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The Centers for Disease Control and Prevention (CDC) reports that deaths from opioid overdoses have quadrupled since 1999. Are your workers using—or abusing—prescription painkillers? What can you do about it?
Abuse Is Not the Only Problem
Opioid painkiller abuse creates many of the same hazards in the workplace as illegal drug abuse. Even if they’re not abusing these drugs, workers who are under their influence may be:
- Drowsy or sedated
- Confused
- Excessively energetic
- Subject to excessive mood swings
These altered mental states can impair a worker’s attention and judgment.
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What Employers Can Do
One problem employers encounter is that preemployment and employment testing programs, including those required by the U.S. Department of Transportation (DOT), do not test for legal drug use, only for a panel of illegal drugs. Even when a drug test shows evidence of legal drug use, many testing agencies don’t report those results to the employer.
What’s more, when it comes to identifying prescription drug abuse, employers come up against a tangle of laws, including the DOT regulations and the Federal Motor Carrier Safety Administration’s rules, the Drug-Free Workplace Act, the Americans with Disabilities Act, the Age Discrimination in Employment Act, the Family and Medical Leave Act, and the Fair Credit Reporting Act, as well as state laws.
Two strategies can help you to identify problematic cases of legal drug use and address them. (Be sure to coordinate your drug-free workplace safety efforts with your human resources and legal departments to ensure compliance with all applicable state and federal laws.)
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Expanding workplace drug testing programs. Although under most circumstances employers are on shaky legal ground when they test for legal/prescription drug use, employers may be able to justify testing workers for an expanded panel of drugs in some situations:
- Workers in “safety-sensitive” jobs. For workers with safety-sensitive jobs, in which even a moment’s inattention can be disastrous, employers may be able to add opioids and other prescription drugs of abuse (typically stimulants and tranquilizers) to the DOT panel. Some employers whose workers hold safety-sensitive jobs also require workers to self-report all prescription medications they use.
- Postaccident situations. After an accident, you may have more leeway in drug testing than in other situations.
Using screeners. The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services, recommends that employers use “screeners”—short questionnaires of fewer than 20 questions that can help detect signs of prescription drug misuse or abuse in workers who don’t appear to have any problems, enabling early intervention. Screeners work by:
- Identifying individuals who are at high risk for prescription drug abuse; and
- Determining whether an individual shows key indicators of prescription drug abuse.
Existing screeners were primarily developed for medical professionals to administer. Employers are legally safest using screeners for employees in safety-sensitive jobs, but SAMHSA suggests that these screeners could be adapted for self-administration by employees or used as part of your wellness, health education, or prescription drug abuse prevention program.
SAMHSA has published a list of available screeners.