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As the opioid epidemic rages throughout the country, the fallout is increasingly noticeable in the workplace. The U.S. Bureau of Labor Statistics reports a 25 percent increase from 2012 to 2017 in the number of workers fatally overdosing on the job. A stunning 70 percent of employers reported that their businesses have been affected by prescription drug abuse, including absenteeism, positive drug tests, injuries, accidents and overdoses. Yet according to recent national surveys, fewer than one in five companies feel extremely well-prepared to combat the opioid crisis.

In construction and trade industries, the impact has been severe. According to a national survey, the construction industry has the second-highest rate of pain medication and opioid misuse. An estimated 15 percent of construction workers have a substance abuse disorder, compared to the national average of 8.6 percent (according to the National Survey on Drug Use and Health by the National Safety Council). Researchers estimate that in the construction industry, each worker with an untreated substance abuse disorder costs an employer $6,800 per year in excess health care expenses, absenteeism and turnover costs.

Although there is no one-size-fits-all approach to address the crisis, employers should revisit drug policies, drug testing protocols and medical emergency preparedness in order to keep their employees and workplace safe:

1. Build a culture of safety and awareness of prescription drug abuse
Build foundational awareness of safety by proactively training employees. In the context of the opioid crisis, this means educating employees about the harmful impacts of abusing painkillers as well as providing resources to support employees facing addiction issues. Ideally, such training would be incorporated into safety meetings and would disseminate information about the workplace consequences of prescription drug abuse, doctor shopping and alternatives for pain relief. Inform employees that because of the impairing nature of opioids, even 鈥渓egitimate鈥� uses of opioid medications pose risks to the workplace. Although any communication with employees about medical conditions should be approached with caution due to potential legal issues posed by the Americans with Disabilities Act (ADA) or Health Insurance Portability and Accountability Act (HIPAA), encourage employees to ask their physicians how the use of a prescription may affect their workplace. Offer to provide a job description to facilitate these conversations. Supervisors should also be trained to spot the first signs of drug misuse and withdrawal symptoms. After consulting legal counsel, be sure to use fitness for duty and drug testing where there is objective evidence of impairment and/or use of prescription or other drugs.聽 Be proactive in bringing safety-related concerns to employees.

2. Adopt strong drug policies
Employers should adapt policies to the opioid crisis by prohibiting the abuse of prescription medication. For example, a policy may stipulate that it is a violation for workers to use, possess, sell, trade or offer for sale alcohol, illegal drugs or intoxicants. Nothing in this provision would address an employee鈥檚 abuse of prescription drugs. Working with legal counsel, employers should adopt policies that prohibit the illegal or unauthorized use of prescription drugs; empower employees to consult with their health care provider when taking prescription and over-the-counter medications that could interfere with safe performance of their job duties; and require employees to use appropriate personnel procedures (e.g., call in sick, use leave, request change of duty, notify supervisor) to avoid unsafe workplace practices.

Update drug-testing policies and procedures to include testing for a robust panel of drugs, including opioids. Rethink zero-tolerance policies for positive tests to provide for flexibility based on the circumstances of the test and whether the employee is in a safety-sensitive position. In such instances, employers can require substance abuse counseling and 鈥渓ast chance agreements鈥� before allowing the employee to return to work.

3. Provide health insurance that covers substance abuse and mental health treatment
Now is also the time to re-evaluate company health care coverage and enhance its provision of drug counseling and mental health programs. Employee Assistance Programs (EAPs) can be an effective first step for employees to initiate support for nonmedical prescription drug problems and receive counseling and referral services. EAPs can also monitor employees鈥� participation in, and compliance with treatment, as well as return-to-work recommendations. Joining an EAP and encouraging employees to use its services confidentially may prevent further drug abuse. Employers should also ensure their health insurance provides necessary tools to deal with opioid addiction by ensuring coverage of at least 30 days of substance abuse treatments. Also consider discussing with the health insurer limits on opioid prescriptions to seven days.

4. Develop an emergency response plan

Many employers in industries with high risks of opioid use and prescription drug abuse are developing emergency response plans to address on-the-job overdose deaths. Surgeon General Jerome Adams has suggested that every employer should have Naloxone on hand and train employees on its use. Naloxone, also called 鈥淣arcan,鈥� can very quickly restore normal breathing for a person whose breathing has slowed or stopped because of an overdose of prescription opioids or heroin. In Oregon, anyone can obtain Naloxone directly from a pharmacist. However, employers should provide training to employees and evaluate risks before introducing Naloxone into the workplace.

Despite the resources dedicated to help people struggling with opioid misuse, the epidemic is far from over. It is important for employers to take proactive steps to address opioid use and misuse in the workplace.

Sarah Hale is a partner at Barran Liebman LLP. She advises and represents employers in a wide array of employment and labor law matters. Contact her at 503-276-2111 or [email protected].