2020 has certainly brought its share of challenges. We are months into the current pandemic with the ever-changing protocols and the physical and emotional demands it has brought. But we cannot lose sight of the other national healthcare crisis that has been with us for much longer. The opioid epidemic continues to impact our country as evidenced by a recent article posted by the National Safety Council (NSC) titled,  “Opioid overdoses are spiking during COVID-19.” It’s a tough topic to deal with during this challenging time, though a topic that needs to be discussed. The ongoing opioid epidemic has left many employers faced with the tragedy of employee overdoses at work or the tough conversations around workers being under the influence while on the job. It is a time where we are seeing a spike in stress, anxiety, emotional strain, and mental health concerns. Employers have a key role to play in supporting employees during this time.

The Bureau of Labor Statistics reported in 2016 that 217 workplace overdose deaths occurred accounting for 4.2% of occupational death injuries that year. This epidemic has rapidly spread over the past 30 years. According to the U.S. Department of Health and Human Services, the late 1990s created the foundation for the current public health crisis with pharmaceutical companies providing the medical community with misleading information stating that opioid pain relievers were not addictive. As a result, medical providers prescribed this medication at greater rates. This led to the misuse and abuse of prescription as well as nonprescription opioids.

The current climate has led to employers asking the question, how do I combat this? The NSC published an article with six simple steps to confronting this matter.

Those steps include but are not limited to:

• treat substance use disorder as a disease
• leverage EAPs (employee assistance plans) to assist employees returning to work
• recognize that drugs impact the bottom line
• implement strong company drug policies
• expand drug testing to include opioids
• train management as well as front line employees on recognition

To further assist in this process the NSC created an employer toolkit providing additional information on how to address opioid abuse. 

Some employers have taken their policy to the next step and implemented an opioid antagonist program to help save lives from overdoses. You might be asking, “what is an opioid antagonist?” Most people are familiar with the opioid antagonist brand NARCAN.

Let’s take apart the words to obtain a better understanding. The National Institutes of Health (NIH) defines Opioid as “a class of drugs that act in the nervous system to produce feelings of pleasure and pain relief.” An Antagonist by definition is “a substance that interferes with and inhibits the physiological action of another.” Putting these words together we can better understand that an opioid antagonist blocks the opioid receptors from the central or peripheral nervous system. Naloxone, the most commonly used FDA approved opioid receptor antagonist, is available in multiple forms- intravenous, intramuscular (autoinjector) as well as the intranasal formulation (nasal spray).

Who can administer an opioid antagonist? According to drugabuse.gov, depending on the state a person lives in, an opioid antagonist auto-injector and/or nasal spray formulation can be administered by a family member, friend or a bystander. State by state information is available from the Prescription Drug Abuse Policy System.  

Organizations have moved towards taking steps in implementing an opioid antagonist use program after seeing the lifesaving benefit. NIOSH published a document ‘Using Naloxone to Reverse Opioid Overdose in the Workplace: Information for Employers and Workers.’ This article provides beneficial information starting with evaluating the organization to determine if a Naloxone Use Program is needed followed by information on steps to establishing a program.

• Risk Assessment
• Liability Consideration
• Records Management
• Staff Roles
• Training
• Purchasing of Naloxone
• Storage of Naloxone
• PPE and other Equipment Storage
• Follow-up Care Planning
• Maintaining the Program

I hope the information provided heightens your awareness and is a reminder that the opioid crisis has not gone away. It has been overshadowed by the coronavirus and COVID-19 for obvious reasons, but all employers can participate in the fight against opioid addiction.

Additional Resources

https://www.hhs.gov/opioids/about-the-epidemic/index.html

https://www.nsc.org/home-safety/safety-topics/opioids/timeline