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Opioids: Addiction, Escalation and Overdose

Sometimes, workplace injuries require serious medical interventions, including the use of powerful prescription medications. Opioids, a class of prescription medications that are all derived from the same plant as heroin, are a particularly powerful—and particularly dangerous—class of prescription painkiller, and one that’s become especially prominent as a treatment for injured workers. In fact, according to the National Institute of Drug Abuse, the number of opioid prescriptions written has nearly tripled in the past three decades, and the trend shows no signs of slowing down.

In certain circumstances, opioids are a powerful tool that can ease a patient’s pain or aid in a speedy recovery from a traumatic injury. However, the risks associated with opioids—addiction, escalation to heroin or other drugs, and overdose—mean that employers need to remain vigilant about this pervasive, and potentially lethal, risk.

Dependence and Addiction
Patients who are prescribed opioids are often susceptible to dependence and addiction. Because the prolonged use of opioids results in a higher tolerance, the body’s endogenous opioids (which are opioids, like endorphins, that occur naturally in the body) become insufficient to stave off the physical symptoms of withdrawal.

Doctors are aware of and even expect many patients to develop a physical dependence if prescribed opioids for a prolonged period of time. Fortunately, doctors can account for this and create interventions that allow patients to break their dependence, usually by gradually lowering the dosage.

Unfortunately, physical dependence is often a precursor to addiction. Addiction occurs when a patient develops uncontrollable cravings for a drug and engages in risky or self-destructive behavior in order to acquire it. It’s worth noting that not all people who develop an addiction have a physical dependency on the drug, just as not all those who have a dependence on the drug will necessarily become addicted.

Heroin Use
One especially disturbing trend has been the rapid increase of both heroin use and heroin overdose. These increases coincide with the increased prevalence of opioid use and overdose in the United States. Though it is a disturbing trend, the correlation isn’t altogether surprising. Prescription opioids are chemically very similar to heroin, which is a naturally occurring drug derived from the opium poppy.

Two factors—the chemical similarity between heroin and prescription opioids and the increased availability of more potent forms of heroin flooding the country in recent years—have created an environment in which people see and use opioids and heroin interchangeably. When opioid users transition to heroin, either as a supplement to or as a cheap replacement for opioids, they then assume all of the risks associated with unregulated, illegal drugs. Unknown levels of purity can make it hard to ascertain the amount of heroin the body can tolerate, and additives used to “cut” the drug might themselves be lethal.

Overdose
Overdose is an especially complicated risk when it comes to opioids. Most overdoses are usually the result of a patient taking a combination of drugs that can depress the central nervous system and depress breathing, resulting in suffocation. Case law has been varied, depending on both the state and circumstances of overdose. In some cases though, employers may be required to pay workers’ compensation benefits to the survivors of workers who have overdosed on opioids prescribed to treat a job-related injury.

But, even in cases where other drugs aren’t in play, patients can and still do overdose. One of the side effects of opioid use is impaired judgment and confusion. It’s not uncommon for a patient to take a dose and find him- or herself taking an additional dose, having forgotten about the earlier dose.

3 Ways to Curb Opioid Abuse
Fortunately, there are measures that employers can take to decrease the abuse of opioids among employees. Some are preventive, while others are designed to identify and combat opioid abuse in employees. Taken together, they represent a robust, comprehensive strategy for keeping employees safe and free from substance abuse.

1. Educate Workers: The best way to combat drug use is to stop it before it starts, and the best way to prevent opioid abuse is through education. The good news is that a number of surveys show that patients are becoming more invested in their health care treatment plans and are looking for more information. Use that as an opportunity to educate your workers on the dangers of opioid use.
2. Speak with Health Care Providers: If your company partners with a clinic, make sure to talk to doctors about the danger of overprescribing opioids. Sometimes, when dealing with severe acute pain or chronic pain for which other interventions have failed, opioids might be an appropriate treatment. Often, though, doctors may prescribe opioids to patients who might do just as well, or better, with other, less dangerous pain relievers. Make sure the doctors that you work with are aware of all treatment options and are diligent about preventing opioid abuse.
3. Gather Thorough Patient Histories: Certain risk factors—like depression, high blood pressure or obesity—radically increase the likelihood of dangerous side effects from opioid use. Gathering patient histories can alert doctors to these risk factors and allow them to alter treatment plans so that patients with a high risk are closely monitored for those ill effects.

