Opioid Abuse Takes A Toll On Workers And Their Employers

Jan 20, 2016
Originally published on January 20, 2016 1:50 pm

Three decades ago, the treatment Michele Zumwalt received for severe headaches involved a shot of the opioid Demerol. Very quickly, Zumwalt says, she would get headaches if she didn't get her shot. Then she began having seizures, and her doctor considered stopping the medication.

"I didn't know I was addicted, but I just knew that it was like you were going to ask me to live in a world without oxygen," she says. "It was that scary."

Zumwalt didn't cut back. In fact, over two decades, the Sacramento, Calif., resident got an ever-increasing number of opioid prescriptions — all while working in corporate sales.

"I could show up at Xerox and put on a presentation, and I was high on Percodan," she recalls. "I mean, fully out of it. I don't know how many I had taken, but so many that I don't remember the presentation. And do you know that people didn't know?"

Her addiction worsened, eventually forcing her to take medical leave. Now sober for a dozen years, Zumwalt wrote a book about recovery called Ruby Shoes.

Her story highlights, among other things, the many challenges employers face in dealing with prescription drug abuse.

According to one study, prescription opioid abuse alone cost employers more than $25 billion in 2007. Other studies show people with addictions are far more likely to be sick or absent, or to use workers' compensation benefits.

When it comes to workers' comp, opioids are frequently prescribed when pain relievers are called for. How often doctors choose opioids varies by state; an analysis found the highest rates in Arkansas and Louisiana.

"The more professional stature you have, the less likely you are going to be forced into recovery, and the longer your addiction is likely to go on unchecked," says Patrick Krill, who directs a treatment program at the Hazelden Betty Ford Foundation that focuses on lawyers and judges. The legal profession has twice the addiction rate of the normal population, he says.

In December, the advocacy group National Safety Council released a survey showing 4 of 5 employers in Indiana said they've confronted painkiller abuse in the workplace.

"Many times they're showing up late to work because they can't find pills," says Dr. Don Teater, medical adviser for the council. "They're starting to have withdrawal symptoms. They know they can't work." He went from family physician in Clyde, N.C., to addiction specialist after seeing prescription opioids and heroin rip through his rural community.

Three-quarters of his patients have lost their jobs. Some manage to hide prescription drug abuse for years, he says, but it does affect brain function and productivity.

"They're not as sharp. They're not thinking as quickly," he says. "For people working in safety-sensitive positions, you know, driving the forklift or something, their reactions might not be as fast."

One of the biggest problems, Teater says, is that many employers aren't testing for prescription opioids.

"I'll be talking to 50 or 60 HR people, and I'll say, 'How many of you test for oxycodone?' And a third of the hands will go up maybe. And oftentimes I'll say, 'How many don't even know what you're testing for?' And a number of hands will go up."

According to Quest Diagnostics, a testing firm, only 13 percent of the roughly 6.5 million workplace drug tests screen for prescription painkillers.

Even federal government workers in public safety positions who are required to undergo periodic drug testing aren't currently tested for prescription opioids.

"Within federal agencies we don't test, so we can't see exactly what the positivity rate would be in prescription drugs," says Ron Flegel, director of workplace programs for the Substance Abuse and Mental Health Services Administration. "But we know from the private employers the percentage is quite high as far as people that are testing positive."

Flegel says in coming months, new rules will include prescription painkillers in federal drug testing.

Meanwhile, the tables have turned for Michele Zumwalt, the recovering addict. She now helps manage her husband's construction firm. "Through the years, we've seen lots of people with addictions," she says. "We can almost recognize it, you know, as employers."

They urge the workers to get into rehab, she says, and hope they turn around.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

And in his State of the Union address, President Obama made America's opioid epidemic a national priority. Republican presidential hopefuls Carly Fiorina and Jeb Bush have talked in personal terms about their own children's drug problems, and it isn't just an issue for families. As NPR's Yuki Noguchi reports, it's also creating costs and challenges in the workplace.

YUKI NOGUCHI, BYLINE: Three decades ago, the treatment Michele Zumwalt received for severe headaches involved a shot of the opioid Demerol. Very quickly, Zumwalt says, she would get headaches if she didn't get her shot. Then she began having seizures, and her doctor considered stopping the medication.

MICHELE ZUMWALT: I didn't know I was addicted, but I just knew that it was like you were going to ask me to live in a world without oxygen. It was that scary.

NOGUCHI: Zumwalt did not cut back. In fact, over two decades, the Sacramento resident got an ever-increasing number of opioid prescriptions, all while working in corporate sales.

ZUMWALT: I could show up at Xerox and put on a presentation, and I was high on Percodan - I mean, fully out of it. I don't know how many I had taken, but so many that I barely remember the presentation. And do you know that people didn't know?

NOGUCHI: Her addiction worsened, eventually forcing her on medical leave. Now sober a dozen years, Zumwalt wrote a book about recovery called "Ruby Shoes." Her story highlights, among other things, the many challenges employers face in dealing with prescription drug abuse. According to one study, prescription opioid abuse alone cost employers more than $25 billion in 2007. Other studies show people with addictions are far more likely to be sick, absent or use workman's comp benefits. Patrick Krill directs a treatment program at the Hazelden Betty Ford Foundation that targets lawyers and judges, a profession he says has twice the addiction rate of the general population.

PATRICK KRILL: The more of a professional stature you have, the less likely you are going to be forced into recovery and, you know, the longer your addiction is probably going to go on unchecked.

NOGUCHI: He says most patients come because work forces them to, but sometimes the job is also a hindrance. Last month, the advocacy group National Safety Council released a survey showing 4 out of 5 employers in Indiana said they've confronted painkiller abuse in the workplace.

DON TEATER: Many times they're showing up to work late if they can't find their pills because they're starting to have withdrawal symptoms. They know they can't work.

NOGUCHI: That is Don Teater, medical adviser for the council. He went from family physician in Clyde, N.C., to addiction specialist after seeing prescription opioids and heroine rip through his rural community. Three-quarters of his patients have lost their jobs. Some managed to hide prescription drug abuse for years, he says. But it does affect brain function and productivity.

TEATER: You know, they're just not as sharp. They're not thinking as quickly. For people that are working in safety-sensitive positions - you know, driving forklifts or something - their reactions might not be quite as fast.

NOGUCHI: One of the biggest problems, Teater says, is that many employers aren't even testing for prescription opioids.

TEATER: You know, I'll be talking to 50 or 60 HR people, and I'll say, how many of you test for oxycodone? And, you know, a third of the hands will go up, maybe. And, you know, oftentimes I'll say, how many of you don't even know what you're testing for? And a number of hands will go up.

NOGUCHI: According to Quest Diagnostics, only 13 percent of the roughly six-and-a-half million workplace drug tests screen for prescription painkillers. Even federal government workers in public safety positions who are required to undergo periodic drug testing are not currently tested for prescription opioids. Ron Flegel is director of workplace programs for the Substance Abuse and Mental Health Services Administration.

RON FLEGEL: Within federal agencies we don't test, so we can't see exactly what the positivity rate would be in prescription drugs. But we know from the private employers the percentage is quite high as far as people that are testing positive.

NOGUCHI: Flegel says, in coming months, new rules will include prescription painkillers in federal drug testing. Meanwhile, tables have turned for Michele Zumwalt, the recovering addict. She now helps manage her husband's construction firm.

ZUMWALT: Through the years we've seen, you know, lots of people with addiction. We can almost recognize it in the workplace now, you know, as employers.

NOGUCHI: They urge them to get into rehab, she says, and hope they turn around. Yuki Noguchi, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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