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Job-related pain (Part Two): The opioid crisis in construction

Prescription pain killers and the slippery slope toward abuse


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March 21, 2017 by John Bleasby

I continue a new series about body stress and strain in construction, how pain is being treated by medication and the associated risks, and preventive measures available to workers and employers.
Read Part One (Medical marijuana)
Read Part Three (Prevention is better than cure)

It’s not uncommon for a trades-person in construction to develop musculoskeletal pains anywhere from the neck down to the ankles. Dealing with this pain using prescription drugs is a relatively easy go-to solution for many in construction. In fact, according to a study released by international commercial insurance provider company CNA, spending on prescription pain killers is 5 to ten per cent higher in the construction industry than any other.

Accidents happen, as do the strains and injury caused by poor work habits on site. However, when drugs are used to mask the pain, there are issues that must be addressed in order to keep the workplace safe for everyone.

First of all, the worker must inform their employer regarding the use of these pain killers, whether it’s a prescription for something as relatively innocent as Tylenol with codeine or as potent as Vicodin, Percocet, or OxyContin.

Pain killer dependency is the industry’s dirty little secret
Correct dosages of these medicines will mask the pain and allow the worker to carry on. However, the slippery slope is the potential for abuse. In its publication, Canadian Model for Providing a Safe Workplace, the Construction Owners Association of Alberta spells out its recommendations regarding prescription drug use on site. “No worker shall misuse prescription or non-prescription drugs while at work. If a worker is taking a prescription or non-prescription drug for which there is a potential unsafe side effect, he or she has an obligation to report it to the supervisor.”

It’s a dirty little secret within the construction industry. Abuse and dependency are serious risks that both workers and their supervisors must consider. The CNA report noted earlier also suggests that although there may be no malicious intent on the part of workers to over-use their prescriptions, the risks increase when the prescription is complete and workers go back to work without the pain killers. . “Workers in the construction industry are especially at risk for prescription opioid abuse,” the study says. “It is estimated that 15.1 percent of construction workers across various specializations have engaged in illicit drug use, including both illegal and legal prescription drug.” This can include either sharing their prescriptions with others or finding alternate sources for the drugs.

Another study, this one from the Centers for Disease Control and Prevention in the U.S. examined the relationship between the number of days of someone’s first opioid prescription and their long-term use. It was scary; patients face a high risk of dependency in as few as four days of taking starting their prescription.

What steps should employers take?
What is problematic for employers is that they cannot act or discriminate against the correct use of prescribed drugs. Privacy is also an issue to consider. Yet so is the safety for everyone on the site. The CNA report suggests that while “used responsibly, opioids are potentially an effective tool to mask acute pain for the worker,” better education concerning responsible opioid use is critical.  In practice, an honor system of sorts needs to be established and understood, creating an atmosphere of openness and support so workers returning to work feel comfortable about speaking up and not being misunderstood.

In the case of abuse observed on the job, the action required is obvious. The Compensation Board of Alberta tells employers to “immediately send any employee home by taxi who reports to work under the influence of alcohol or drugs and notify Corporate Wellness… document any incidents of substance abuse, and  …investigate the violation and follow through with the appropriate discipline.”

Seeking a better solution at the root cause
In addressing this issue, GCA International, based in Whitinsville, MA, and a leading executive search firm with special attention to and appreciation for green building and sustainable design, quotes Liz Griggs, chief executive of Canterbury Healthcare, a San Francisco-based healthcare and workers’ compensation insurance company. “The construction industry has to really start looking at prevention programs,” Griggs says. “The benefits of having a prevention program in place far outweighs [the cost of] dealing with the back end of someone getting addicted to opioids.”

In other words, the smartest move of all would be to take steps to prevent accidents of course, but also to prevent the likelihood of injury through poor work-site habits and repetitive movements that twist or strain the body unnaturally. That’s next in my series.

Tomorrow….Part Three of this series: Preventative measures to reduce musculoskeletal injury 

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