Opioid Misuse in Construction: Identifying Risk and Managing Impact

Opioid misuse in construction: Identifying risk and managing impact

Opioid misuse and prescription drug addiction have reached epidemic proportions nationwide. According to the latest estimates from the Centers for Disease Control and Prevention (CDC), nearly 49,000 Americans died from opioid overdoses in 2017. This number represents a 13 percent increase from the year before, with overdose deaths involving synthetic opioids rising sharply from 14,400 in July 2016 to 28,600 in December 2017.

At the same time, seven in 10 companies now report being directly impacted by prescription drug misuse. And for the construction industry specifically, evidence shows that the risks are even more significant. For example, employees in construction have a 60% higher rate of substance use disorders than the national average (15 percent vs. 9.4 percent).

Employees in construction have a of 60% higher rate of substance use disorders than the national average.

The risk factors for opioid misuse in construction

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

  • The field is male-dominated, and data shows that 67 percent of workers who have substance use disorders are men, and of those, 61 percent misuse pain medication.
  • The physically demanding nature of construction work can lead to more wear-and-tear issues, increasing the likelihood of aches and pains – and in turn, pain relievers.
  • The incidence rate of nonfatal injuries and illnesses is greater in construction compared to most industries — 3.2 cases per 100 full-time equivalent (FTE) workers versus 2.9 cases per 100 FTE workers for all private employers — which may lead to prescribed opioids to treat associated pain.

The high costs of opioid misuse

Because of all of these factors, construction workers are potentially more at risk for opioid misuse.

In addition to taking a devastating personal toll on individuals and families, opioid misuse also negatively impacts businesses. Lost time, decreased job performance, on-the-job drug use, and poor morale are among many effects of prescription drug use experienced by employers, found a National Safety Council (NSC) report. According to the report, almost 47 percent of all companies have experienced absenteeism or missed work, while 26 percent have experienced an injury (or injury near-miss), overdose, or arrest.

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 $433,700 per year in Massachusetts, $401,000 in Oklahoma, and $390,000 in Texas.

As the scope of the problem in the construction industry finally begins to be measured, there’s increasing evidence that opioid-related deaths are also rising. Case in point: nearly 1,000 construction workers across seven Midwestern states suffered fatal opioid-related overdoses in 2015, according to estimates in a 2018 report by the Midwest Economic Policy Institute.

The role of workplace safety in mitigating injuries

As the rate of injuries and illnesses is greater in the construction industry than in others, it makes sense that by promoting safe work practices, construction companies can help reduce the risk of accidents, employee injuries, and related workers compensation claims—some of which may include prescription pain medications like opioids as part of their treatment plans.

A commitment to safety from top management and input from front-line are critical to developing truly successful safety programs.

-Michael Mills, Technical Director, Liberty Mutual Insurance’s construction unit

Components of workplace safety programs may include daily, supervisor-led, pre-task analyses that outline methods for performing the day’s work, says Mills. Contractors, subcontractors, and project owners should also partner with their insurance brokers and carriers to develop strategic plans for improving safety and reducing opioid misuse by:

  • Establishing senior management’s commitment to safety as a core company principal that is never put aside for budgetary or deadline reasons.
  • Engaging front-line employees in developing and managing programs to address opioid addiction.

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 and, if necessary, imposing fines for those that don’t.

A strong workers compensation claims framework can help manage opioid use

When an injury occurs, managing the impact of opioids also requires delivering the right care for each case, says Dr. Craig Ross, Regional Medical Director for Liberty Mutual.

“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 reduce the risks from overmedication or other non-evidence 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.

Proactive steps to help manage opioids and protect your company

Opioid Misuse in Construction: Identifying Risk and Managing Impact 1

Construction companies can play a key role in efforts to manage opioid abuse and addiction. Consider that each construction worker with an untreated substance abuse disorder costs an average of $6,800 per year in excess healthcare expenses, absenteeism, and turnover costs. But when a construction worker recovers from substance abuse, contractors can save nearly $2,400 per year.

When a construction worker recovers from substance abuse, contractors save nearly $2,400 per year.

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. Recently, the CDC also released resources for workplaces that are considering implementing naloxone programs to reverse opioid overdoses.

By taking these actions, companies can help reduce the risks of opioid dependence, prolonged disability, and higher workers compensation costs.  

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.

This website is general in nature, and is provided as a courtesy to you. Information is accurate to the best of Liberty Mutual’s knowledge, but companies and individuals should not rely on it to prevent and mitigate all risks as an explanation of coverage or benefits under an insurance policy. Consult your professional advisor regarding your particular facts and circumstance. By citing external authorities or linking to other websites, Liberty Mutual is not endorsing them.