Abstract
Keywords
Over the past few years, the United States has been experiencing a crisis of similar even of higher magnitude than the COVID-19 pandemic, the Opioid Crisis. From 1999 to 2021, almost 645,000 people died from prescription and illicit opioids (Centers for Disease Control and Prevention, 2024). In 2022, over 81,000 overdose deaths were due to opioids. This equates to 224 Americans dying every day from an opioid overdose, with an economic cost exceeding over 1 trillion dollars in 2017 (U.S. Department of Health and Human Services, 2024).
As a public health concern, the opioid crisis has spilled into the occupational health space with varying costs across industries (e.g., average per capita cost of $2,689 and $13,534 for workers with untreated substance use disorder in agriculture and communication industries, respectively) (U.S. Bureau of Labor Statistics, 2022). In 2022, two-thirds (30.1 million) of the 46 million Americans who experienced a substance use disorder were employed (Substance Abuse and Mental Health Services Administration, 2023). Since 2011, we’ve experienced a 619% increase in worker deaths due to unintentional overdose from nonmedical drug usage (National Safety Council, 2024). Drug overdose affects not only workers but also their family members, their community, as well as their co-workers and work organizations.
An effective national strategy to reduce opioid overdose deaths is to expand access, and availability of naloxone, including in the workplace (The United States Government, 2024). Naloxone is an opioid antagonist that reverses the respiratory depression associated with opioid overdose (Boyer, 2012; National Institutes of Health, 2022; Weaver et al., 2018). Naloxone has been used by medical personnel for over 40 years and was recently approved by the Food and Drug Administration in 2023 as an over-the-counter medication in the intranasal form of Narcan® or RiVive™ (FDA, 2023). Naloxone is an emergency medication similar to an Epi-Pen® and is available to reverse overdoses in the workplace.
Although the Occupational Safety and Health Administration (OSHA) has yet to develop a standard for providing naloxone in the workplace, there is a national push to utilize naloxone in the workplace as a lifesaving approach for struggling workers, preventing deaths (National Institute for Occupational Safety and Health, 2018). Occupational health nurses (OHNs) can use tools like the federally proposed Recovery-Ready Workplace Toolkit and collaborate with employers to establish first aid protocols, including naloxone administration training, personal protective equipment, and record-keeping (Federal Recovery-Ready Workplace Interagency Workgroup, 2023). OHNs can develop and implement risk assessment protocols and address stigma and concerns relating to recovery, return to work, workers’ mental health, and a workplace culture of support.
Although some employers may have concerns about the liability of providing this medication in their organization, the increasing number of workplace overdose-related deaths cannot be ignored. Having a clear plan and being prepared is the best way to address this issue head-on. OHNs are well-equipped to support employers to provide a safe and healthy working environment for workers struggling with drug abuse.
