Opioids, Overdoses and Court Cases

As employers struggle to address the ongoing problem of alcoholism and illicit drug use among employees, another potentially deadly threat to worker well-being is on the rise: drug overdoses.

 

Death rates because of an overdose have doubled in the past decade as more injured employees become addicted to pain pills such as oxycodone, methadone and hydrocodone, according to the U.S. Centers for Disease Control and Prevention. And it is taking both a personal and economic toll on employers. 

 

“A lot of employers are unaware of how incredibly addictive these medications are,’’ said Tess Benham, a senior program manager at the National Safety Council, which recently released a report examining the impact of opioid overdose on workers’ compensation claims. “People get a prescription from their doctor and they stay on the drugs a little too long, and that’s all it takes. When that gets too expensive for someone to maintain, they sometimes turn to heroin.”

 

Opioids not only increase medical claim and workers’ compensation costs and raise the risk of addiction, but also they aren’t the most effective way to treat pain, Benham said.

 

“Studies show that if someone is on the drugs, it could double the risk of disability one year later,” she said.

 

According to the National Safety Council, workers who are prescribed even one opioid have average total claims costs that are four times higher than similar claims for employees who were not given a prescription. 

 

And in recent court cases, employers have been ordered to pay for detox treatment as well as death benefits to a surviving family, even when an employee took more than the prescribed dose or mixed the pills with alcohol, according to the report.

 

In a 2012 case, Washington state courts awarded survivor benefits to the family of an employee who died after drinking alcohol while taking multiple prescription medications to treat pain from an industrial accident. Medical experts found that the cause of death was the combination of drugs and alcohol, and the court ruled that the initial injury and the death were connected.

 

The council’s report highlights another case in Texas involving a man who died from an accidental overdose of hydrocodone after taking more than the prescribed amount. Even though he failed to follow his doctor’s orders, a jury determined that his death resulted from the treatment for his injury. His wife argued that her husband overdosed because he became confused and disoriented, which caused him to take excessive amounts of the drug.

 

There are a number of factors that increase the risk of overdose, including taking pain medications for an extended period of time or at a high dose, mixing them with alcohol or other medications, and sleep apnea, Benham said.

 

But there are several things that employers can do to protect their employees’ well-being and their bottom line, she said, like requiring workers’ compensation insurers and health care providers to follow prescribing guidelines issued by the American College of Occupational and Environmental Medicine and by putting certain safeguards in place. 

 

“If someone is on pain medication for more than 30 days, there should be a point of intervention before more medication is given,” Benham said. “Also, employers should look at their drug-testing program and make sure that their drug-testing panel includes the most common opioids.”

 

The National Safety Council recommends that employers screen injured workers for depression and other mental health conditions and prior substance abuse. The council also suggests that all pharmaceuticals be purchased and managed by a pharmacy benefit manager, many of which have systems to flag dangerous prescribed drug combinations and suspicious prescribing patterns. 

 

But the first step is making sure that the company has a substance-abuse policy in place, according to Will Wesch, director of admissions at Novus Medical Detox Center near Tampa, Florida, which specializes in prescription drug addiction.

 

Addressing substance abuse can be tricky for employers, especially when the drugs are legal and prescribed by physicians, Wesch said. He recommends consulting a lawyer to address the issues of privacy and protection of personal medical information, among other legal concerns, when developing policies. 

 

“The fact is that most companies are going to have somebody with some kind of a drug problem, so they should have some place where employees can go for help, like an EAP, and they should have a clearly defined substance-abuse policy that applies through the company,” he said, referring to employee assistance programs.

 

He cited a 2014 study from Quest Diagnostics Inc., a provider of clinical laboratory services, which shows that positive workplace drug-test rates have increased for the first time in 10 years. At Novus, Wesch said he has seen a 10 to 15 percent increase in the past few years in the number of corporate executives seeking drug addiction treatment. 

 

“These issues have been around for a while, but they are tricky for employers to deal with,” he said. “But with the costs associated with drug-abusing employees and the lost productivity, employers are being forced to come up with a solution.”