The Problem with Pills

For workers lucky enough to secure workers’ compensation benefits after being hurt on the job, a new hazard is emerging from the shadows: addiction to the pain medication prescribed to them.

Signs of the opioid addiction in our communities are all around us, from illegal open-air drug markets to a spike in obituaries in our newspapers. But what is less clear is how these life-controlling addictions start. MassCOSH, in partnership with the Center for Promotion of Health in the New England Workplace, is just beginning to explore how dangerous jobs are a prevalent contributor to our nation’s massive addiction crisis.

“Addiction is a wildly complex issue, but what we are focusing on is the role workplace injuries play in starting people on the road from opioid use to abuse, because this affects all workers,” said MassCOSH Executive Director Jodi Sugerman-Brozan. “From construction workers who hurt their backs, to accountants experiencing painful carpal tunnel syndrome, if your job has you repeating the same motion over and over, you are at risk.”

While MassCOSH’s partners at the Occupational Health Surveillance Program (OHSP) at the Massachusetts Department of Public Health are looking closely at the links between certain occupations and opioid-related overdoses, there are some things we already know. Work-related injuries that result in pain medication prescriptions are very common and under-counted. In 2015, there were 5,515,593 occupational injuries that required time away from work, and 1,764,990 of those workers were prescribed opioids for their occupational injuries. Medical literature documents that long-term use of opioids carries a risk of fatal overdose at a rate of 0.04%. Using that statistic, a sobering 724 overdose deaths took place in 2015 that would never have happened if the worker had not been hurt on the job.

One study found that many opioid-related deaths occurred in individuals who were currently employed. This confirms what workers, particularly in the construction trades, have been telling us: they are risking painkiller addiction to keep up with the ravages that excessive work has on their bodies.

As research continues, what needs to be done is becoming clearer. First, chronic pain from work related injuries from must be prevented. Massachusetts must step in where OSHA has struggled, and mandate employers prevent the number one work-related injury: musculoskeletal disorders, with a special focus on repetitive motion and back pain. Massachusetts’ public health and labor agencies also must cease focusing on workers as addicts and instead, go upstream to the root of the problem: hazardous work.

“Decades of ergonomics and safety research has provided us with the tools to help prevent painful back injuries,” says occupational ergonomist and MassCOSH member Jamie Tessler. “Ergonomists know how to identify job tasks that place workers at increased risk of painful back injuries. Now, Massachusetts must step up to the challenge and prevent these injuries from happening in the first place.”

MassCOSH is also fighting to ensure Massachusetts can continue to monitor workplace injuries and fatalities to better know what types of jobs are resulting in injury, addiction, and overdose death. OHSP is critical to that work, and we will continue to advocate for the program to be fully staffed and funded.