Naloxone, commonly sold under the brand name Narcan and available without a prescription in every US state except Nebraska, is an opioid receptor antagonist used to treat overdoses of heroin and other opiates. Delivered via injection or a nasal spray, the drug has been credited with saving many addicts’ lives and has lately been the subject of numerous awareness campaigns in the US urging people who interact frequently with opioid users to have the antidote on hand and know how to administer it.
Last month, US Surgeon General Jerome Adams urged employers to stock naloxone at worksites as well, and train employees on how to use it, Allen Smith reported at SHRM:
“For a heart attack, we train employees how to do CPR until the paramedics arrive,” Adams noted April 19 in Washington, D.C, at Business Health Agenda 2018, a conference sponsored by the National Business Group on Health, speaking about the opioid epidemic. “Why is that not the case with naloxone and Narcan? We need to make these emergency treatments as ubiquitous as knowing CPR and calling for a defibrillator when someone is having a heart attack, or using an EpiPen when someone’s having an allergic reaction.”
Even before the surgeon general’s statement, a few clients of Nancy Delogu, an attorney with Littler in Washington, D.C., made naloxone available at work. They made this decision after employees overdosed on opioids at work. …
For a growing number of US employers, the answer is “no,” Rebecca Greenfield and Jennifer Kaplan report at Bloomberg, pointing to organizations like Excellence Health, a 6,000-employee company which stopped testing candidates outside safety-sensitive roles for marijuana two years ago and now no longer bothers drug testing them at all:
We don’t care what people do in their free time,” said Liam Meyer, a company spokesperson. “We want to help these people, instead of saying: ‘Hey, you can’t work for us because you used a substance,’” he added. The company also added a hotline for any workers who might be struggling with drug use.
With marijuana becoming legal in more states, a historically tight labor market, and rising rates of illegal drug use (particularly cannabis) causing the number of candidates who can pass drug tests to dwindle, more employers are finding that a zero-tolerance approach to drugs is no longer effective. Like Excellence Health, many have shifted their policies on drug use toward helping employees who struggle with abuse and addiction instead, treating drugs primarily as a health and safety issue rather than a legal issue.
This is particularly true for employers in states that have legalized marijuana, such as Colorado, Greenfield and Kaplan note. Others are moving in the same direction, however, though some are not eager to advertise their softening stance on drug use. Amid a rise in the number of American adults who use drugs and a growing recognition that smoking pot doesn’t disqualify an employee from most jobs any more than drinking alcohol does, pre-employment drug testing “is no longer worth the expense in a society increasingly accepting of drug use,” they write:
Drug use among US employees has been increasing in recent years, with marijuana accounting for about half of the American workforce’s illegal drug habits. With a tight talent market, greater mainstream acceptance, and state-level legalization of marijuana, some employers have begun relaxing their drug testing policies, abandoning the zero-tolerance approach in favor of case-by-case judgments. The biggest substance abuse problems in the US, however, are not illegal drugs but rather alcohol and prescription opioid painkillers. Opioid addiction, as well as the underlying physical health issues that lead to these drugs being prescribed, has been persuasively identified as a significant driver of the decline in American workforce participation rates, particularly among men in what ought to be their prime working years.
Even more disconcerting is that the number of US employees dying from drug- or alcohol-related causes while at work has also risen sharply in recent years. While in absolute terms, those numbers remain very small, the rapid rate of increase is cause for concern, Gillian B. White warned at the Atlantic last month:
Last year alone, the number of workers who died at work because of drug- or alcohol-abuse-related incidents increased by more than 30 percent, to more than 200. While that number may seem small, it’s evidence of how rapidly the problem is growing—less than five years ago, fewer than 70 people died from overdoses at work. Since 2012, the number of people dying from drug or alcohol related causes while on the job has been growing by at least 25 percent each year, according to the Bureau of Labor Statistics. …
The crisis of opioid addiction in the US is no longer something employers can afford to ignore. A growing body of research points to opioids as a significant factor in the hollowing out of the US workforce, particularly among prime-aged men. We’ve also heard many stories in recent years about employers having difficulty hiring for safety-sensitive roles in certain geographies because of the lack of qualified candidates able to pass a mandatory drug test.
So for most US businesses, opioid addiction is an issue that affects both their workforce and their talent pool, and employers who find ways to support workers affected by it are doing both economic and social good. Phil Albinus thinks through some of the ways employers can help at Employee Benefit News:
There could be an increase in benefits like telemedicine services, which would broaden the reach of medical treatment to rural areas where doctors are often in short supply. In addition, employers (if they have not already done so) may review service coverage for behavioral health and/or employee assistance program needs. An evaluation of the behavioral health portions of health insurance policies and EAP contracts will help to ensure employees are covered for abuse of prescription drugs. …
Dennis Yip/Flickr/Public Domain
In a paper last year on the disappearance of many prime-age men from the US workforce, Princeton economist Alan Krueger presented the unsettling finding that 44 percent of working-age men who were not in the labor force reported taking pain medication on a regular basis, and two-thirds of these men were taking prescription pain medication. While improvements in video game technology may be contributing to these men’s lower workforce participation by making long-term unemployment more bearable, Krueger wrote, their high rates of poor health and use of narcotic painkillers are much more disconcerting.
In the Fall 2017 edition of the Brookings Papers on Economic Activity, Krueger publishes an update of that research with new data, homing in on the impact of opioid epidemic on the labor market. That impact, he finds, is even more significant than previously thought, accounting for some 20 percent of the decrease in men’s labor force participation between 1999 and 2015, and 25 percent of the decrease among women, Brookings editor Fred Dews explains:
Krueger’s paper suggests that, though much of the decline can be attributed to an aging population and other trends that pre-date the Great Recession (for example, increased school enrollment of younger workers), an increase in opioid prescription rates might also play an important role in the decline, and undoubtedly compounds the problem as many people who are out of the labor force find it difficult to return to work because of reliance on pain medication.
Quest Diagnostics’ Drug Testing Index, which analyzed some 11 million workplace drug test results, found that the percentage of US employees who tested positive for drugs hit a ten-year high in 2015:
Insights from the 2015 data show that the positivity rate for 9.5 million urine drug tests in the combined U.S. workforce increased to four percent, a relative change of 2.6 percent over the positivity rate in 2014 (4.0% versus 3.9%). The 2015 positivity rate reflects a relative increase of 14 percent over the 10-year low of 3.5 percent observed in both 2010 and 2011. The last year that the positivity rate for urine drug tests in the combined U.S. workforce was at or above four percent was 2005, when it reached 4.1 percent. …
In oral fluid drug testing, the overall positivity rate increased 47 percent over the last three years in the general U.S. workforce to 9.1 percent in 2015 from 6.7 percent in 2013. The increase was largely driven by double-digit increases in marijuana positivity during this time period. In 2015, there was a 25 percent relative increase in marijuana detection as compared to 2014 (7.5% versus 6.0%). Slightly more than nine percent of oral fluid test results were positive for one or more drugs, suggesting that nearly one in eleven job applicants were unable to pass an oral fluid drug screen.
Among drug testing methods, overall positivity in the general U.S. workforce was highest in hair drug tests, at 10.3 percent in 2015, a seven percent increase over 2014 (9.6%) Because hair testing shows repetitive drug use as far back as 90 days, it can give a more complete drug-use history.
The Wall Street Journal’s Lauren Weber hears more from the Quest director in charge of the analysis about which drugs employees have been using—you can probably guess which one is the most common: