The National Center for Health Statistics (NCHS) has reported that opioids – prescription, heroin and fentanyl – killed more than 47,600 people in 2017, more than any year on record. Of those overdose deaths, 37% were the result of prescription opioids, clearly indicating that the United States is in the midst of an opioid-related overdose epidemic.
Opioid Addiction in America’s Workforce
Numbers from the Center for Disease Control (CDC) paint an even gloomier picture of the opioid crisis in the United States. In 2017, 95% of the 70,067 U.S. drug overdose deaths occurred among the working age population – those 15-64 years old. According to the National Survey of Drug Use and Health (NSDUSH), an estimated 4.3% of respondents age 18 years or older reported illicit opioid use in the past year, while an estimated 66.7% of these self-reported illicit opioid users were employed full or part-time.
Employers can also expect that workers with a current substance abuse disorder will miss on average 14.8 days per year. Those with a pain medication use disorder miss on average 29 days per year. This is in contrast to the average worker who may miss 10.5 days, or the 9.5 days missed by workers in recovery from a substance disorder.
What is also worrisome is that despite the fact that there are dangers associated with opioids and how easily people can become dependent or even addicted to the drugs; they are still being prescribed in overwhelming numbers. In 2016, 44% of all workers’ compensation claims with prescriptions had a least one prescription for opioids, based on data from 40 states.
The good news is that this figure has declined from 55% since 2012.
When Should Opioids Be Prescribed?
The question is when is opioid use necessary, and should it be something to be avoided?
“Addiction to prescription opioids can happen quickly to some individuals, which in turn can affect job performance,” warned Dr. Richard D. Blondell, MD, professor and vice chair for addiction medicine at the Department of Family Medicine at the University at Buffalo.
One problem with opioids is that currently there is no comprehensive strategic plan in the United States to address the epidemic, which would include offering alternatives to opioids as a first line therapy for mild to moderate pain, Blondell told ClearanceJobs.
“These drugs have the potential for addiction, and as such they should not be used unless necessary – and if they are used, patients should be monitored carefully,” added Blondell.
Opioids and Your Security Clearance
This should be especially true when the issue of security clearance is considered.
“It would definitely be a concern to me, even if a clearance is not involved, because of the potential for addiction,” Mark S. Zaid, founding Partner of Mark S. Zaid, PC., told ClearanceJobs.
However, despite those concerns, this may not be something that a legitimate user of opioid pain killer would need to disclose.
“(It is) nothing that needs to be affirmatively reported if the medication is legally prescribed and being taken according to the terms of the prescription,” added Zaid.
“As long as you are using the prescription the way it is supposed to be used, it doesn’t need to be reported,” added Greg T. Rinckey, founding partner of the D.C.-based Tully Rinckey Law Firm.
“However, if the prescription lapses and a year later you still have pills and pop one when you injure your back, that is another matter,” Rinckey told ClearanceJobs. “People who are using old medicine can have a problem, but that can be mitigated by explaining the situation. In a clearance review that could result in a deeper look into other conduct issues, such as if you were often late for work, or the work was suffering. If it was a one-time thing, chances are it might not be an issue.”
Another problem can occur when a spouse or friend gives someone a “pain pill” that turns out to be an opioid, but Rinckey said that can be mitigated too.
“It could be an honest mistake, and a hair test can show that you’re not a chronic user,” he explained. “Most opioid abusers tend to be chronic users as they use it consistently. So a ‘my wife gave me a pill and I didn’t realize it was an opioid’ can be proven in a hair test, as a urine test only shows recent drug use while the hair test shows long term usage. The biggest issue is that people continue to use the pills after a prescription, but if the VA or a doctor is prescribing it for legitimate issues, that isn’t an issue.”
Yet for the reasons laid out, opioids are best avoided unless the pain is so intense that other alternatives don’t work. In other words it should be the last option considered.
“It’s bad in terms of overdose deaths and requirements for addiction treatment — the over-prescription and the over-production of opioids,” explained Blondell.