Drugs in Your Workplace – Time to Rethink?

Like many of you, I travel the interstate to get to work every day and it seems that the traffic isn’t getting any lighter. Every time I look ahead and see a long line of brake lights ahead of me, my immediate response is to look in my rear view mirror. If I see a large semi or dump truck bearing down on me at 70mph, I start to wonder; is this the guy I saw in the clinic last week with the drug problem? Is he awake and alert, or am I about to become the next highway statistic?

No joke. My associates and I see workers every day in our clinics that are hooked on drugs. Not the drugs you would expect however—I’m referring to prescription drugs. This is a growing epidemic and a serious public health concern. It is also a very serious concern for the small business owner as well.

For years now we have all been made aware of drugs in our society and the devastating effects they have on individuals and workplaces. The drugs we associated with this were the illegal ones—marijuana, cocaine, and methamphetamine to name a few. However, according to SAMHSA, the Substance Abuse and Mental Health Services Administration, drug abuse has a changing face. Their 2007 Survey on Drug Use and Health revealed significant declines in the use of illegal substances. The abuse of prescription drugs, especially opioid pain relievers like hydrocodone, oxycodone, and methadone is skyrocketing.

Prescription drugs are now the second most abused class of drugs, second only to marijuana. However, if you look at those who are currently initiating abuse, prescription drugs are now number one. And it isn’t just our youth who are abusing. Prescription drug abuse among 55-59 year olds doubled in 2007. It appears some old hippies have found a new groove.

Why is this happening, and what does it mean for the business owner? There are many reasons for this change in culture. Unfortunately, there has been a trend in recent years to overprescribe pain medications for benign chronic syndromes like low back pain, bursitis, and fibromyalgia. Ibuprofen just doesn’t cut it anymore. Doctors with shrinking margins in a volume-based practice sometimes don’t have the time to address real issues with patients. It is easier to write a script. And of course, physicians have been slammed for the undertreatment of pain. It is a tough balance and one that is hotly debated in medical circles.

Another growing concern is the availability of drugs on the Internet. The Drug Enforcement Administration has made it clear that the standard for prescribing controlled substances is that it must be for a legitimate medical purpose by a physician acting in the usual course of professional practice. Internet doctors who have patients fill out a questionnaire and then dispense prescriptions do not in my opinion meet that standard.

We often see workers who are taking an incredible amount of prescription pain killers, anti-anxiety drugs, sedatives, and hypnotics that can directly affect their ability to perform. There is a sense that because these drugs were prescribed by a physician that they are not an issue in the workplace. However, having a legitimate prescription for a drug doesn’t obviate the safety or performance problem. These workers are driving forklifts, operating equipment, and performing other safety sensitive duties while their cognitive functions and ability to react may be greatly impaired.

Sometimes an argument can legitimately be made that individuals who take these medications tolerate them well and it doesn’t affect their ability to function. While there can be some medical truth to that, from a risk management standpoint I think that is a weak argument. If someone in your business is involved in a serious accident which results in injury or fatality and it is discovered that they were taking these drugs, don’t you think that it will become a major issue? The question will be asked by OSHA or a court-why was this person working and allowed to take these drugs?

Awareness of this growing problem is your first step. Discuss it openly with supervisors and your entire team. Put policies in place that spell out what a team member is supposed to do if their doctor places them on medication. At minimum, they should discuss with their physician whether or not they believe a new medication could affect their ability to work. Who do they report to and what is done with the information? If they have a serious medical problem that really requires these medications, then accommodation may have to be addressed.

Consider your drug testing program. Does it effectively identify the prescription drugs that are commonly abused? All drug tests are not equal. Special panels are sometimes required to identify an offender. When you are in doubt about whether someone has a medical problem that requires prescription drugs or someone who may be abusing legal substances have your occupational health provider evaluate them for fitness for duty. Do not let confidentiality concerns stand in the way of making your workplace safe. There are legal ways to do this.

The drug problem in our society is not going to disappear for a long time. Great strides have been made and we can all hope for the day when illegal substance abuse becomes a rare phenomenon. Unfortunately, prescription drug abuse seems to be taking its place. So for now, I’ll be the guy you see in the next lane over who is looking in his rear view mirror and squirming in the seat.