Workers and opioids

Employer actions

To help employees make wise decisions regarding opioids, employers can make pamphlets or other informational materials available in the workplace. In states in which the employer selects a panel of providers for their workers to choose from, Cloeren said employers should evaluate the doctors’ treatment and education philosophy for opioids as part of the criteria.

At work, employers also should be alert for signs that drugs may be impairing behavior. As Cloeren explained, “The employer is not going to be the person that has the expertise for judging whether the treatment plan is appropriate, but they certainly should be able to monitor how the person is doing. Is the person alert? Are they following orders? Are they getting to work on time? Are they performing well?”

Coupland emphasized the importance of occupational health surveillance, which can include having employees annually declare any medications they are taking that may have an impact on their ability to safely perform job duties.

In the 1970s, employers were watching for signs that an employee was intoxicated or hungover, Coupland said. Now, the big issue is opioids, and supervisors should be trained to identify behavior that indicates prescription drug misuse. An example of a yellow flag would be an employee who is excessively drowsy and falling asleep at his or her workstation. A red flag would be a driver who gets lost on a regular route.

Employers have to be careful with what they say and focus on work performance rather than speculate about the worker’s drug use, Coupland said. Let the worker know falling asleep is not acceptable and ask if he or she needs to speak with a health care professional about a health concern. For red flags, Coupland suggested the employer have the worker evaluated for fitness of duty.

Both Coupland and Cloeren said employers should recognize that many workers take opioids in accordance with the prescription and do not experience adverse problems in the workplace.

“I think that employers … have to know that people who are on appropriate doses of opioids can perform safely,” Coupland said. “It’s a very individual thing. People metabolize these drugs differently, so you really have to know as an employer if this particular person is able to perform their cognitive job demands on opioids.”