Patient expectations, prescriber practices and powerful new opioid drugs have all combined to create a perfect storm of prescription drug abuse that is wreaking havoc throughout the nation, spawning what the CDC has labeled an abuse epidemic. Physician Kevin Pho talks about the role that pain has played in the current opioid epidemic in his highly regarded KevinMD blog. He notes that despite being a symptom and subjective in nature, pain has come to be regarded as the fifth vital sign. “This is based on the (mistaken) idea that pain medication is capable of rendering patients completely pain free. This has now become an expectation of many patients who are incredulous and disappointed when that expectation is not met.”
Each day, 46 people die from an overdose of prescription painkillers in the US.
Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.
10 of highest prescribing states for painkillers are in the South.
These stats are from the CDC’s Vital Signs earlier this year, which delineates how where you live makes a difference: in 2012, health care providers in the highest-prescribing state wrote almost 3 times as many opioid painkiller prescriptions per person as those in the lowest prescribing state in the US.
While some prescription drug abuse is the result of illegal activity, all too often, people who abuse prescription drugs were prescribed the drugs legally for a medical condition. For example, prescription drugs are a very big issue in workers’ comp claims. Today, people with work injuries like sprains and strains are often being prescribed extremely potent narcotics that were intended for cancer treatment and other serious pain issues. Consequently, many recovering workers become addicted to drugs so what started out as a fairly routine sprain or strain can mushroom into full-blown addiction. It’s important to work with insurers to ensure that work comp physician networks adhere to best practices in prescribing practices; an employee’s return-to-work after recovering from an injury might be a critical time for managers to be on alert.
See: Opioid Epidemic Plagues Workers’ Comp
Where’s Your Bottle of Painkillers?, which makes the case that organizations must work harder to protect injured employees from the destruction opioids can wreak.
What employers can do
The National Safety Council discusses The proactive role employers can take: OPIOIDS IN THE WORKPLACE
Drug-Free Workplace Policy Builder – Prescription and Over-the-Counter Medications
In this tool, the Department of Labor advises:
“Employers should not implement a blanket policy requiring all employees to disclose prescription drug use for legitimate medical purposes. Moreover, the Americans with Disabilities Act and the Rehabilitation Act of 1973 permit an employer to ask disability-related questions only if they are job related and consistent with business necessity. However, there are some prescribed and over-the-counter medications, such as amphetamines and benzodiazapines, that may result in a positive drug test. In this event, a Medical Review Officer (MRO) or other appropriate company personnel may inquire to determine if the employee has a legitimate medical explanation, such as a physician’s prescription, for a positive drug test.
However, employers may want to consider incorporating language regarding prescription and over-the-counter drug use by employees who perform jobs that directly affect public safety and health. Because important privacy interests and non-discrimination protections must be balanced with the need to address workplace drug use, employers are strongly encouraged to consult with an attorney specializing in employment law before deciding to cover prescription and over-the-counter drug use in their drug-free workplace policy.”
Other tools and resources
- The National Institute of Health lists prescription drugs & cold medicines that are commonly abused
- Our prior post: Prescription drugs: the new face of substance abuse and addiction
- National Conference of State Legislatures: Overview of State Laws
- CDC: Injury Prevention & Control: Opioid Overdose
- Opioids: The Gateway to Heroin
- Prescription for a Hazardous Workplace
- SAMSHA: Preventing Prescription Abuse in the Workplace (PAW) Prescription Drug Abuse Webinar (PDF)
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