When opioid addicts count their losses, the numbers seem simple: One marriage. Two jobs. Custody of three children.
But when you measure the effects prescription drug dependence has on business, the math gets murkier.
You could start by multiplying daily wages by the number of times an addict calls in sick.
But how can you gauge what’s lost when an employee reports to work but cleans five fewer hotel rooms, makes 10 fewer sales calls or stocks 15 fewer shelves than normal?
Some researchers have tried, estimating lost productivity at $229 billion to $335 billion a year, according to the Indiana attorney general’s office. Those same studies found addicts are 33 percent less productive and 10 times more likely to miss work.
Liability is another issue.
An addict on an assembly line might neglect to tighten vital bolts. An addict in the operating room might administer too much anesthesia. And an addict driving a semi might trigger traffic fatalities.
Addicted workers are responsible for 40 percent of all industrial fatalities and are five times more likely to injure themselves or others on the job, according to data from the Indiana attorney general’s office.
Despite those serious liability and productivity issues, many employers aren’t in a hurry to fire workers addicted to opioids.
It’s typically less expensive, they say, to help an experienced employee get clean than to get a new hire up to speed.
A bigger problem
Last year, the National Safety Council and the Indiana attorney general’s Rx Drug Abuse Task Force surveyed Indiana employers with 50 or more workers about addicted employees. They were unable to say last week how many such firms are in the state.
Of the 201 respondents, 174 companies drug test workers. It’s unclear whether testing is done only before employment or is ongoing throughout employment.
Even those employers that routinely drug test might not be able to catch addiction, however.
Different workplaces test for different substances. Although 91 percent who conduct tests check for opiates – including heroin, codeine and morphine – only 52 percent test for synthetic opioids – including oxycodone, hydrocodone, dilaudid and fentanyl.
Looking at all the respondents, 80 percent reported observing a drug-related issue with at least one employee.
In fact, 64 percent said they believe prescription drug abuse is a bigger workplace problem than illegal drug use.
But that belief isn’t necessarily shared by their workers, especially those who’ve had surgery or suffered serious injury. Abuse is commonly defined as using a prescription painkiller daily for 90 days or more.
Gayle Goodrich, a former union official, thinks some people are naive about the dangers of dependence on painkillers.
"It’s the kind of thing that flies under the radar, unfortunately," said Goodrich, who was an engineer at Navistar International Corp. and handled pension and insurance benefits for United Auto Workers Local 2911. "People think: A doctor prescribed this, so it’s OK."
Even some doctors might underestimate the danger of prescription drug addiction, according to Dr. Vivek H. Murthy, U.S. surgeon general.
In a letter to the medical profession last month, Murthy said, "Many of us were even taught incorrectly that opioids are not addictive when prescribed for legitimate pain."
Healthentic, a health analytics company in Seattle, reports that 4.9 million people nationwide admitted to using prescription opioids for nonmedical use in 2012.
The American Society of Addiction Medicine describes addiction as being characterized by "an inability to consistently abstain from use, impairment in behavioral control, a craving for drugs, diminished recognition of significant problems with one’s behaviors and personal relationships and dysfunctional emotional response to situations."
Saving a life
Many companies offer employee assistance programs, also called EAPs, to help workers address addiction, anxiety and other issues.
Mike Bynum is a former EAP coordinator for Dana Inc. He worked with United Steelworkers Local 903 members for nine years.
Some addicted workers came to him on their own and others were referred after a disciplinary issue. Sometimes, people didn’t think they needed help, that they could handle the problem on their own, he said.
Bynum, who is now labor liaison to the United Way of Allen County, referred addicted workers to a counseling program, either locally or elsewhere in the state.
Those who continued to work while seeking outpatient treatment met with Bynum or another EAP coordinator until they got a handle on the situation, he said.
He estimated that he worked with about a dozen workers with prescription addiction issues.
Bynum had two priorities when dealing with workers. No. 1, he wanted to save a life, and No. 2, he wanted to save the person’s job.
He believes the program was successful because seeing the EAP coordinators was convenient. One was available on each of Dana’s three production shifts.
"I appreciated being in that position," Bynum said, "of being able to help co-workers save their life."
A little wobbly
Guiding workers to addiction counseling can fall on a company’s human resources professionals.
How they approach that task depends largely on company policies, according to Edward Yost of the Society for Human Resource Management, a professional association in Alexandria, Virginia.
According to last year’s survey of large Indiana employers, 48 percent of participants require employees to notify supervisors of prescription drug use.
Yost said that’s the time when a worker could ask to have his job duties adjusted if, for example, a prescription cautions patients not to operate heavy machinery.
"Supervisors need to accommodate such requests, which help protect both the employee and the company," Yost said.
But if a worker hasn’t given HR a heads-up, there could be serious consequences if his supervisor suspects drug use, Yost said.
The fallout could affect the worker and the company.
"If the employer is aware of an employee’s drug addiction but does nothing, the company can be held legally liable for property damage and personal injuries," Yost said.
The safety implications are especially troubling when it comes to public safety professions such as air traffic control, he said.
Responsive employers will address situations quickly, but the survey showed 65 percent of supervisors didn’t feel confident they could spot warning signs of prescription drug dependence. Taking note of questionable behavior, though, is important.
"Supervisors need to document dangerous practices," Yost said.
"You have to do the legwork. You have to follow up. You have to document everything," he added. "(Addicted workers) could have questionable judgment because they’re tired or just a little wobbly."
Getting an employee into a rehab program is typically the smart move, Yost said. Studies show that each dollar spent on employee assistance programs yields $1.49 to $13 in benefits, he said.
"How do you beat that (return on investment)?" Yost asked. "The sheer dollars and cents of it tells you it’s cheaper to keep somebody than to hire somebody."