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“Injury Prevention, Workers Compensation, Chronic Pain, and
Addiction in the Workplace” Employer Wellness Roundtable Series
Presentation 1, May 11th 2016
www.summithealth.org/WellnessAtWork
Session Speakers for Today
April Brown
Jamie Goetz
Jamie Steier
Connie Stock
Traci Ingram
Injury Chronic Pain Opioid
Prescription Opioid Abuse Addiction
How can injury lead to substance abuse in the workplace?
What can employers and health care providers do to prevent and manage injury and addiction?
Prevention of Injury
Wellness
Education
Chronic Pain Management
& Alternatives to Opioids
Opioid Education
Pain Medication Contracts
Testing & Follow Up
Intervention, Detox, Rehab,
Support
Injury Chronic Pain Opioid Prescription
Opioid Abuse Addiction
Prevention of Injury
Wellness
Education
Chronic Pain Management
& Alternatives to Opioids
Opioid Education
Pain Medication Contracts
Testing & Follow Up
Intervention, Detox, Rehab,
Support
Injury Prevention
Jamie Steier, MPT
Causes of Work Injuries
Overuse Accidents Poor Posture Faulty Body Mechanics Stressful/Unhealthy
Habits Poor Physical Fitness *MANY OF THESE
WE CAN CONTROL*
Injury Prevention
Decreasing Stress and Healthy Living
Exercise Prework/Post-Offer
Screens Proper Body Mechanics Good Ergonomics
Unhealthy Habits to Avoid
Smoking Improper diet Alcohol consumption
in excess Sleep deprivation Couch potato
The Benefits of Exercise
We need to equip our bodies to perform the tasks required during our workday
Exercise Improves your fitness level and body
composition Combats disease and illness Improves mental health and decreases stress Improves sleep patterns Increases our energy reserves
The Benefits of a Warm-Up Exercise Routine
Increased joint nutrition Increased blood flow to cold muscles Increased flexibility and range of motion Increased energy Decreased likelihood of injury
GET YOUR BODY PREPARED TO WORK!!
Prework/Post-Offer Work Screens
Test the worker’s ability to complete the functional demands of the job safely
Based on functional job analysis/functional job description
**Do the physical abilities of the prospective worker match the requirements of the employer?**
Proper Body Mechanics
Education Training
Ergonomics
• Decrease ergonomic stress
• Decrease the likelihood of potential injuries
ADAPT THE WORKSTATION TO FIT THE WORKER
Repeated movements, excessive force and awkward positioning put stress on the body and over time may
result in permanent and disabling injuries.
Repetition-Force-Posture Triangle
The ideal ergonomic situation: low repetition, low force and a neutral posture.
FORCE REPETITION FORCE REPETITION
POSTURE POSTURE *Decrease ergonomic stress by decreasing one or more sides
STRESS
S T R E S S
Work Injury Rehabilitation Outpatient and on-site injury rehabilitation Body mechanics education Ergonomic intervention Work simulation and progression Pain management Home exercise programs Therapeutic exercise
Chronic pain definition
Pain that persist for longer than 6 months (IASP = international Association for the Study of Pain)
Widespread pain is defined as 2 contralateral quadrants of the body and in the axial skeleton, and persists for at least 2 months.
Problems associated with chronic pain
Altered mods/appetite Psychosocial problems Fatigue Sleeplessness Immunosuppression Impaired cognitive
abilities Victim mentality
Post-injury Work Reintegration
Functional Capacity Evaluations (FCE) Job-specific return to work screens Return to work contracts
Chronic Pain Management
TENS Pool Therapy Exercise Modalities Education/Pain Management Techniques
Effects of exercise on Chronic Pain
Improved mood Decreased depression and anxiety Increased strength and range of motion Decreased pain Improved function Increased pain threshold Improved well-being and cognitive function Improved sleep quality
Injury Chronic Pain Opioid Prescription
Opioid Abuse Addiction
Prevention of Injury
Wellness
Education
Chronic Pain Management
& Alternatives to Opioids
Opioid Education
Pain Medication Contracts
Testing & Follow Up
Intervention, Detox, Rehab,
Support
DRUG-FREE WORKPLACE PROGRAM
Without A Program Increases benefits Cost Jeopardizes Safety Increases Liability Slows Productivity Increases Risk for theft and
fraud
With A Program Provides a healthier Work
Environment Increases Safety Increases Productions Decreases Revenue losses
HAVING A CLEAR POLICY REGARDING SUBSTANCE USE IS NECESSARY FOR BUILDING
A GREAT FOUNDATION FOR A DRUG-FREE WORKPLACE
BENEFITS OF A DRUG-FREE WORKPLACE PROGRAM
Deters candidates who regularly use drugs from applying for a job at a company with a drug testing program
Sends a clear message that drug use in the workplace is prohibited
Having a program helps employers to respond diligently
Raises awareness about the health and life issues of substance misuse
Potential Incentive Programs
POLICY
It is important to have a current, clearly written policy that complies with relevant federal and state laws
You should have one person responsible to understand these laws
SUBSTANCE ABUSE TESTING OPTIONS
Reasons for Drug Testing
Substances for which to test
Comparing Types of Drug testing
Point of Collection vs. lab-based testing
Alcohol Testing
REASONS FOR DRUG TESTING
Understanding what each test means
Pre-Employment
Random
Periodic
Post-accident
Reasonable Suspicion
Return to Duty
Follow-Up
SUBSTANCES TO TEST 5 Panel Drug Test
Amphetamines
Benzoylecgonine-Cocaine
Marijuana
Opiates
