Day in and day out, the repetitive nature of construction work can take a toll on the body – causing wear and tear, and ultimately forcing many workers to seek relief from chronic pain.

But pain relief that includes taking opioids can turn into a dangerous addiction. Construction workers are almost twice as likely to have a substance use disorder as compared to the general population. Even opioid misuse can result in poor employee health and increase the costs of a contractor’s workers’ compensation claims.

Builders Mutual’s Tina Hill, Director of Workers’ Compensation Claims, and Bernard Urtecho, Senior Risk Management Consultant, share why it’s so important to raise awareness about the hazards of opioid misuse and what Builders Mutual is doing to help proactively address, manage, and reduce the costs of opioid-related claims.

A threat to workers’ health

The opioid epidemic that has plagued the U.S. over the past decade has certainly not spared the construction industry. Indeed, research has shown that construction workers had the highest rate of death from overdose among all occupations. What’s more, about 1 percent of construction workers have an opioid use disorder, almost twice the national average.

These conditions usually begin, tragically enough, at a doctor’s office. Workers who may be suffering from injuries such as sprains, strains, and fractures, or recovering from surgery, may be prescribed opioids to help them handle the pain. Over time, workers may need more and more pills to keep the pain at bay, eventually developing an addiction. And yet, time isn’t always a necessary factor. According to the Centers for Disease Control and Prevention, the chances of chronic opioid use begin to increase after just the third day of people taking opioids.

Workers with opioid dependence may not always show symptoms. Nevertheless, they may experience drowsiness, slower reaction times, or impaired judgment – an unsafe combination on a job-site where heavy machinery and elevated platforms are involved. Individuals may be placing their own health and that of their co-workers at risk.

What makes construction workers susceptible to opioid use disorder?

Several factors contribute to the risks of opioid misuse among construction workers:

  • Nature of the injuries. Many workers endure musculoskeletal pain from the constant lifting, carrying, and bending required in their jobs. Research has found that construction workers prescribed opioids for musculoskeletal pain had a higher risk for developing opioid use disorder. Long-term users were found to be nearly 10 times more likely to develop opioid use disorder.
  • Demographics. Despite women increasingly taking on construction jobs, the industry continues to be male-dominated. Some studies have shown that men are more susceptible to opioid misuse.
  • Age. Construction workers have a median age of 42 – an age group that is more likely to have musculoskeletal pain and be prescribed opioids.
  • Financial concerns. The majority of construction workers are paid only if they work. Faced with that situation, workers may choose to work through the pain, or return to work too soon after an injury. This practice further harms the body, requiring workers to take even more opioids to help them recover.
  • Stress. Construction crews work in risky job environments and often must spend extended periods of time away from home. To deal with these stresses, workers may take drugs, including opioids.

Financial impact of opioid-related claims

Opioid disorders not only jeopardize a worker’s health but also a contractor’s business. Employers may experience decreased job performance and poor morale from workers who have opioid use disorder. According to the National Safety Council, turnover, absenteeism, and healthcare expenses resulting from employees with untreated substance use disorders can cost companies more than $14,000 per worker per year.

Costs can also come in the form of higher workers’ compensation claims. When a worker is injured on the job and files a claim, healthcare expenses tied to that original injury all go to that claim, including long-term use of opioids and even rehabilitation if addiction develops. Today, according to Hill from Builders Mutual, about 25 percent of all workers’ compensation claims involve reimbursement for opioids. Rising claims costs can over time impact a contractor’s experience modification rating and the cost of their future policies.

For many years, the costs of opioid-related claims continued to rise. But then, about five years ago, the trends began to change. Around that time, several states passed laws – such as North Carolina’s Strengthen Opioid Misuse Prevention (STOP) Act – that provided guidelines to doctors around prescribing opioids. For example, restrictions were placed on how many pills can be prescribed at one time to a patient.

In this period, doctors began to change how they treated patients with pain. In addition, Builders Mutual began working with third-party pharmacy benefit managers to ensure prescribing guidelines are followed and alternative treatments such as physical therapy are considered.

The result: Since 2018, while the number of opioid-related claims has increased 2 percent at Builders Mutual, the costs of these claims have fallen 54 percent.

What can contractors do to help?

Pain is difficult to manage, and opioid use disorder is challenging to overcome. Contractors aren’t doctors. But there are steps employers can take to help protect their workers and businesses:

  • Conduct drug screening. Workers should be tested for drugs, including opioids, before they’re hired, at random times while on the job, and “for cause” – meaning if they demonstrate abnormal behavior that suggests they may be taking drugs. Also, Builders Mutual mandates that drug screening be performed after an accident.

Drug screening is an effective way to deter illegal drug use and to help monitor those who are undergoing legitimate treatment. Some employers may be hesitant to do drug screening, fearful that it may drive away workers amid labor shortages. But the benefits outweigh the risks when it comes to improving worker safety.

  • Establish a clear drug and alcohol policy. In the employee handbook, clearly spell out your policy, including a prohibition that illegal drugs should never be taken at work or on the premises, and employees should never show up under the influence. Have employees notify their supervisors if they take any medications that are clearly connected to their ability to do their job safely; this includes both prescription and over-the-counter medication, like allergy medicines, that could interfere with their tasks. Builders Mutual customers who have a formal drug and alcohol policy in place are eligible for policy discounts.
  • Organize safety training. The best way to avoid opioids is to not need them in the first place. Educate workers on how best to operate machinery and perform tasks so they can minimize injuries. In addition, educate workers on the dangers of opioid dependence, as well as their options for treating pain. Workers should be encouraged to discuss with their healthcare providers treatment options other than opioids.
  • Support employees. Provide contact information for local resources and outreach to help employees deal with opioid-related problems. Studies have shown that workers in recovery programs have lower turnover rates, are less likely to be hospitalized or injured, and are less likely to miss workdays.
  • Have an effective Return-to-Work (RTW) program. An RTW program enables injured employees to get back to work as quickly as possible during their recovery. On average, claims costs can be much lower for employees who can return to work within seven days of their injuries. These employees can be given productive, yet less physically demanding jobs, such as working in an office environment. When appropriate, it’s important to encourage employees not to simply stay at home, where the recovery process may lag. When an employee eventually does come back, they may not be physically prepared, resulting in additional injury and the need for more painkillers – a vicious cycle that an RTW program can help break. Builders Mutual can help contractors establish an effective RTW program.

Contractors don’t need to go at it alone. Builders Mutual claims experts can advise how best to manage opioid-related claims. Our risk management consultants can help companies set up drug-free workplace programs and provide lists of local resources. Builders Mutual teams are also available to conduct on-site trainings that include education about the risks of opioids, as well as simple exercises workers can do to help prevent injuries.

Contact your risk management consultant today to learn how to keep your opioid-related workers’ compensation claims in check.