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OPINION: Helping employees avoid substance abuse

Bruce Morton is a senior loss control consultant at the Milwaukee office of Marsh & McLennan Agency. He can be reached at

Bruce Morton is a senior loss control consultant at the Milwaukee office of Marsh & McLennan Agency. He can be reached at [email protected].

I know a safety professional at a construction company who found a small, plastic bag with white powder on a work site. What’s the right thing to do with something like that? More importantly, what can managers do to help employees avoid substance abuse that threatens their safety and health – both at work and at home?

We know that substance abuse is a serious concern in the construction industry, which has some of the highest rates of substance abuse among all industries. This is especially troubling for our industry, in which workers are routinely operating machinery, using tools and spending time in work environments with high risk for accidents. Research indicates that substance abuse is associated with lost productivity, higher absenteeism, workplace accidents, staff turnover, increased costs and lower morale. Not only does this expose your employees to harm, but it can raise your costs as a business, cause delays in completing projects and affect your risk ratings. There are no simple answers, but there are four things that can help:

Front-line superintendents and crew leaders need to be trained on what to look for with substance abuse. Employers should provide instruction on opioids – including common brands, risk factors for opioid misuse, and reasons for opioid prescriptions. This should also discuss non-opioid pain-relief alternatives, signs of opioid disorder, ways to safely dispose of opioids, and ways to talk to family and friends about opioid use. Remember that follow-up training is equally important in that it can reduce the chance that someone takes an opioid in the first place and reduce the stigma of opioid use disorder.

Workplace policies help set expectations and boundaries for employees. Have clear, compassionate, drug-free workplace policies in place; when employees understand and follow policies designed to prevent unnecessary opioid use, their risk for misusing opioids or developing an opioid-use disorder decreases. Managers and supervisors are often the first to notice impairment or other signs of drug use. Train them on policies and procedures, and on recognizing impairment. Identifying and dealing with these situations early can prevent safety hazards and prevent opioid misuse or OUD from becoming worse.

Medical-leave policies should be flexible enough for employees to attend medical appointments and heal fully before returning to work after an injury. Overly restrictive policies can lead to employees taking prescribed opioids for longer than necessary or illegally obtaining opioids so they can return to work early – even if they are not ready. This may also lead to skipping medical appointments necessary for recovery from injury or their recovery from an OUD.

Workplace culture
One of the strongest prevention mechanisms an employer can provide is a supportive workplace =. This can lessen the effects of factors that put people more at risk for developing an opioid-use disorder. If employees feel supported and encouraged to seek help when needed, an early diagnosis can help prevent emerging substance-use disorders from progressing and becoming worse. Promote health and wellness in the workplace. Activities may include employee committees on health and wellness, health fairs and brown-bag lunches on health topics, and other activities promoting a healthy lifestyle.

Hold stress to a minimum in the workplace; encourage self-care, and support from managers and supervisors when employees complain of stress. Promote ergonomic and overexertion initiatives and follow best practices to reduce injury risk in the workplace. Support recovery in the workplace and serve no alcohol at work-sponsored events.

Benefits and health care plans
Benefits and health care plans can provide preventative services as well as treatment. All services provided should be confidential and easy to use. Ensure health care plans cover mental and behavioral health services, and encourage annual screenings for substance-use disorders. Ensure the coverage of alternative pain management treatments including non-opioid drugs, acupuncture, chiropractic, physical and occupational therapy. Add a program that helps manage the prescribing of opioids and prescription opioid use – many pharmacy benefit management programs now offer opioid-specific services.

Also, provide or increase access to employee assistance programs. EAPs provide help to employees and their loved ones who are working through an opioid use disorder. Easy access to support and medical care can prevent early stages of a substance-use disorder from becoming more serious.

About that bag. What this safety professional did, after talking it over with others at the company, was to flush the contents of the bag down the toilet. This is not recommended. My acquaintancs in law enforcement, on hearing about what the contents of the bag looked like, tell me it very likely contained fentanyl. Even a tiny amount of this could induce a fatal reaction. Much better would be to call law enforcement and let them take care of it. Needless to say, the person who found the bag and touched it with bare hands was quite concerned, and for good reason.

But finding the bag served as an early warning that employees were at risk and in need.

Fentanyl is a synthetic opioid considered to be up to 50 times more potent than heroin, and was involved in 80% of the of the 140 overdose deaths among construction, maintenance and natural resources workers in Rhode Island. It also was linked to 75% of the overall drug overdose deaths. The construction industry needs to be more vigilant about drugs on our sites and the use of them by our workers. Effective policies, supportive workplaces, and appropriate employee benefits and health care plans are four ways employers can help.

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