While the past year has brought some modest improvements, opioid misuse and related deaths are still a national crisis, and the opioid-related death rate in Massachusetts is more than twice the national rate.

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and many others.

The U.S. Centers for Disease Control and Prevention estimates that the “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion per year, including the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.

According to a recent survey by the National Safety Council, more than 70 percent of U.S. employers report feeling a direct impact of prescription drug misuse in their workplaces.

An added problem is that many don’t know what to do if an employee, or a member of his or her family, may be suffering from opioid addiction. What are the signs and symptoms of addiction? And where can they go for help?

Detecting opioid abuse
The effects of opioid abuse permeate a person’s work and home life and alter their relationships with family and colleagues. Symptoms can be subtle and difficult to detect, and not all abusers share the same warning signs and behaviors.

The Center for Behavioral Health has put together a list of 10 physical signs that opioid addiction might be occurring:

1. Mood changes: A person who is actively misusing opioids may seem drowsy and disoriented. Users seem to fall asleep while sitting or even standing, with their head hung down. Movements may be slowed, and speech may be slurred.
2. Flu-like symptoms: Opioid withdrawals cause nausea, fever and headache, symptoms that are similar to those associated with the flu.
3. Sleep habits: The individual’s sleep habits may become irregular – prolonged or excessive at times and then shortened or even non-existent.
4. Weight loss: Opioids change the metabolic makeup of the individual, often resulting in weight loss.
5. Eye changes: Opioid use results in bloodshot eyes or unusually large or small pupils.
6. Energy level: Opioid use causes energy levels to fluctuate, often resulting in lethargy.
7. Decreased libido: Opioid use lowers testosterone and estrogen levels.
8. Old habits: Opioid users tend to fall back into old habits, such as resuming smoking cigarettes.
9. Relationships: Friendships that were once important may lapse or even end.
10. Overspending: Opioid use often interferes with an individual’s judgment, resulting in bad choices, particularly in the spending category.

People who are abusing opioids will also tend to lose interest in normal activities, focusing instead on trying to obtain more of the drug they’re abusing.

Families can play an important part in the recovery of someone abusing opioids, and finding support groups for families can help them care for an addict.

Four actions for employers
Given the prevalence of opioid abuse by those in the workforce today, it is imperative that employers be proactive.

The National Safety Council recommends four key actions:

1. Partner with insurance, a medical and/or pharmacy benefits manager, and employee assistance program (EAP) providers, and provide access to high-quality mental health services.
2. Re-evaluate policies and testing for prescription drugs to include opioids.
3. Invest in management and employee education. Provide training to managers, human resources professionals and employees about the danger of using opioids and the signs of opioid addiction.
4. Increase and ensure confidential access to help and treatment.

Employee assistance programs
Employee assistance programs play an important role in drug-free-workplace programs and can provide a low-barrier, confidential way for employees to seek help quickly. Employees must be assured that EAP services are confidential and protected by federal privacy regulations (HIPAA).

Key areas of support include assisting with education and training, and assessing and treating substance abuse presenting issues.

“EAPs are in an excellent position to draw from their professional background and experience to provide multiple channels for information and awareness about addiction,” says Will Brown, New England Region operations director for AllOne Health. “When we are contacted by an employee or their loved ones, we determine what level of care is clinically indicated and make recommendations. If the person is in need of a detox, we help the employee navigate their health insurance and find a facility that can provide care.”

Recovery resources
There are many resources available to help people with opioid abuse and addiction recovery, including the following:

• Massachusetts Substance Abuse Information and Education Helpline – 800-327-5050 or www.helpline-online.com: The helpline is the only statewide, public resource for finding licensed and approved substance use treatment and recovery services. The helpline is funded by the Department of Public Health’s Bureau of Substance Addiction Services.

• Learn to Cope – www.learn2cope.org: This nonprofit support network offers education, resources, peer support and hope for parents and family members coping with a loved one addicted to opioids or other drugs. Meeting locations and times are available on the website. Family members may receive overdose prevention, recognition and response education at group meetings.

• Allies in Recovery – www.alliesinrecovery.net: An online learning platform for when a loved one is struggling with drugs and/or alcohol, Allies in Recovery offers free membership for Massachusetts residents. They provide community, personalized guidance, and a scientifically proven program to provide the skill set needed to help loved ones.

• Substance Abuse and Mental Health Services Administration – 800-662-HELP (4357) or www.samhsa.gov/find-help/national-helpline: SAMHSA is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s National Helpline provides 24-hour free and confidential treatment referral and information about mental and/or substance use disorders, prevention and recovery in English and Spanish.

• Mental health screenings: MIIA offers 10 different anonymous screenings, in areas such as depression, anxiety, eating disorders and alcohol abuse, at www.mentalhealthscreening.org/screening/miiawellness.

In addition, doctors and health care professionals can refer patients to treatment centers or opioid addiction counselors and resources.

Written by Jayne Schmitz, MPH, MIIA Wellness Program Specialist.