Nov. 15, 2016 5:30 a.m. ET
A handful of companies are trying strong medicine to limit employees’ use of prescription painkillers like OxyContin.
Engine-maker Cummins Inc. is one of the few large employers aggressively responding to opioid misuse in their ranks. After managers found evidence of drug activity in one of its plants in 2013, the Columbus, Ind., company now requires personnel to take drug tests for prescription painkillers and encourages employees to seek alternatives to their use.
According to federal data, nearly two million Americans are abusing prescription opioids, with sales of those prescriptions nearly quadrupling from 1999 to 2010.
Prescription opioid-related dependence and abuse cost the country an estimated $78.5 billion, according to new Centers for Disease Control and Prevention research based on 2013 data. Employers bear a large share of those costs; some $16.3 billion is lost due to reduced productivity and increased disability, and $14 billion is borne by private health insurers, according to the study.
Cummins says it is treading carefully, since most prescription painkillers are legally prescribed and most workers don’t end up abusing them. All the same, they can impair users’ judgment, leading to safety risks at work.
“We don’t want someone not to have access that something they could use to reduce their pain,” says Dexter Shurney, chief medical director at Cummins. “But we don’t want to encourage addiction and abuse.”
The 55,000-person company requires employees in some plants to attend training sessions on identifying and addressing drug activity and prescription-drug abuse. The company has also added opioids to its panel of drug tests for both new and current employees with cause, Dr. Shurney says.
Testing positive for prescription opioids isn’t necessarily a fireable offense at Cummins. After a positive test, the company steers workers to treatment if needed and reassigns them from safety-sensitive jobs.
Opioid abuse among workers comes largely at employers’ expense.
Nearly one in three opioid prescriptions covered by employer health plans is being abused, according to research conducted by health-care firm Castlight Health Inc. Opioid abusers cost employers $19,450 in average annual medical expenses, nearly twice as much as non-abusers.
Rex Butler, a safety and environmental manager at Central Iowa Power Cooperative in Des Moines considers it his mission to educate the utility’s 100 workers about the dangers of painkillers. A decade ago, Mr. Butler lost his younger brother Bill to overdose at age 33. Bill was first prescribed opioids for a back injury sustained at work and later became addicted.
“As long as workplace injuries occur, a possibility exists for employees to take a medication that kills 45 people every day,” says Mr. Butler.
“I just keep repeating the mantra, don’t get the prescriptions,” he says.
In Indiana, where Cummins is based, workplace opioid usage is high. Some 80% of Indiana employers said they have been affected by prescription drug misuse and abuse, facing issues like impaired performance, positive drug tests and employee arrests, according to a survey by the National Safety Council and the Indiana Attorney General’s Prescription Drug Abuse Prevention Task Force.
Only 52% of the employers surveyed said they conducted drug tests for synthetic opioids, which include many prescription painkillers.
The Castlight study found significant age, socioeconomic and geographic variation nationally when it comes to opioid abuse. Older baby-boomer employees are roughly four times more likely to abuse prescription painkillers than younger workers. Abusers were more likely to live in the rural South, and to live in areas with lower incomes than nonabusers.
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Cummins now teaches supervisors how to spot painkiller problems among employees and trains plant managers to stabilize and triage workers having an overdose, Dr. Shurney says. This summer, the company opened a new health center at its corporate headquarters, with services like massage, acupuncture, physical therapy and a full-time pharmacist, guiding workers to alternative pain treatments.
More firms are expected to take measures to curb opioid use. In 2017, about 30% of employers will implement restrictions on opioid prescriptions and 21% say they will add programs to manage prescription opioid use, such as requiring prescriptions to be filled at one pharmacy or adding case-management programs to keep watch over employees’ use of painkillers, according to a survey of 133 large companies by the nonprofit National Business Group on Health.
Cummins already is working with its pharmacy-benefits manager to flag opioid prescriptions, notifying physicians and pharmacists if patients appear to be pill shopping or receiving excessive dosage, Dr. Shurney says. (Cummins only sees aggregate, not individual, employee prescriptions.)
At Cummins, the number of opioids prescribed to employees under the company’s health plan has decreased by 3.9% between 2013 and 2015, the company says.
“We are in an area where that is not usually the case,” says Dr. Shurney. “That means we are winning the battle.”
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AP Photo/Evan Agostini, File
Tags: alternative pain treatments, Castlight Health Inc, Centers for Disease Control and Prevention, Cummins Inc., drug tests, impact of drugs on the American worker, opioid, opioid-related dependence, Opioids, OxyContin, painkillers, prescription drug abuse, prescription drugs, taking drugs at work