High Time

Everyone is talking about marijuana, as the recreational use of cannabis becomes legal in July. Even OHS Canada magazine is organizing a symposium on marijuana in the workplace on February 21 at the International Centre in Mississauga, Ontario to share best practices in addressing weed at work.

Among the key concerns surrounding the use of recreational marijuana are impairment, the administration of random-testing programs and litigation risks relating to privacy issues when enforcing fitness-for-duty policies. While these are valid concerns, the focus on marijuana has overshadowed a more prevalent problem plaguing Canadian society and workplaces alike: prescription-opioid addiction.

Like our neighbour south of the border, Canada — the second-largest per capita consumer of opioids in the world after the United States — faces a national opioid crisis. According to a Canadian Institute for Health Information (CIHI) report released last November, opioid prescriptions in Canada rose 6.8 per cent between 2012 and 2016. Although the quantity prescribed declined five per cent, strong opioids like oxycodone, hydromorphone, morphine and fentanyl — which make up 57 per cent of all opioids prescribed in 2016 — are being prescribed increasingly. Opioids were also responsible for more than 2,800 deaths in Canada in that year.

The prescription-opioid epidemic has a direct bearing on job safety. A conference I attended in Indianapolis last year cited job injuries as one of the main contributors to opioid addiction. Aside from the heightened risk of addiction and occupational accidents caused by impairment, especially those in safety-sensitive positions, opioid use also affects return-to-work. In 2015, McMaster University in Hamilton, Ontario published a study showing that disability claimants who are off work due to low back pain stay off longer if they are treated with opioids. A report on opioids in the workplace by the United States’ National Safety Council confirms this finding: prescription painkillers profoundly spikes workers’ compensation costs by increasing the length of worker disability and lost time.

From this perspective, the opioid crisis is more insidious and pressing than weed, considering that the people who are getting hooked on prescribed painkillers — obtained legitimately from doctors’ offices and pharmacies — are by and large good citizens who hold jobs and pay bills.

The opioid crisis is a woolly mammoth that must be tackled from all sides: creating strong workplace policies to ensure fitness for duty; raising awareness on the danger of prescription opioids; rethinking current pain-management strategies; shifting the emphasis from quick fixes to longer-term rehabilitative programs in workers’ compensation plans and extended healthcare benefits; elevating the need to monitor opioid use and prescribing patterns; and developing treatment programs for those who inadvertently become addicted. As well, regulators need to take a closer look at how pharmaceutical companies are pushing opioids into the marketplace and making it into the go-to treatment for pain.

Until we take the bull by its horns, it will be a while before this mammoth is encased in permafrost and relegated to the realm of history.

Jean Lian