Mitigate the Risks
Opioids can be a powerful tool to assist in the healing process, so eliminating them completely isn’t an option. For more information on how to mitigate the risk of opioid abuse, contact Warren G. Bender Co. today.

Filed under: Health — Jillian Bender-Cormier @ 4:13 pm August 1, 2018


Employee Safety When Working Alone

Across all industries, certain workers may be required to work alone. Whether it’s due to staff shortages, late-night shifts, the nature of the job or for other reasons, employees who work alone tend to be more vulnerable than those who have co-workers present. Lone workers may face an increased risk of workplace violence, especially if they work with the public. Additionally, if and when workplace accidents occur, lone workers may lack the support needed to properly respond to the incident or to receive necessary assistance.

By taking a proactive approach, employers can help protect their lone workers and make them more comfortable in their roles. In turn, employers can improve productivity, reduce employee turnover, strengthen their reputations and greatly reduce the likelihood of a costly incident.

Who has the greatest risk?
While employers must manage all lone workers with care, certain categories of workers are especially at risk. Individuals who work with patients, clients or the public may be put in challenging situations if they are working alone. Working with the public means that dozens—maybe even hundreds—of people may be coming in and out of the workplace each day.

When interacting with lone workers, individuals may alter their behavior. If there is only one worker present, people may think they can more easily get away with certain crimes, such as robbery or physical assault. Similarly, if clients or patients are unhappy or frustrated, they may attempt to intimidate, threaten or otherwise take advantage of a lone worker. These risks are magnified for workers who work off-site or who are required to enter an individual’s home.

Workers who perform hazardous work are also especially at risk when working alone. If a workplace accident occurs, no one may be around to give the worker assistance—and if the incident is severe, he or she may be unable to call for help.

Lone workers often suffer from exorbitant amounts of stress, due to the fact that their jobs are more risky. This anxiety can trigger negative health conditions or cause pre-existing conditions to flare up, which can in turn lead to lost productivity, more days off work and high employee turnover.
What is the law?

OSHA states that “employers have a general duty to provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harms,” but there are no specific rules for lone worker safety—only broad guidelines regarding how to stay compliant with the general duty clause.

In general, OSHA and courts across the United States have established that employers violate the general duty clause if:
• They fail to keep the workplace free of a hazard to which employees were exposed;
• The hazard was recognized;
• The hazard was causing or was likely to cause death or serious physical harm; and
• There was a feasible and useful method to correct the hazard.

All four of the conditions described above must be present before OSHA can issue a citation under the general duty clause.

How can you minimize or eliminate the risks?
Identifying lone-working risks and putting procedures in place to address those risks is the most important step to keeping your employees safe.
OSHA offers broad guidelines regarding how to stay compliant with the General Duty Clause:
• Ensure lone workers have no medical conditions that can make them unsuitable for working alone.
• Be aware that some tasks may be too difficult or dangerous to be carried out alone.
• Provide some level of supervision.
• Put contact and communications procedures in place for lone workers who may be faced with workplace violence.
• Check for any specific legal requirements or regulations in their state or industry.

The following are some additional suggestions you should take to minimize or eliminate lone-working risks:
• Conduct a workplace hazard assessment of all potential risks a lone worker may face.
• Implement workplace safety procedures tailored to the risks your lone workers face.
• Ensure all workers receive proper training, and determine a schedule for refresher training.
• Create a check-in procedure for lone workers.
• Schedule high-risk tasks during a time when another worker is present.
• Provide workers with the appropriate protective clothing, protective barriers and escape routes.
• Evaluate the design, physical arrangement and materials of the workplace. Modify these to reduce risks, if necessary.
• Make sure the worker is visible at all times on a security camera. If this is not possible or applicable, make sure he or she has access to a voice-communication system at all times.
• Make sure workers can always see the entrances and exits, so they are aware of who is coming and going. If this is not possible, make sure there are locks in place to prevent entry through doors that workers cannot see.
• Install panic buttons in the workspace.
• Install a locked drop safe, if employees are handling money.
• Make sure the inside and outside of the workplace is well-lit.
• Create and regularly practice an emergency action plan.
• Investigate all incidents as soon as they arise, and don’t forget to record near misses. Revise emergency procedures and the emergency action plan accordingly.
• Solicit input from employees on their work and work conditions in order to come up with the best possible solutions to fix any issues that arise.