Phencyclidine - PCP
Synthetic Drugs • ~Synthetic Cannabinoids • ~Synthetic Stimulants
10 Panel Drug Test Amphetamines Barbiturates Benzodiazepines Benzoylecgonine-
Cocaine
Marijuana Methadone Opiates Phencyclidine – PCP Porpoxyphene
COMPARING TYPES OF DRUG TESTING Urine drug testing Oral Fluid drug testing Hair drug testing
Drug detection window
Detects recent drug use (24-72 hours) Marijuana – Avg .30 days
Detects recent drug use (24-72 hours)
Detects a pattern of repetitive drug use up to 90 days
Reasons for testing
Suitable for all testing reasons
Suitable for all testing reasons, especially post-accident and reasonable suspicion
Pre-employment, random, return to duty and follow-up
Type of collection Not Observed –restroom facilities required
Observed-making donor cheating difficult
Observed-making donor cheating difficult
Collection Collection Site At the employer location or at a collection site
Collection Site
Drug testing site Laboratory/Rapid Onsite
Laboratory Laboratory
Drugs tested Comprehensive drug test panel options
Primarily illicit and some prescription drugs
Primarily illicit and some prescription drugs
Point of Collection Drug Testing Vs
Lab-Based Drug Testing
DRUG TESTING PROCESS
Onsite testing
Donor Selected Specimen
Collected Rapid Test Performed
Non-Negative Result -Specimen send to the Lab
Lab Analysis MRO Verification Negative Test Result Test Complete
Refusal Employee
Removed from Duty
Positive Test Result
DRUG TESTING PROCESS
Lab –based
Donor Selected
Specimen Collected
Specimen send to the
Lab Lab Analysis
MRO Review Negative Test Result
Test Complete Refusal
Employee Removed from Duty
Report Result to DER
Positive Test Result
Breath Alcohol •Always directly observed •Minimal Risk of Tampering •Results are immediate
Saliva Alcohol •Always directly observed •Minimal Risk of Tampering •Easily performed in various locations
ALCOHOL TESTING
ALCOHOL TESTING PROCESS
Donor Selected ASD or EBT .02 or higher 15 minute
wait
Re-test with EBT
.02 or lower
.02 or lower Test Complete
.04 or higher (federal)
Positive
Refusal
Positive
Removed from Duty
.02-.04 result
SUPERVISOR TRAINING
Training supervisors to advocate for a Safe and Drug-free Workplace
• Understanding the In’s and Out’s of a Drug-free Workplace
• How to identify Signs and Symptoms of Drug/Alcohol use
• How to confront an employee
• How to document
• What to expect at the collection site
EMPLOYEE EDUCATION
In order to ensure understanding of the drug-free workplace program you should consider the following:
• Explanation of the policy
• Distribution of the policy
• Notification when changes are made
• Information about drugs and potential safety risks
• Who to contact in the case of concerns
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Inform Employees:
• Role in the Drug-Free Workplace
• Who and How to contact
• What is an MRO?
• What is their role
in the process? MRO
Laboratory
Collectors/Collection Site
Third Party Administrator(TPA)
Designated Employer Representative (DER)
Substance Abuse Professional (SAP)
MEDICAL REVIEW OFFICER
IMPORTANT REMINDERS
Some Important things to remember when developing a substance abuse policy:
• Know all applicable state laws
• Consult an attorney
• Communicate with employees on an ongoing basis
• Make applicable to ALL employees
PENNSYLVANIA – MEDICAL MARIJUANA LAW
On April 17th, 2016 Gov. Tom Wolf signed the Medical Marijuana Act (SB 3)into law, making Pennsylvania the 24th state to legalize medical marijuana.
Injury Chronic Pain Opioid Prescription
Opioid Abuse Addiction
Prevention of Injury
Wellness
Education
Chronic Pain Management
& Alternatives to Opioids
Opioid Education
Pain Medication Contracts
Testing & Follow Up
Intervention, Detox, Rehab,
Support
What is an EAP?
An employer sponsored benefit that provides face to face assessments, evaluations, and short term counseling services for employees and their dependent family members
Designed to help employees and their family members identify and resolve problems that could impact their personal lives and work performance
Promotes wellness, healthy living, and productivity in the workplace
Confidential and Proprietary Information © 2015 Quest Behavioral Health, Inc. All Rights Reserved.
EAP Services Should Include:
Face to face counseling appointments
3-5 free sessions per member
Telephonic consultations
Legal, financial, eldercare
Wellness component
Online resources
Confidential and Proprietary Information © 2015 Quest Behavioral Health, Inc. All Rights Reserved.
EAP Services Should Include:
Confidential and Proprietary Information © 2015 Quest Behavioral Health, Inc. All Rights Reserved.
Supervisory Referrals
Work related disciplinary action
Substance abuse
Critical Incident Stress Management (CISM)
Access 24/7 to clinical staff
On site CISM response team
Who is Quest EAP?
Jointly owned by five of central Pennsylvania’s premier health systems
Serve over 180,000 employees and family members since 1997
Provider network of over 1,500 credentialed professionals for added freedom of choice
Confidential and Proprietary Information © 2015 Quest Behavioral Health, Inc. All Rights Reserved.
Injury Chronic Pain Opioid Prescription
Opioid Abuse Addiction
Prevention of Injury
Wellness
Education
Chronic Pain Management
& Alternatives to Opioids
Opioid Education
Pain Medication Contracts
Testing & Follow Up
Intervention, Detox, Rehab,
Support
Questions?
Thank you for Attending!
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