Opioid misuse in construction: Identifying risk and managing impact

Opioid misuse and prescription drug addiction have reached epidemic proportions nationwide. Drug overdoses are now the leading cause of unintentional death in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 90,000 Americans died from drug overdoses in 2020—nearly a 30 percent increase from the year before, due in large part to the continued presence of more potent synthetic opioids on the market.

The opioid epidemic is wreaking havoc on businesses, as well, with studies showing that more than 70 percent of people with a substance abuse disorder are also employed. For the construction industry, specifically, the risk of opioid abuse among workers is high. Employees in construction are almost twice as likely to have a substance use disorder as compared to the national average (15 percent of construction workers vs. 8.6 percent of the general population).

What makes the construction business susceptible to prescription opioid addiction issues? Experts point to several factors that contribute to the risk:

In addition to taking a devastating personal toll on individuals and families, opioid misuse also negatively impacts companies. Lost time, decreased job performance, on-the-job drug use, and poor morale are among many effects of prescription drug misuse experienced by employers. According to recent data from the National Safety Council (NSC), employees with untreated substance use disorders can cost companies more than $14,000 per year in cumulative costs from turnover, absenteeism, and healthcare expenses.

Using an NSC calculator tool to estimate annual business loss paints an even clearer picture. A construction company with 1,000 workers, for example, can expect to lose $1.9 million in Massachusetts, $1.5 million in Oklahoma, and $1.2 million in Texas.

The construction industry has been especially impacted by the opioid crisis—and the pandemic has only exacerbated the challenges. Because the rate of injuries and illnesses is high in the construction industry, promoting safe work practices becomes even more critical for construction companies. Contractors, subcontractors, and project owners should partner with their insurance brokers and carriers to develop strategic plans for helping improve safety and reduce opioid misuse. Ideally, these plans include:

General contractors can also take the lead on making safety a priority by putting contracts in place that stipulate that trades adhere to their safety programs.

Sometimes accidents happen—but opioid addiction doesn’t have to be the outcome. “When an injury does occur, managing the impact of opioids requires delivering the right care for each case,” says Dr. Craig Ross, regional medical director for Liberty Mutual Insurance.  Although opioid dispensing rates continue to be very high, the national opioid dispensing rate fell to its lowest of 14 years in 2019.

“The focus should be on delivering the best possible long-term outcomes for injured workers and helping them recover and return to work,” he notes.

As part of Liberty Mutual’s workers compensation claims process, for example, nurse case managers serve as patient advocates for injured workers to promote better outcomes and to help reduce the risks from overmedication or other nonevidence-based treatments, Ross says. Other measures include conducting utilization reviews to determine if particular medical treatments are necessary and incorporating the CDC Guideline for Prescribing Opioids for Chronic Pain as part of the claims and pharmacy approval process. Liberty Mutual doctors and nurses frequently engage providers in peer-to-peer discussion to clarify treatment, including appropriate alternative options.

Construction companies can play a key role in efforts to manage opioid abuse and addiction. In a 2017 survey, employers reported that their workers in recovery programs have lower turnover rates, are less likely to be hospitalized or injured, and are less likely to miss workdays. By providing access to potentially life-saving treatment programs, construction companies not only support their workers and help address the public health crisis but could also reduce business expenses and improve their bottom line.

To help employees and protect your company, the NSC recommends several steps, including enacting strong company drug policies, expanding drug testing to include opioids, and training supervisors and employees to identify red flags for drug misuse. Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) provides a robust toolkit to help companies optimize their workplace policies and procedures and combat substance use. Recently, the CDC also released resources for workplaces that are considering implementing naloxone programs to reverse opioid overdoses.

Additionally, growing evidence suggests the efficacy of company-provided Employer Assistance Programs (EAPs). For employees experiencing mental health and substance abuse challenges, EAPs can provide valuable access to confidential counseling services at reduced or no costs.

Using case studies of nationally recognized clients, Magellan Healthcare reported that the majority of cases were resolved successfully using EAP services. The right employee assistance can translate into businesses savings and reduced risks, as well. According to a study by the Lancet, EAPs bring a return of $3-$10 for every dollar invested in the program.

By taking proactive actions, construction firms can help reduce the risks of opioid dependence, prolonged disability, and higher workers compensation costs while taking good care of their employees.  

Liberty Mutual is at the forefront of helping companies take practical steps to help manage opioid use in workers compensation claims. To learn more, see our article, How to manage opioids and medical marijuana in workers comp claims.