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Employers Confront Questions About Substance Abuse and Screening Part III: Opioids

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Here’s a statistic that could keep you up at night: Over 20% of the workforce have used opiates non-medically, according to the National Safety Council.[1]

It’s no wonder that more than 70% of employers say they are affected by prescription drug abuse. The opioid epidemic is having a negative impact on workforce participation[2], costing up to $53 billion in lost productivity each year,[3] and driving up absenteeism, turnover, and workplace accident rates. Sadly, the number of people dying from overdoses on the job has risen sharply.[4] Some industries, such as construction, have been especially hard hit, and the implications for safety are staggering.

Unfortunately, opioids are yet another difficult topic for employers. That’s because opioids can be, and often are, taken for medically valid reasons. Thus a positive test for opioids is not alone indicative of illegal behavior or substance abuse. At the same time, these drugs carry warnings about possible impairments, meaning even legal use can cause issues in the workplace.

Antidiscrimination Laws Apply

Under the Americans with Disabilities Act, employers cannot discriminate against employees taking legally prescribed medications, including opioids. Drug addiction is also considered a disability.[5] The unlawful consumption of prescription drugs, on the other hand, is not protected. It’s important to institute policies that discern between the two.

Companies should work with qualified legal counsel to develop appropriate drug workplace free policies in addition to drug testing parameters. 

For employers conducting drug testing, appropriate follow-up to a positive test result will include coordination between a medical officer, who will review the test results, and the employee’s physician(s). This will serve to confirm the medication has been prescribed. The physician may also weigh in on whether there is a safety risk relative to a particular job function (e.g., driving a forklift) and if any medication substitutions are possible to avoid medical disqualification. It’s important to also be cognizant of state laws that may afford additional protections to individuals as it relates to drug testing (Minnesota is a good example).

Testing Works

Research indicates that instituting a drug testing program reduces injuries.[6] When employees are aware they will be tested, behaviors can change in a positive way. Although drug testing has often been limited to safety-sensitive roles, the opioid epidemic is leading some employers to widen their pre-employment screening and periodic rescreening policies.

Many states do require cause for testing current employees for opioids and other substances. Employers in these jurisdictions must have reasonable suspicion of substance abuse and believe safety or performance is being compromised.[7] Random testing is more widely permitted for safety-sensitive roles, but rules and regulations are complex. It’s vital to work with experienced legal counsel when updating workplace drug-free policies and procedures.

Better Opioid Panels

It is startling to realize that even existing drug testing has been overlooking commonly abused opioids. Only since January 1, 2018, for example, has the Department of Transportation drug panel included four “semi-synthetic” opioids, common names like oxycodone and hydrocodone. Since included in the panel, these drugs have seen a higher rate of positive returns than traditional opioids.

This finding underscores the need for employers to check their drug screening practices. The easiest approach may be to find a provider who can advise on including semi-synthetics and synthetics, such as fentanyl. Casting a broader net for opioids increases the costs, but eliminating tests for less commonly used substances, such as quaaludes, can defray the budget impact.

Making sure the drug panel you run provides the information you’re seeking—that’s just one service a high-quality employment screening service can provide. From compliance updates to driving record searches, it’s worth working with experts in the field. Although there is no easy solution to the opioid crisis or its impacts on employers, simple, swift drug screenings will continue to provide information to help guide employers’ decisions.