Workers Compensation and Addiction
The topic of addiction relative to Workers’ Compensation has become a contentious issue over the past decade, mostly because of the staggering number of injured workers who have become addicted to drugs and alcohol and even more tragically, have become victims of prescription opioid misuse. Currently, between 38 percent and 50 percent of all Workers’ Compensation claims are related to the use of drugs and alcohol in the workplace.
While a key issue concerning Workers’ Compensation has revolved around employees who have become addicted to the drugs used to treat their pain resulting from a workplace injury, another issue has arisen that may not be receiving the same level of attention: treating injured employees whose struggles with drugs and alcohol pre-date their injuries. For this population, the Workers’ Compensation industry must determine what the optimum treatment modalities need to be for those battling addiction in terms of identifying addiction, addressing comorbidity, and distinguishing addiction from co-occurring disorders.
Most importantly, employers need to realize that those with addictions have a brain disorder. Like employees with other chronic medical conditions such as heart disease, diabetes and other types of organ/system disorders, addiction must be approached with the same objectivity, diligence and compassion as those with other illnesses.
Addiction is a Chronic Disease
Many people don’t understand addiction and why or how someone can become addicted to drugs or alcohol. Those suffering with addictions are mistakenly believed to lack moral character or the willpower to abstain, and that they can stop using drugs or alcohol simply by choosing to do so. In reality, addiction is a complex disease that impacts the brain’s structure and functioning. Addiction is not a simple reflection of a behavioral problem and poor choices, although both are symptoms of the disease.
Addiction affects the brain’s reward center, motivation, memory and related circuitry in a way that alters and replaces healthy self-care behaviors with self-destructive actions that serve to maintain the addiction. Addiction also affects the brain’s frontal cortex, resulting in altered impulse control and judgment. As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward center to respond to it. This lessens the “high” that a person feels compared to the high that was induced when they first started taking the drug, an effect known as tolerance.
Once a person builds tolerance for a drug, they might increase the drug’s dosage to achieve the same high as when they first started taking it. These brain adaptations usually lead the person to become less and less able to derive pleasure from those things they used to enjoy in life like food or social activities.
Long-Term Substance Use
Long-term substance use also results in changes in other brain chemical systems and circuits. These changes affect key cognitive functions such as learning, judgment, decision-making, memory and behavior. Despite being aware of these harmful outcomes, many people who misuse drugs or alcohol continue to do so. This is the nature of addiction.
Addiction per se, is not recognized as an official diagnosis. Instead, an addiction to drugs or alcohol is diagnosed as a severe form of a substance use disorder. As with most other chronic diseases like diabetes, asthma and heart disease, treatment for addiction generally isn’t a cure, but it is treatable and can be successfully managed.
How to Move Forward
In consideration of the strong negative impact drug and alcohol misuse has on the workplace in terms of safety, productivity and costs, employers can address this issue by implementing a workplace substance use policy, being cognizant of the warning signs of possible substance misuse, and guiding employees who exhibit these signs to obtain help.
One of the most important things employers can do to be proactive on the subject of substance misuse and addiction is to educate themselves on the unique risks of their employee population and determine the best course of action to support their specific needs.
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