocodone, oxycodone, morphine and codeine. Common proprietary names for these opioids include Vicodin, OxyContin, Percocet and Kadian. Use of opioids can cause dependence or addiction, such as a physical dependence that occurs when there are normal adaptations to chronic exposure of the drug. However, addiction, which includes dependence, is distinguished by compulsive drug seeking—even when the person knows the consequences. Opioid abuse is associated with patients experiencing chronic pain with injuries often impacting three or more areas of the body.

Is the construction industry at risk?

Workers in the construction industry are especially at risk, so there is a strong need to perform drug screening for opioids in the workplace to monitor appropriate opioid usage. The Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates more than $100 billion in workplace losses can be attributed to accidents, lost productivity and other problems related to alcohol and drug abuse. In addition, a Department of Labor report found employers lose approximately 79 percent of all negligent hiring suits, so it’s important to be prepared and drug screen all clients.

An estimated 15 percent of construction workers across various specializations have engaged in illicit drug use, including illegal and legal prescription drugs, according to a presentation by Dr. Peter Greaney, CEO and medical director of WorkCare, Inc. Therefore, understanding the risks associated with opioid abuse is critical for any business owner in the construction field.

What can an employer do?

Although there is no way to completely eliminate the risk of opioid abuse in the workplace, there are proven measures that an employer can take to help reduce the risk. Those measures can involve, but are not limited to, the following.

  • Educate employees about responsible prescription opioid use. When used responsibly, opioids can be an effective tool to mask acute pain. It’s also important to educate workers about the potency of these drugs, how they work, how they interact with other drugs and how they can become addictive.
  • Understand risk factors of opioid abuse. Understanding and communicating the risk factors for opioid abuse is vital for prevention in the construction industry. Employees should learn about doctor shopping, physician dispensing and other risk factors supported by evidence.
  • Provide support and safe return to work to injured employees. If a worker is injured, it is important to provide strong social support from fellow workers, especially the immediate supervisor and management, to help the worker safely return to work. The most important person in returning an employee back to work is the immediate supervisor. A strong social support system can help the worker and prevent any further injury to themselves or others. Research indicates strong social networks are positively beneficial to combat alcohol and drug problems. When implemented, a program of key steps can result in fewer lost days and decreased wage loss for employees. It also will redirect the focus from the injured worker's disability to promoting work ability, leading to greater employee morale.
  • Communicate treatment options. If treatment is necessary, it is important to educate the worker on options, including counseling and pharmaceutical treatment. Drug addiction is a brain disease that can be treated effectively. Treatment options include behavior modification and/or pharmacological interventions. Behavioral treatments help the addict deal with cravings, avoid situations where drugs are present and strengthen social support. Pharmacological interventions include the use of addiction medications. Research indicates a combined approach may be best.
  • Ask the right questions. Lastly, it’s important to ask yourself and your physician questions. The American College of Occupational and Environmental Medicine (ACOEM) suggests a number of guidelines.
It’s important for business owners to educate themselves and their employees on drug screening and related policies. Consult with an insurance provider on workers’ compensation policies, such as what programs the carrier may have in place to combat opioid abuse, to better understand risks and coverage options available. It is also important to be prepared to support an employee in their efforts to return to work in a healthy and safe manner. By implementing these strategies, a business is one step closer to managing its risk.

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