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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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