It is your legal duty to provide all workers with a safe and healthy workplace, no matter the industry. Our library of extensive resources can help you. Please contact Warren G. Bender Co. for more information on the hazards of working alone.

Filed under: Safety — Jillian Bender-Cormier @ 4:05 pm


Ageism: Are Your Employees Affected?

It turns out 60 percent of older employees feel discriminated against due to their age, according to a report from the Equal Employment Opportunity Commission (EEOC).
However, only 3 percent of those employees say they submitted a formal complaint about age discrimination. The EEOC report says this indicates underreporting of the issue.

What is Ageism?
Ageism is stereotyping and discrimination based on age, according to the World Health Organization (WHO). Much like racism or sexism, ageism takes many forms. In the workplace, this kind of discrimination could mean overlooking older employees for promotions or favoring younger employees’ help on projects.

Impact in the Workplace
In addition to negatively impacting individuals’ careers, the WHO says ageism can affect employee health directly.
Conditions like high blood pressure and anxiety can be caused by age discrimination in the workplace, according to the WHO.

How to Combat It
The first step to countering ageism is examining company culture, according to the EEOC. The EEOC says company culture determines whether employees feel valued.
Another method is simply recognizing ageism and rejecting its stereotypes. For instance, if you find yourself routinely tapping younger workers, consider including older employees in tasks.

Unfortunately, there is no clear-cut way to dissolve ageist attitudes, but awareness is a good first step. If you notice these trends among employees or managers, speak up before the issue persists.

Filed under: HR — Jillian Bender-Cormier @ 3:56 pm


Staying Safe While Playing Sports

Every day, millions of youths participate in recreational sports. While these activities build the body and mind, they can also lead to serious injuries if the proper safety precautions are ignored. To avoid injury, parents should do the following:

• Tell your child to abide by the rules of the sport.
• Schedule a physical examination to make sure your child is cleared to participate in physical activity.
• Purchase the proper apparel and protective gear for your child.
• Instruct your child to warm up and stretch before and after playing a sport.
• Make sure your child drinks plenty of fluids before and during the sport.
• Don’t let your child play if they are extremely tired or in pain.

If your child experiences any pain or discomfort following a game, prompt treatment can often prevent a minor injury from becoming worse. If you notice the following warning symptoms, consider scheduling a doctor visit:

• Inability or decreased ability to participate in the sport
• Visible deformity, such as a shoulder out of joint
• Severe pain in the extremities

Keeping these tips in mind will ensure that your children stay safe and healthy whenever they participate in a sport.

Filed under: Health & Wellness,Personal Insurance — Jillian Bender-Cormier @ 3:50 pm


Create a Fire Escape Plan

It only takes a few minutes until an entire house is full of thick, black smoke and is engulfed in flames.

Every year thousands of people die or are injured in house fires. Don’t let your family become a statistic—many of these injuries are avoidable if you have a sound escape plan in place to protect you and your family if a fire occurs in your home.

Preparation
First, always ensure that your smoke detectors are properly installed and operating. Test them every month—a working smoke detector is the earliest signal alerting you to a potential fire.

Second, you and your family should establish an escape plan that outlines at least two exits from each room in your home in the event of a fire. If the primary exit is blocked by fire or smoke, you will need a second way out.

Every member of your family should practice the escape plan each month both in the light and in the dark so that everyone knows how to feel their way out of the house.

The Plan
When creating an escape plan, incorporate the following elements:
• When coming to a closed door, use the back of your hand to feel the top of the door, the doorknob and the crack between the door and the frame to make sure that the fire is not directly outside. If the door feels hot, use the secondary exit. If the door feels cool, brace yourself against it and open it slowly.
• Do not waste any time trying to save your personal property. Instead, take the safest exit route.
• If you must escape through smoke, crawl low under the smoke and cover your mouth.
• Establish a meeting place outside of the home where everyone knows to go once they are safely out. Designate one person to go to a neighbor’s house to call the fire department.
• Never go back into a burning building for any reason.

Filed under: Personal Insurance — Jillian Bender-Cormier @ 10:00 pm July 9, 2018