Written by Sally Spencer-Thomas
What is the most concerning substance abuse trend facing workplaces today? Is it meth? Heroin? Cocaine? When we look at who is showing up in our emergency rooms after overdosing and who is showing up at addiction treatment centers, the drugs that are affecting the working aged population most are the drugs we usually get with a prescription.
What is prescription drug abuse? Prescription drug abuse is the non-medical use of prescription medications. Prescription medications are only safe for the prescribed patient, for the prescribed reason, for a prescribed time. After they have been used for their intended purpose, they should be safely discarded, and yet many stockpile and share these potentially deadly and addicting medications, leaving them readily accessible for abusive purposes.
For example, OxyContin, which is essentially the same drug as heroin, is often prescribed for pain relief after major surgery. This toxicity of this medication is perceived quite differently when it comes in a prescription pill bottle from the medicine cabinet, and yet the body doesn’t know the difference between this pill and its illicit cousin heroin. The common perception is that these prescription drugs are safe because they come from a doctor rather than off the street. Yet, the consequences of abuse can be just as deadly. When we look at national overdose deaths, we find that prescription drug abuse deaths are:[1]
· Four to five times higher than those of black tar heroin in the 1970s
· Twice as high as the peak years of crack cocaine in the 1990s
More people are dying each year from prescription drug overdoses than from heroin and cocaine overdoses combined. In 2005 there were 22,400 prescription drug overdose deaths in the United States versus 17,000 homicides.
The alarming trend in prescription drug abuse poses a dilemma for doctors. Chronic and severe pain is often best managed with narcotic based medicine until the source of the pain has healed. Very often drug-seeking patients will show up at their primary care clinic complaining of dental or injury pain and will claim they “just need something to get them through the weekend.” Since pain is so subjective, prescribing healthcare providers are often unsure about how to handle such situations and may err on the side of relieving the symptoms the best way they know how.
Sometimes workers who had legitimate pain medication prescriptions find themselves hooked and will “doctor shop” to get additional refills to support their addiction. Other overwhelmed overachievers may turn to prescription drugs for an edge in our highly competitive society. It is not uncommon for Mom or Dad to sneak stimulant pills prescribed for their teen’s Attention Deficit Disorder so that the parent can work longer hours.
The impact of prescription drug abuse on the workplace is evident. Because these pills are usually paid for through insurance, the healthcare costs for workplaces are affected when the drugs are being abused. Performance is impacted when workers are operating under the influence of narcotics, but unlike the abuse of other substances, prescription drug abuse often leaves little evidence: no smell, no paraphernalia, and no visible marks on the skin. Workers can abuse the drugs right at their desks without others noticing.
With all these pills around, the opportunities for intentional and unintentional overdoses increase significantly. Emergency room monitoring shows an upward trend of people experiencing medical crises from these effects.[1] Given these health risks and workplace implications what can employers do?
Like other health issues, the best intervention is early detection. Thus, workplaces can raise awareness by educating employees about the dangers of prescription drug abuse and offer screening to identify those at risk for abuse. Workplaces can help promote events like the Colorado Department of Public Health’s “Take Back” challenges where people can bring in unused prescription medications and dispose of them safely. When writing policies regarding substance abuse, prescription drug abuse should be included. Whatever the approach, workplaces that acknowledge the potential risks of prescription drug abuse will be better able to proactively work to reduce its impact.
Acknowledgement
I would like to thank Beverly Gmerek from Peer Assistance for her leadership in the area of prescription drug abuse prevention and for the information presented at the May 14th, 2010 Colorado EAPA meeting which was used for the basis of this article.
About the Author
As a psychologist and the survivor of her brother’s suicide, Dr. Sally Spencer-Thomas addresses the issue of suicide prevention, intervention and postvention from many angles. Currently she is the Executive Director for the Carson J Spencer Foundation (www.CarsonJSpencer.org), a Colorado-based (USA) nonprofit that is dedicated to “sustaining a passion for life” through suicide prevention, social enterprise and support for emerging leaders.” In 2009, the Carson J Spencer Foundation launched the Working Minds Program (www.WorkingMinds.org), a comprehensive suicide prevention initiative for workplaces. As a professional speaker, she frequently presents keynotes and trainings for workplaces, campuses, and conferences around the world. In addition, she is the Executive Secretary for the National Action Alliance for Suicide Prevention, the public-private partnership advancing the Surgeon General’s National Strategy for Suicide Prevention. Finally, she is the Division Chair for Survivors of Suicide Loss for the American Association of Suicidology.
[1] Gmerek, Beverly (2010, May 14). Prescription Drug Abuse. Presentation at the Colorado EAP Meeting. Denver, Colorado
[2] Gmerek, Beverly (2010, May 14). Prescription Drug Abuse. Presentation at the Colorado EAP Meeting. Denver, Colorado
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