It’s more common than you may think, according to a new study by the Integrated Benefits Institute released today that finds one-third of the U.S. workforce uses prescription pain medications.
When it comes to addressing the opioids epidemic, the implications for employers often center on the risk of on-the-job accidents or difficulties in filling job vacancies in areas heavily affected by addiction and dependence. But according to the IBI study, “this may not only underrepresent the more pervasive productivity impact of lost work time, but also obscures the larger issues of chronic pain and substance use more generally.”
The IBI study is based on data from the National Survey on Drug Use and Health, a cross-sectional survey of U.S. households that provides national estimates for the use of drugs, alcohol and tobacco among the civilian population of at least 12 years of age. The study used data from the years 2015, 2016 and 2017, which include information about the appropriate use (i.e., prescribed) of pain relievers, as well as the problematic use (i.e., abuse and dependence).
Among the other data points uncovered in the IBI study:
- Rates of alcohol abuse and dependence exceed the problematic use of pain relievers and other prescription medications. Any reported use of cocaine or methamphetamine was relatively uncommon (< 3% and < 1%, respectively).
- Excess absences associated with pain relievers were greater than excess absences associated with any other substance. On average, non-problematic use of pain relievers was associated with 0.8 days of excess absences per month compared with non-users. The problematic use of pain relievers was associated with 2.0 absences, or 1.2 excess days per month compared with non-users.
- Generally, excess absences associated with problematic use of substances are significantly greater than for non-problematic use.
- Assuming a 20-day work month, the use of pain relievers was associated with a loss of about 1.3% of the monthly labor capacity of 1,000 workers. The non-problematic use of pain relievers accounts for nearly all (96%) of those losses.
So what can employers glean from this information?
“The biggest takeaway,” says Brian Gifford, director of research and analytics at the Integrated Benefits Institute, “is that when we look at usage of pain relievers and other opioids, the vast majority of it is by prescription for someone with an injury, surgery or chronic pain. So if we are going to look at the opioids epidemic, then we have to understand it within a larger context, and that is there are a lot of pain medications being prescribed to the workforce.”
(Gifford will be moderating a panel session titled “Treating the Opioid Crisis: Workplace Challenges and Remedies” at the upcoming Health and Benefits Leadership Conference.)
Gifford says both he and researcher Erin L. Peterson were surprised by the “magnitude” of the number of Americans battling various forms of pain.
“We understood there’d be quite a bit of people experiencing pain in the workforce,” he says, “but when we came up with the finding that one in three workers are using pain medications, at a gut level, that seems like a large amount. … There are a lot of people who are being managed for pain in the workforce.”
Implications for productivity
Generally speaking, Gifford says, for almost every substance, “when we see people develop dependence, our findings are that, in all those cases, people are going to have more sick-day absences than those who are using pain medications non-problematically.”
And those sick days can add up and drag down a company’s bottom line, which Gifford says should help drive home an important message to American employers.
“If employers are thinking the opioid crisis is a tragedy but it’s not an issue for them,” Gifford says, “I think these findings perhaps take away an excuse to not pay attention to it. It’s happening in your workforce and, in any case, even when people are using their prescriptions appropriately, there’s a business consequence to that.”
The study includes five points of guidance for employers, including using confidential health-risk assessments to identify employee issues and medications with potential for abuse. “Ensure that covered topics include such health risks as alcohol, tobacco and illicit drug use but also the prevalence of painful conditions for which opioids may be prescribed. Given the sensitive nature of this information, it may be necessary to partner with third-party organizations.”
According to Gifford, “the most important thing for employers here is that they have a really comprehensive and integrative substance-abuse approach” that accounts for different forms of substance abuse (i.e. alcoholism, drug addiction).
“Because when, unfortunately, the next substance-abuse crisis comes around,” he says, “they won’t have to start from scratch.”