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Why US Employers Should Care About the Opioid Crisis

HR Column
Periodically we use a fictitious legal team at Sunderland Manufacturing (also fictitious) to illustrate challenges real companies face. Among other challenges, the Sunderland legal team has determined how to compensate workers after natural disasters, whether to hire candidates with felony records, and how to deal with bad employee communications in litigation. Sunderland is one of the more than 70 percent of employers that have been impacted by the opioid crisis. The company has its share of the 21 million Americans battling substance abuse disorders.

"Y ou have a troublesome employee.” Jordan Powers, Sunderland Manufacturing’s general counsel did not mince words. To her surprise, Sarah McIntosh, production supervisor, shook her head.

“It’s the drugs,” muttered Isaac Matombo, Sarah’s human resources business partner, who had requested the meeting. Jordan looked at Isaac, who sat crumpled in his seat, inspecting a spot in Jordan’s seemingly flawless carpet.


Jordan tried again. “This production worker had a great track record the last five years.”

“Yes!” Sarah agreed with enthusiasm.

“It’s the drugs,” muttered Isaac, staring a hole in his spit-shined boot. Jordan eyed him again as Sarah pretended he wasn’t there.

Jordan continued, “But lately your worker has dozed on the job, his behavior has been erratic, he performs some core functions of his job poorly even though he’s been doing them for years, and he’s constantly scuttling off to whisper on his phone.”

Sarah looked as if someone had told on her.

“It’s the drugs,” whispered Isaac.

Patience wasn’t Jordan’s strength.

“Alright Sarah,” she said firmly, “Why are you here and what’s this…” she gestured toward Isaac, “about the drugs?”

Defeated, Sarah sighed while Isaac unfolded and came alive.

What are opioids?

Opioids are medications that relieve pain by lowering the number of pain signals the body sends the brain. They also change the brain’s response to pain. Opioid drugs include opium, codeine, fentanyl, heroin, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, paregoric, sufentanil, and tramadol. Doctors most often prescribe opioids to relieve pain from:

  • Injuries;
  • Surgeries;
  • Dental procedures and toothaches; and,
  • Chronic conditions such as cancer.

Opioids are safe when used correctly, but misuse of these powerful drugs can lead to addiction.

How big a problem are opioids?

In 1995, the United States Food and Drug Administration approved OxyContin for prescription use. Since then, use and abuse of opioids has proliferated in the United States and has spread globally to Canada, Australia, the European Union, and Latin America. While efforts are being made to combat the addiction crisis, prescription pain medications continue to be an essential element of treatment, and of employer-sponsored healthcare benefit packages.

  • The United States currently has the highest overdose and drug-related death rates in the world, followed by Iceland, El Salvador, Sweden, and Australia.
  • The National Institute on Drug Abuse (NIDA) reported that in 2015, more than 33,000 Americans died from an opioid overdose, two million suffered from related addictions, and 591,000 were heroin users.
  • The US Surgeon General reports that nearly 21 million Americans live with substance use disorder; that is more than the population of New York state, and more than the total number of cancer patients. This disorder costs the US economy more than US$400 billion a year.
  • Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. NIDA estimates that about 80 percent of heroin users first misused prescription opioids.

Are opioids a problem for employers?

Opioids are a US healthcare crisis, and no company is immune from the risks and negative consequences of addiction. Before you dismiss opioids as someone else’s problem happening out there, consider Princeton Economist Alan Krueger’s findings, which suggest that the increase in opioid prescriptions from 1999 to 2015 could account for approximately 20 percent of the observed decline in men’s labor force participation, and 25 percent decline in women’s labor force participation during that same period. In the last 15 years, labor force participation declined more in US counties where more opioids were prescribed. Moreover, a National Safety Council survey of US employers with 50 or more employees, uncovered the following:

  • 75 percent of people struggling with substance addiction are employed. These workers miss nearly 50 percent more work days than their peers — up to six weeks annually;
  • Prescription drugs impacted more than 70 percent of employers;
  • 76 percent of employers offer no training on how to identify signs of misuse;
  • 81 percent of employers lack a comprehensive drug-free workplace policy;
  • Although 57 percent of employers drug test all employees, 41 percent do not test for synthetic opioids; and,
  • Only 19 percent of employers feel extremely prepared to deal with prescription drug misuse.

Employers impacted by prescription drugs reported the following:

  • Missed work or absenteeism;
  • Injuries or near misses;
  • Impaired or declining job performance;
  • Increased complaints to human resources;
  • Increased workers’ compensation costs;
  • Increased length of worker disability;
  • Increased use of emergency room services, hospitalizations, and other medical costs;
  • Increased healthcare coverage costs;
  • Employees using, borrowing, selling, or buying prescription pain relievers at work;
  • Negative impact on employee morale;
  • Positive drug tests;
  • Arrests off and on the job;
  • Impact on employees’ family members; and,
  • Overdosing.

Symptoms of opioid addiction

As the dialogue between the Sunderland Manufacturing employees demonstrates, the first step for employers is to recognize opioids are a problem in the workplace. While employers must be careful not to cross lines prohibited by the Americans with Disabilities Act in nosing into employee healthcare matters, there are some physical, behavioral, and psychological signs that, when together, can suggest an employee has a substance abuse problem:

  • Abandoning responsibilities;
  • Anxiety attacks;
  • Chills or shaking;
  • Constipation;
  • Drowsiness;
  • Depression, euphoria, irritability, or mood swings;
  • Fatigue;
  • Lowered motivation;
  • Nausea or vomiting;
  • Pain;
  • Physical agitation;
  • Poor coordination;
  • Poor decision-making;
  • Shallow or slow breathing;
  • Slurred speech; or,
  • Sweating.

Employers face a new reality in addressing substance abuse; legal drugs, which now include marijuana in some states, create workplace hazards, and compromise employee safety. Addressing opioid misuse can lead to more productive workers and lower healthcare costs. Read the next article in the series for potential solutions.

About the Author

Spiwe L. JeffersonSpiwe L. Jefferson is general counsel of ChristLight Productions Ltd., LLC, Patron Fellow of the American Bar Foundation, and board secretary and legal advisor to The BrandLab. She is a member of the ACC employment and labor, law department management, and litigation sections.

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