It’s all over the news: the Opioid Epidemic in America. Most people know that this refers to the increased abuse of prescriptions painkillers, subsequent substitution with cheaper heroin, and increased mortality due to opioid abuse. Many federally funded and not-for-profit organizations, as well as state, local and federal legislative bodies,have taken steps to address the problem. But there is so much more to be done, witnessed by the continuing trends. While fatal overdoses associated with prescription opioids (e.g. morphine, oxycodone, methadone) fell between 2010 and 2015, fatal overdoses from heroin tripled, from 8% in 2010 to 25% in 2015.

Impact of the Opioid Epidemic

Opioid abuse affects everyone: those addicted or dependent, friends, families, communities, and employers. Sobering statistics illustrate the magnitude of the epidemic and its consequences:

32% of all opioid prescriptions are being abused.

Patients who are abusing opioids cost nearly 2 time more in healthcare spend per year than non-abusing patients.

Opioid abuse is costing employers $42 million per year in lost productivity.

Deaths resulting from opioid abuse have quadrupled nationwide since 1999.

Between 2014 and 2015, heroin overdose deaths increased 21%, but deaths from prescription pain medications (including Fentanyl) increased 72%.

Drug overdoses now cause more deaths per year than car crashes

By 2010, more people were dying annually from prescription opioid abuse than from heroin and cocaine combined.

Prescription painkillers contribute to more deaths now than any other abused substance.

Prescription painkillers account for 19% of workers’ compensation medical costs.

In 2012, workers compensation claimants that were prescribed even one opioid cost more than 3 times that of claimants with no opioid prescriptions.

Opioid medications are readily available. More than half of chronic abusers (using more than 200 days during the past year) received medications from prescriptions (27.3%) or were given medications by friends and family (26%). Another 23.2% purchased opioid medications from friends/family while only 15.2% purchased from dealers.

Receiving more than a 7 day supply of opioid medication soon after an injury doubles the risk of disability one year later.

Less than 7% of health professionals conduct baseline and periodic drug screens for their patients taking opioids on a longer-term basis.

Opioids are chemically-related drugs that include prescription pain medications (such as oxycodone, hydromorphone and fentanyl), heroin, methadone and buprenorphine (both used to treat and manage opioid addiction). They act on the nerve cells in the body and brain to block pain. They also produce euphoria or a general sense of well-being and therefore are susceptible to misuse and abuse. They are also highly addictive – the body develops a tolerance for the opioid, requiring increasing dosages to achieve the same effects (pain reduction and euphoria). While opioid pain medications are generally safe for short-term use as prescribed by a doctor, regular use, even as prescribed by a doctor, easily leads to dependence.

Opioid addiction and dependence cuts across socioeconomic, geographic, occupational and educational strata. No one is immune. SAMHSA reports that approximately 2 million people were dependent or abusing prescription opioids in 2014, and chances are, you know someone who is abusing opioids.

The detrimental impact of opioid abuse on the workplace is pervasive: employees expose themselves and others to risk when driving to and from work, operating machinery or other equipment, making critical errors, and compromising productivity and quality of work.

Most people who become addicted to prescription pain medications did not set out to abuse the medication or become dependent. The phenomenon is poignantly described as “falling down the rabbit hole”. Heroin and prescription pain medications are bedfellows: they act similarly on the brain, and taking one increases the susceptibility to becoming addicted to the other. Add to that the trend in Fentanyl abuse – another prescription opioid that is 50 times stronger than heroin – and the situation has become a full-blown, savage and unrelenting epidemic.

Solving the Puzzle: What Can Employers Do?

Employers are in a strategic position to reverse these trends. Because opioid addiction and dependence have become synonymous with availability of prescription opioids and medical pain management through employer health plans and workers compensation, employers must change the landscape of opioid availability, pain management strategies, and workplace safety. Consider this four-pronged approach, adapted from the National Safety Council:

Re-evaluate Drug-Free Workplace Policies

Invest in Management and Employee Awareness and Education

Evaluate and Shore Up Your Workers Comp, Medical, and PBM Plan Benefits and Controls

Increase and Ensure Confidential Access to Help and Treatment