Last updated : November 11, 2024
The use of heroin in the United States is at its highest level in over a decade. While the rate of heroin use by teens aged 12 – 17 has been steadily declining, use by young adults aged 18 – 25 has skyrocketed. It’s a worrying trend also being seen in the American workplace, where the number of employees testing positive for many opioids between 2002 and 2013 has nearly tripled. Most alarming is that studies indicate a direct correlation between legally accessible prescription painkillers and heroin addiction.
Doctors commonly prescribe opioids like hydrocodone, vicodin, and oxycodone as a way to treat the pain associated with injuries. In the case of the workplace, those prescriptions often come as the result of accidents suffered on the job. Opioids attach to receptors in the brain and block the pain centers, essentially tricking the body into not registering the impact of injuries. These drugs are sometimes called “heroin lite” due to their similarity to the street drug and the pattern of dependency associated with them. Opioids have some dangerous effects, such as being highly addictive, dangerous when combined with alcohol, and prone to causing slowed breathing that can result in accidental overdose.
Heroin use preceding the 1990s was characterized as a singular addiction. Users would lean on their addiction when it was available and go into withdrawal when it wasn’t. The heroin user of today typically relies on both universally illegal heroin and legally prescribed but illegally obtained prescription drugs to feed their dependency. Street level heroin may sometimes be cheaper, but the painkillers are more readily available, particularly if users have suffered chronic pain in the past and already have access. A report from the Centers For Disease Control and Prevention revealed that heroin deaths doubled from 2010 to 2012—following a federal crackdown on prescription drugs.
The correlation seems readily apparent, but perhaps the most alarming aspect of this new rise in heroin use involves the demographics. One might assume that the ready availability of prescription opioids has merely created a new outlet for existing addicts to feed their dependency, but sociologists and addiction researchers see opiates as a “gateway drug” to heroin. A significant portion of users are young professionals and suburban mothers. In this case, groups considered atypical targets for drug abuse are being exposed to highly addictive substances with which they might not otherwise come in contact. Doctors may well prescribe the drugs with the best intent, but their naturally addictive properties often lead to a down slide into addiction, and the general acceptance of prescription drugs as safe means the burgeoning dependency may be overlooked before it’s too late.
On-the-job injuries can put a rapid halt to promising futures, but the Americans with Disabilities Act largely limits the ability for employers to report the use of prescription drugs. In many cases, injuries caused on the job and a subsequent prescription were factors that led to addiction. Businesses may not have the support infrastructure in place to help their employees cope with their dependency. As performance declines and addicted employees run the risk of termination, the stigma of addiction may prevent them from finding the help they deserve, depression sets in, and the downward spiral continues.
The increased prevalence of opioids in the workplace has a discernible effect not just on the workers but on the business as well. The numbers indicate that opioid use has been a factor in higher accident rates, theft and absenteeism at many companies. As a result, a number of businesses are instituting zero tolerance policies and establishing assistance programs to help combat addiction, but again, state regulations may limit the ability to eliminate all risk. While painkiller use may not be permitted in industries using heavy machinery (for example) it can only catch users who can’t legally report a prescription or screen out users who attempt to use a prescription while at work. In types of work, the employee may be able to use for quite some time before a problem is revealed.
In the past, many saw heroin addiction as a problem best dealt with by criminal justice, but the recent rise in users—what the CDC calls an “epidemic”—may push it to the forefront of public health concerns. Recognizing the signs and raising awareness of addiction can help prevent dependencies before they develop. It may also be necessary to consider multidisciplinary approaches to pain treatment to provide sufferers of chronic pain with tools to cope without dependency. Employers may have to reconsider the design of employee assistance programs to include more attention to workplace accidents, as long as it fits in with the law.
