Beyond the incalculable emotional pain to addicts and their families, the increasing number of overdoses and deaths from opioids is costing the U.S. economy hundreds of billions of dollars.
Prescription opioids (hydrocodone, oxycodone, morphine, codeine and fentanyl) and illegal opioids such as heroin are now the most commonly abused drugs in the workplace. Many employers claim they’ve been impacted by prescription drug use among their employees. Absenteeism and turnover are on the rise, and declines in job performance are increasingly linked to the opioid crisis.
Against this grim socioeconomic backdrop, how can companies protect their people and their business? Implementing strong workplace policies and investing in education, training and employee support programs is a good place to start.
Drug Policies and Testing
A worker may have legally-prescribed medication, including opioids. Workers (and potential hires) who lawfully use drugs to treat a covered disability may be protected by the Americans with Disabilities Act (ADA). However, even with a legal prescription, opioids can impair workers and present a hazardous worksite. When a medical restriction interferes with a worker’s ability to perform his or her duties, the ADA requires the employer to engage in the interactive process and communicate with the employee concerning an accommodation. The purpose of the interactive process is to identify the limitations resulting from the disability and potential reasonable accommodations that could overcome those limitations. If opioid use impairs job performance or affects the employee’s ability to work safely, the employer should engage in the interactive process with the employee to determine whether a reasonable accommodation is available that will not cause the employer undue hardship.
Post-hire, an employer may conduct a drug test if there is reasonable suspicion that an employee is under the influence – which can be difficult to identify with opioid use. Reasonable suspicion should be based on specific observations by the supervisor and, when possible, a witness concerning the employee’s current physical appearance, behavior, speech and smell, which are some indicators that an employee may be under the influence. The supervisor should speak with the employee about his or her behavior by focusing on job performance. All employer actions during this process should be well documented.
Employers should have a clear, written policy about drug use, its consequences and resulting disciplinary action. Employers also should annually re-evaluate or update their drug policies and testing procedures, and understand the potential legal implications. For example, drug testing can be modified to test for legal prescription medications. Employers are advised to consult with an attorney to determine if additional testing is necessary under the circumstances. Finally, as a cautionary measure against disability discrimination claims, an employer must be consistent in how it enforces its policy. It is best to look at how positive test results have been treated in the past for a position. Consider the specific facts of each case. An employer will be vulnerable to a charge of discrimination if the company policy is not applied consistently to every employee. By treating employees in the same position equally, employees will know what to expect from the policy.
Health Care and Workers’ Compensation
Companies should understand the coverage position of their health care benefit provider and workers’ compensation carrier regarding opioids. Find out if they offer any programs that focus on opioid use. An opioid management program and/or a prescription benefit management program can help identify and prevent prescription medication misuse and abuse. Employers also should consider offering an employee assistance program (EAP), which can provide employees and their qualified dependents with short-term counseling, and referrals to long-term treatment resources including peer support and addiction recovery groups.
Education and Training
Investing in programs to educate employees about opioids and the abuse of other prescription drugs is also recommended. Teach employees - at every level of the organization - how to identify the symptoms of opioid addiction, including changes in behaviors among co-workers, and what to do if they suspect a problem and how and when to report it. This can prevent issues from escalating and becoming more difficult or costly to address later on. Training programs should be tailored to fit the workforce and culture, and reflect the company’s drug testing and other policies and benefit programs.