If you take OxyContin or Vicodin, make no mistake, you’re taking an opioid drug that has more in common with heroin than mild painkillers like Tylenol. Prescription opioids are causing huge problems all across the country, leading to widespread addiction and shocking numbers of deaths from overdoses. Understanding the epidemic of prescription drug abuse and how it got started gives you a broader perspective on the root of the problem, but the impact it’s having on the workforce often escapes notice. Not only does the high rate of opioid use in the workforce increase the risk of addiction and overdose, it can also create liability risks for employers and lead to reductions in efficiency and productivity.
The Prescription Drug Abuse Epidemic and Opioids
The most recent data for drug overdose deaths comes from 2011 and illustrates the problem with prescription medicines – in particular, opioid drugs – very clearly. There were 41,340 deaths from drug overdose in the U.S. in 2011, and almost 55 percent involved pharmaceutical drugs. Opioid painkillers like oxycodone (OxyContin), hydrocodone (Vicodin) and methadone (Dolophine) were responsible for almost 17,000 deaths, or roughly three-quarters of the pharmaceutical-related deaths. Painkiller addiction has been called an “equal opportunity destroyer,” affecting people from all walks of life. In fact, most people who are addicted to them didn’t have a drug problem until they began using prescription opioids. People often get started for medical reasons, but the addictive nature of the drug lures them into taking more and more, creating a long-term addiction. As tolerance builds and individuals take bigger doses, the risk of overdose skyrockets.
Big Pharma’s Marketing Shift
Ted Shults, founder of the American Association of Medical Review Officers and a toxicologist, argues that the epidemic of prescription painkiller abuse stems from a marketing shift by pharmaceutical companies. According to Shults, in the ’90s, “They started to push the idea that pain is one of five vital signs, and it would be unethical not to treat it. That’s more marketing than science.”
The idea was pitched to workers’ compensation programs as a way to reduce the costs of treatment by helping injured workers get back on the job more quickly, as well as by reducing spending on physical therapy. However, the widespread acceptance of this idea has proven the assumption to be incorrect, with a 2013 report showing that opioid painkillers are the most expensive class of therapy for workplace injuries, accounting for almost a third of overall pharmacy costs.
The city of Chicago in 2014 sued five pharmaceutical companies, arguing that they deliberately misled the public and the medical community about the safety of opioid painkillers. The city’s lawyers say the companies overstated the drugs’ benefits and downplayed or even dismissed the risks of long-term use, like addiction, overdose and death. Two similar lawsuits have been filed by California counties.
Effects of Prescription Drug Abuse on the Workplace
According to research from the Workers Compensation Research Institute, 55 percent to 85 percent of injured workers in the U.S. received opioid painkillers between 2008 and 2010. However, according to medical guidelines, these medicines should be offered only when other approaches have failed or when the pain is severe. Moreover, despite the requirement that people taking these addictive painkillers receive psychological evaluations, fewer than 5 percent of patients do. With narcotic painkillers apparently being the primary method of treatment for those with work-related injuries, yet almost nobody checking whether addiction is a serious concern (or a developing problem) for them, it’s hardly surprising that workplaces and the country as a whole have an issue with painkiller addiction.
For workplaces, having employees on psychoactive substances creates obvious risks of accidents, further problems with health and wellness, and a less productive and efficient workforce overall. Michael Clarkson, chairman of the drug testing practice group at the law firm Ogletree Deakins, said, “Employers should be proactive if there’s a problem. You don’t want to wait until some guy’s hand gets mangled in a machine or somebody overdoses.”
What Can We Do About Prescription Drug Abuse?
In both wider society and the workplace, many steps can be taken to reduce the numbers of people becoming addicted to and overdosing on prescription medicines. One of the most widely implemented approaches countrywide is the use of prescription drug monitoring programs, which keep track of prescriptions of problematic drugs in a central database to prevent people from “doctor shopping.” Additionally, ensuring doctors are educated about the risks of addiction is crucial to minimizing the numbers of prescriptions.
For workplaces, encouraging adherence to clinical guidelines for dealing with chronic pain is the first (and possibly the most important) step. This would ensure that opioids aren’t used as a first-line treatment, and would also increase the number of individuals who receive psychological evaluations while taking them. Drug testing policies can also have a positive impact, but this is ultimately limited by the competence of the medical review officer who administers the tests. Employee assistance programs are another preferred approach, because these offer anonymous support and advice on drug-related problems. Most employers are very understanding when it comes to addiction, ordinarily wanting to help employees who contact such programs get better.
The problem isn’t one that’s going to disappear overnight, and in both workplaces and wider society, further education on the risks of opioid painkillers is essential. It might not be the easiest task, but with continued effort, encouragement to attend counseling or rehab centers and increased understanding of the issue, we can end the prescription drug epidemic.