Opioid abuse can take employers by surprise, in part because addiction can be hard to spot and its impact on health care costs and productivity takes time to surface. But for Suffolk Construction the effects of the opioid epidemic are impossible to ignore.
The company’s Boston headquarters is next to the so-called Methadone Mile, a stretch of the city known for drug dealing and methadone clinics.
“We see it every day, but we also look at data and follow the trends,” said Alex Hall, executive vice president of environment, health and safety, at Suffolk, which has offices in Florida, California, New York and Texas. “What’s become clear to us is that given the high rates of opioid abuse relative to other industries is that consequently more people in construction are being prescribed painkillers.”
It is estimated that 15.1 percent of construction workers have engaged in illicit drug use and that opioids comprise about 20 percent of prescription drug spending in the construction industry — about 5 to 10 percent higher than other industries, according to a 2015 report by commercial insurance underwriter CNA Financial Corp.
And yet employers often overlook the problem because they are focused on day-to-day business operations, such as replacing a missing worker or managing performance issues, and may not see the underlying problem of addiction, said Tess Benham, a senior program manager at the National Safety Council, a nonprofit organization that promotes health and safety.
“Employers who are not in hard-hit states are just now waking up to how this crisis is impacting their workforce and their business costs,” she said. “Companies that are smaller or in industries without a lot of machinery and tools are the least prepared to deal with it.”
The National Safety Council offers a substance use cost calculator that allows employers to enter their industry, location and size to determine how much substance abuse might be costing the company.
Employers across industries and around the country are becoming increasingly concerned about the abuse of prescription opioids and are looking for ways to address what many experts say is a public health crisis, according to Brian Marcotte, president and CEO of the National Business Group on Health. According to the association’s “Large Employers’ 2018 Health Care Strategy and Plan Design Survey,” 80 percent of employers are concerned about the abuse of prescription opioids, with more than half stating that they are very concerned.
Prescription opioids include painkillers such as oxycodone, morphine and hydrocodone and can lead to addiction to heroin — an illegal opioid.
“We’ve had information sessions for employers this past year and concern is really heating up,” he said. “While health care costs are a concern, the real cost has to do with lost productivity. It’s a major driver of excessive absenteeism.”
In fact, opioid abuse could be costing U.S. employers about $18 billion a year in lost productivity and medical expenses, according to a 2016 study by health information firm Castlight Health. It found that on average, 4.5 percent of employees who received an opioid prescription showed signs of abuse. Overall, this group accounted for 32 percent of all written prescriptions and 40 percent of prescription painkiller spending, according to the study.
Employers can take steps to fight abuse by approving opioids in limited supplies, limiting coverage to a network of pharmacies and providers, and encouraging physicians to find alternatives to pain management, according to Marcotte.
At Suffolk, a “holistic approach” that addresses workplace safety and educating employees and providers on opioid abuse is the most effective way to deal with the problem, according to Hall.
“The first step is to reduce injuries and eliminate the need for pain treatment,” he said. “We want to heighten awareness of safety and encourage everyone to look after one another on the job site.”
The company also meets with physicians at the clinics it contracts with to discuss their treatment protocols and opioid abuse.
“These are not easy conversations to have because we’re not experts,” Hall said. “We’re not here to tell them how to do their job. We just want people to properly administer treatment protocols. We want to be part of the solution and creating awareness of the problem is absolutely critical.”
Suffolk also trains supervisors on how to administer naloxone, a medication that prevents overdose.