The Workplace and Prevention of Opioid Deaths

For many years it has been a theory among some in the substance abuse prevention field that inclusion of the workplace in community prevention efforts has been a “missing link.” A recent essay published this month in the American Journal of Public Health, entitled, Work Environment Factors and Prevention of Opioid–Related Deaths, lends further credence to that assumption, stating the authors’ belief that “this is a critical gap in prevention efforts.”

The article outlined a number of studies relating opioid overdose deaths preceded by workplace–related injuries and opioid use. One U.S. study found that 57% of overdose deaths occurred after a work injury, 13% of them within 3 years of the injury. The U.S. Centers for Disease Control and Prevention (CDC) identified 6 major occupational categories with elevated proportional mortality ratios and these include: construction, extraction (mining and petroleum industry), food preparation and serving, health care practitioners and technicians, health care support, and personal care and service. These occupations are some of the most physically strenuous and have high injury rates.

In the article, authors Shaw, Roelofs, and Punnett, identified the ways that work conditions may have contributed to the initiation of pain medications and to chronic pain syndromes that lead to opioid use. Some of the conditions include both the physical and mental health effects of working environments such as strenuous work, job insecurity, precarious work, high job demands, low job control, and low social support. Workplace injuries can also cause stress from the impacts of lost earnings, risk of further injury, and long-term disability. The combination of the high-stress job conditions, the injury and its resulting stressors, and the introduction to opioids create the potential pathway to opioid use disorders and potential opioid overdose deaths.

There are a number of barriers for employers to implement organizational responses to address the effects of opioid use resulting from injuries. One such barrier is the reluctance of employees to report injuries or their opioid use disorders for fear of employer retaliation or stigma. One of the biggest concerns is related to the lack of understanding of the problem by the employers themselves placing the blame of opioid use disorders on healthcare, insurance, and pharmaceutical industries.

Employers have an important role to play in prevention, intervention, treatment, and recovery. Early interventions reducing hazardous conditions that cause injuries and programs to avoid use of prescriptions that may lead to opioid use disorders are examples of a perfect public health model of prevention. Implementation of return-to-work accommodations, safer opioid prescribing protocols, follow-up and monitoring of injured employees’ progress, alternative therapies, and education are all examples of proactive measures that employers can take to positively affect the lives of employees, the workplace, and the community.

Click here to read the article

Citation:

Shaw, W., Roelofs, C., & Punnett, L. (2020). Work Environment Factors and Prevention of Opioid-Related Deaths. American Journal of Public Health, 110(8), 1235–1241. doi:10.2105/AJPH.2020.305716