Opioids — drugs such as Vicodin, Oxycontin, and heroin — have been responsible for $1.4 billion in worker’s compensation claims annually. Construction-related claims for opioids accounted for 20 per cent of spending on worker’s compensation, twice as much as other industries. Opioids were the cause of more than half of the 47,000 lethal overdoses in the US in 2014.
The opiate epidemic is real, and the construction industry is one of the hardest hit. It is unfortunate that the safety issues are not all caused by illicit drug use; workers who are appropriately taking prescription opioid medication also represent a risk when operating in a safety-sensitive area.
Construction work is hard on the body with back and joint injuries that can result in chronic pain among the most common. When the need to keep working is added to the mix, employees have an incentive for coming to work while impaired by medication. Their impairment is not generally obvious, especially to the untrained eye, and they are allowed to take the controls of heavy machinery, drive vehicles, and perform other activities that require high levels of judgment and unimpaired reflexes.
The opiate epidemic is real, and the construction industry is one of the hardest hit.
The construction industry is responding to the threat, but there are challenges to overcome.
Identifying Prescription Opioids
Four opioids are the most common cause of prescription overdose and death. Each was developed for a slightly different effect and marketed under a variety of brand names.
- Oxycodone is prescribed as a tablet and has a high potential for abuse. It affects the nervous system and is sold under brand names that include OxyContin, Percodan, and Percocet.
- Hydrocodone is provided in tablets, syrups, and capsules. Its use has increased substantially and is sold as Vicodin, Lortab, and Tussionex, among other brand names.
- Meperidine comes as a tablet but has been smoked, snorted, or crushed and injected by abusers. Brand names include Demerol, Dilaudid, and Darvon.
- Methadone (Dolophine) has been used to relieve chronic pain in cancer patients and as a drug to control withdrawal symptoms in people undergoing treatment for opiate addiction.
Many of these names have become familiar over the years while new brand names and versions continue to be released. Opiates are also prescribed as Tylenol 3 with codeine and other mixtures.
How Do Addiction and Abuse Begin?
Many current abusers started as patients who had been prescribed opioid pain relief by a physician or a dentist. In the past, it was not unusual for a patient to receive 30 or more pills at a time, particularly if they were being treated for chronic pain.
Once addicted, they obtain more drugs by doctor shopping, getting refills at multiple pharmacies, and buying them from friends or dealers. Often, the expense eventually leads to heroin use.
Often, the expense eventually leads to heroin use.
Doctors and dentists still prescribe opioids for pain, even though alternative treatments are more effective and less dangerous. To combat this abuse, many states have implemented controls on prescribing such as limiting a prescription to a seven-day supply.
Detection Is Difficult, but Screening Has Expanded
The problem seems to be invisible between managers and workers because self-reporting is rare, and opioid use is not always detectable except to a trained observer. However, data from Sedgwick Claim Management Services shows over half of injured workers are on prescription opioid medication, and claim duration increases 53 weeks when opioids are involved.
Urine drug screening has trended upward in the past two decades in pre-employment and random urine drug screening. Policies differ between companies and between Federal and private projects. Some companies have a policy of releasing any worker who tests positive for opiates or other drugs while others require the employee to enter a treatment program before coming back to work.
Prescription opioid abuse and addiction are at critical levels, despite intervention from the government and private sector.
Some states authorize employers to conduct random drug screens on anyone in a high-risk, safety-sensitive position, which includes most construction jobs. Managers may receive training to recognize symptoms of drug abuse on the jobsite and require a drug screen for probable cause.
On October 1, 2017, Mandatory Guidelines for Federal Workplace Drug Testing Programs for urine testing will increase the standard opioid panel to include oxycodone, oxymorphone, hydrocodone, and hydromorphone to the previously used five drug panel.
What Construction Companies Can Do To Help
The most effective way to combat opioid abuse is through education.
- Train employees about the risks and potential health or workplace consequences of using prescription and illicit drugs.
- Train managers to monitor workers in high-risk positions and how to identify the signs of potential opioid use.
- Update the employee policy to include when an employee can use prescription drugs in the workplace and establish screening programs. If possible, make accommodations for employees who must take opioid drugs for illness or disability by placing them in low-risk positions, at least during the time they must take opioid medication.
Due diligence on the jobsite, employee training, and increased efforts to educate physicians and dentist about appropriate opioid prescriptions and more effective alternatives have already caused the number of positive drug screens to decrease.
Many who work in the construction industry decline to speak about the problem, making it difficult to provide accurate reportage.
Prescription opioid abuse and addiction are at critical levels, despite intervention from the government and private sector. Many who work in the construction industry decline to speak about the problem, making it difficult to provide accurate reportage. One construction manager who was contacted for this article stated that he didn’t recall seeing a problem on a jobsite and was uncertain if he would recognize one.
Education across the industry and for healthcare professionals is making a dent in the problem but there are still challenges and a long way to go before the opioid epidemic can be declared over.