Narcotic Painkillers - In the Workplace

Reviewing cases involving industrial accidents presents many interesting facts about the

workplaces we toil within, both construction & industrial. This information is gathered to a large degree from transcripts of testimonies from the injured and of interest is after the incident’ outcomes as it pertains to the treatment (medical) and the waiting disruption of the lives of injured workers.

I have always been amazed at the amount of narcotic pain medicine prescribed (loratab a favorite) to individuals with a past history of drug abuse. In several cases the worker sought out further treatment for addiction after on-going receipt of narcotic pain ‘killers’. It made me wonder why these physicians are prescribing these narcotics and what are the alternatives? The National Safety in its July 2014 edition of 'Safety & Health’ magazine reported on a study of prescription painkillers; “worker use of prescription painkillers; wide-spread, varies by state report”, authored by the Workers Compensation Research Institute released May 14, 2014. Upon review of 264,000 workers compensation cases and this 1.5 million Rx associated with them demonstrated some startling facts.

• On average 85% of injured workers in most states (25 states included in study), received narcotic painkillers.

• Typically the workers received 1800 milligrams of morphine equivalent narcotics per claim.

• Workers in N.Y and Louisiana received 3600 milligrams on average. This is equivalent to taking a 5 milligram Vicodan tablet ever 4 hours for 4 months.

You further have to ask yourself how much of these narcotics go beyond the injured worker to others for illicit use? We all know the problems occurring with Rx drugs getting into the hands of recreational drug abusers!These drugs are leaving Rx by physicians working under U.S. authorization and certainly their aim is pain reduction after an accident. But it seems clear that the physicians and the U.S. Systems of States must begin to reconsider this approach and seek improved treatment and alternative pain reduction treatment. Perhaps faster diagnosis and treatments authorized by the W.C. Systems would shorten the pain cycle experienced and get the resolution of the problem faster. Certainly, prevention of the accident in the first place would resolve the problem. Treatment modalities using narcotics as a last resort, not first reaction, would seem in order. Long term chronic cases should be sent to pain clinics for alternative treatment options. Any worker taking narcotic pain relievers would be suspect for return to work while taking the medication. Close review of a patients history of past drug abuse would certainly give pause to prescribing narcotics.

This is a serious situation requiring study and response...

Author: John P. Coniglio - PhD, CSP, CHMM, RPIH, CSC

Managing Director of OSEA (www.osea.com)

How do we make safety a priority?

You don’t!  Surprising response to this often asked question.  We've tried over the years.  Our humanist tendency compels us to set safety as the standard.  Yet, our “blind eye”, not an uncaring spirit puts it behind other workplace concerns.  Safety First!  Well, how has that worked?  While we do make continual improvements, those come from regulatory pressure, technological advancements and a clear change from a heavy industrial complex to a service driven economy.  Serious accidents still occur at an unacceptable rate, especially in what is left of industry and in construction.  We have also lagged in adjusting our thinking to prevention in the service sector with ergonomics being a prime concern.

What’s the answer?  Safety needs only to be a common thread mixed within all the other threads of the workplace.  Part of the common fabric of planning, decision making and expectation-at all levels!  Just an automatic part of what we plan and do.

Start with culture, quite frankly an over worked phrase!  But the truth is, it’s important and the very factor that separates average from exceptional.  Some companies have found the formula to achieve the common expectation of a safe work environment.  With our basic socialization within the workplace, hierarchy of position and leadership, it’s not surprising that as always is stated, it starts at the top!  Management sets the tone, the pace and the expectation.  Culture emanates from this simple fact.  Management sets the culture not the employee. To think passing this responsibility down the line to them is the answer only sets an improper expectation and the foundation for excuse.  Effective management does not work toward minimal compliance to regulations as an expectation; they espouse an, “Is It Safe” environment.  This equals the concern for profitability and quality.

Empowering employees to be part of this process gets them to be part of this process, gets them to work automatically in a safe manner and not just toward minimal compliance.

Profitability, quality and safety are then one fabric!

Author: John P. Coniglio - PhD, CSP, CHMM, RPIH, CSC

Managing Director of OSEA (www.osea.com)