The opioid epidemic poses a challenge to the traditional tools for contending with addiction in the workplace, largely because of the speed with which the addictive painkillers can upend a life and lead to death from an overdose.

"Our tools are being tested," said Gregory P. DeLapp, chief executive of the Employee Assistance Professionals Association, an Arlington, Va., trade group for people who aren't necessarily social workers, but perform some of the same functions in workplaces to help employees and their families with all sorts of problems, including addiction.

"We need the employer and the union to be willing participants in this adaption to a new intervention," DeLapp said.

So what should companies do?

  • "You have to have a drug and alcohol policy, and it has to go beyond, 'don't use drugs and alcohol,' " said Bert Alicea, executive vice president of the work life division of West's Health Advocate Solutions, of Plymouth Meeting. The policy has to detail the circumstances under which a manager could have "reasonable suspicion" that an employee is abusing a drug and the procedures that must be followed to get the employee tested, Alicea said.
  • Pay attention when a worker has a work-related injury. DeLapp said that 55 percent to 85 percent of workers who are out sick for seven days or more receive at least one opioid prescription. "The leap from legally prescribed to inappropriately using opioids to the next step, heroin, is an easy slide," he said.
  • Understand the emotional dynamics that may cause the employee, colleagues, and supervisors to ignore symptoms, DeLapp said. Colleagues "are used to thinking of the coworker as a friend or a colleague or a buddy," so they may be unwilling or reluctant to see their friend as an addict. ... If you have concerns, don't wait. Things do not get better on their own."
  • After an employee has mandatory treatment under an employer's drug and alcohol policy, drug testing needs to be part of the recovery regimen, experts said.
  • "Addiction is a disease characterized by relapse. Do we set an expectation when you leave work due to heart attack that you will be terminated if you have another one later?" DeLapp said. "A relapse is not a failure of treatment, it is confirmation of the disease your employee has. Work with it.
  • "We allow our deep-rooted and completely mixed biases, stigma, and life experience to get in the way of being the employer we could be with our employees affected by addictions."