Project Description

Opioids, Pain and Absence

The Productivity Implications Of Substance Use Among U.S. Workers

The opioid epidemic has resulted in many analyses of the social and economic costs related to the problematic use of heroin and opioid pain relievers. The implications for employers as stakeholders often center on the risk of on-the-job accidents or difficulties in filling job vacancies in areas heavily affected by addiction and dependence. This may not only underrepresent the more pervasive productivity impact of lost work time, but also obscures the larger issues of chronic pain and substance use more generally. This study examines the use and abuse of prescription pain relievers and other substances and their association with absences from work.

Study highlights

  • One in three workers reported using pain relievers—the majority of whom used medication as prescribed. Less than one in 20 workers reported abuse of pain relievers or dependence. Less than 1% reported any heroin use.
  • Rates of alcohol abuse and dependence exceed the problematic use of pain relievers and other prescription medications. Any reported use of cocaine or methamphetamine was relatively uncommon (< 3% and < 1%, respectively).
  • Excess absences associated with pain relievers were greater than excess absences associated with any other substance. On average, non-problematic use of pain relievers was associated with 0.8 days of excess absences per month compared with non-users. The problematic use of pain relievers was associated with 2.0 absences, or 1.2 excess days per month compared with non-users.
  • Generally, excess absences associated with problematic use of substances are significantly greater than for non-problematic use.
  • Assuming a 20-day work month, the use of pain relievers was associated with a loss of about 1.3% of the monthly labor capacity of 1,000 workers. The non-problematic use of pain relievers accounts for nearly all (96%) of those losses.

Guidance for Employers

To help employers develop effective substance abuse management strategies for their workforces, IBI sought input from experts at leading healthcare, benefits and absence management firms. A sample of their guidance follows. More details can be found on this infographic.

Understand your risks

Employers with a clear sense of how many of their employees may be at risk of developing a substance abuse problem will be better positioned to prioritize resources for prevention and treatment.

Use confidential health risk assessments to identify employee issues and medications with potential for abuse.

Work with your group health carrier or pharmacy benefits manager to track overall spending and trends for opioids and other prescriptions with the potential for abuse.

Raise awareness in your workforce

Employees and supervisors are unambiguous stakeholders in your efforts to prevent workforce substance abuse problems.

Provide workplace training and education for managers, including awareness of your company’s risk and their roles and responsibilities in identifying potentially problematic behavior.

Educate employees about the resources available to them as a benefit of their employment.

Publish a formal drug-free workplace policy statement with specific references to opioids (as opposed to simply “illegal substances”) and other substances prone to abuse.

Prevent pain management from becoming abuse

The findings of this report serve as a reminder that the opioid epidemic occurs within a larger context of widespread pain.

Identify injured employees with risk factors and respond immediately to workplace injuries, focusing on rapid access to treatment and early referrals to pain management specialists.

Coordinate a post-injury plan with the employee and use return-to work strategies that include graduated returns, flexible schedules, temporary job reassignment and work accommodations.

Work with your pharmacy benefits manager to ensure pain medications comply with opioid prescribing guidelines.

Ensure that employees get needed treatment for substance use disorders

Even with the best awareness and prevention efforts in place, some employees will develop problems with opioids or other substances. Approaching substance use disorder as a chronic condition and ensuring patients’ access to evidence-based treatment resources can help restore their quality of life and allow them to resume their role in the workplace.

Evidence-based treatments include cognitive behavioral therapy, motivational interviewing, brief interventions, relapse prevention, community reinforcement approaches, contingency management and pharmacological treatments.

Leverage partners’ expertise

Even the largest, most successful organization will be challenged to address workforce substance abuse issues on its own. Coordinating efforts with partner organizations can help ensure the success of efforts to maintain employees’ health and productivity through episodes of pain, psychological distress or substance abuse.

Confirm that partners responsible for disability, absence management and stay-at-work/return-to-work programs have direct clinical expertise with substance use disorders and chronic pain issues.

Ensure that drug testing procedures are conducted by federally certified labs that screen for opioids.

Partners can also be instrumental in ensuring that your policies conform to regulations.

Download Report

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