Pain Hampers Productivity, IBI Researcher Says

San Francisco, CA (WorkersCompensation.com) - “There’s a very high proportion of people using prescription pain relievers in the workforce,” said Eric Peterson. “This tells us that pain is a big problem for employees.”

Peterson, a researcher at the Integrated Benefits Institute, authored a study showing the extent of pain among U.S. workers and their efforts to alleviate it. The study shows the implications of substance use on productivity and offers recommendations for employers to proactively address the issue.

The Study

The study included phone interviews with 84,579 adult workers of which 74 percent worked full time. Per a WorkersCompensation.com interview with Peterson said the drugs were classified into two categories – Problematic and Non-Problematic.

“Our data comes from the National Survey on Drug Use and Health (NSDUH), which has different categories of drug use depending on the type of drug,” Peterson said. “This makes sense because some drugs are legal, some are illicit, and some can be obtained through a prescription. However, those differing categories make it difficult to compare use patterns across drugs.

“Because we were interested in looking at use patterns of prescription pain relievers in the context of other drug use, we made our own categories to facilitate that comparability,” she added. “We have three major categories of use: non-use, non-problematic use, and problematic use. We defined problematic use as the use of a drug with behavioral implications, where the drug is affecting an individual’s relationships, work or home life, or ability to stop taking the drug (ie addiction). We defined non-problematic use as someone who used a substance – regardless of legality – but who did not show any signs of abuse or dependence on the drug.”

Although the report of pain reliever use as prescribed was high, few workers reported abuse or dependence on them. Reports of illegal drug use for cocaine was less than 3 percent, and methamphetamine and heroin use reported was less than 1 percent.

Impact on Work

While the report of substance abuse was low, it appears that pain reliever use did have an impact on work missed and caused more absence than other substances. When compared to non-users, the average absences per month was .8 days for non-problematic users. Problematic use of pain relievers resulted in 1.2 excess days per month when compared to non-users. Based on an average work month for 1,000 employees, this resulted in 1.3 percent work loss, with around 96 percent accounting for non-problematic pain reliever use.

Peterson believes the prescription use does indeed have a direct impact on workplace productivity. “We did find that prescription pain reliever users had more missed work days than non-users. Those with problematic use (abuse or dependence) had even more missed days than those who used prescription pain relievers, but not to the extent that they showed problems related to their use. This makes intuitive sense – presumably those who are using prescription pain relievers experience pain, which is preventing them from being present at work as often as their colleagues who aren’t experiencing pain.

“The high prevalence of prescription pain reliever use is really driving the productivity implications; when so many people are experiencing pain in the workforce that they’re taking prescription medications to manage that pain, absences throughout a large work force are really going to become apparent. In fact, we found that when extrapolated to a workforce population, those using prescription pain medications without a problem are associated with more lost work time than any other substance or type of use.”

Alcohol abuse and dependence was also cited as problematic in the study. In fact, it exceeded problematic use of pain relievers at 7 percent of the employees interviewed.

When asked whether or not she felt the high percentage of prescription pain reliever use had a direct impact on workers’ comp claims, Peterson stated “work safety and the ability to hire in parts of the country with high rates of addiction has already been one of the areas that has gotten attention from employers. What we wanted to explore was the level of risks to employers generally, including those that operate in industries with low rates of on-the-job injury and illness and don't feel the need to drug test. Unfortunately, we don’t have information through this dataset about the use of prescription pain relievers related to workers’ compensation claims.

Advice for Employers

Peterson believes that employers should be proactive in helping to manage their employees to avoid issues, and she has been a champion of such efforts. “We spoke with experts to help employers manage the risks of prescription pain reliever use in their workforce,” she said. She suggested they take proactive measures, such as: 

• Working to understand how many of their employees are at risk of developing substance use problems
• Raising awareness in the workforce through training and education
• Helping employees with pain manage it quickly, effectively and according to best practices.

“The experts we spoke with in the field recommend working with pharmacy benefit managers to make sure prescriptions comply with opioid guidelines,” she said. “This could also include identifying high prescribing physicians, and educating those physicians about guidelines to help prevent employees from becoming problematic users.”

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