When you picture a person suffering from opioid addiction, who comes to mind? Do you picture a stranger, a friend or relative? Or how about ... a coworker?
If that hasn't crossed your mind, consider this: according to the National Survey on Drug Use and Health, 50 percent of those who reported abusing pain medication also said they have a full-time job, while an additional 15 percent said they work part-time. That reality has some employers rethinking their approach to drug use in their workforce.
Take drug testing. Although it鈥檚 not uncommon for employers to give employees drug tests鈥攅specially in industries such as transportation, healthcare, and construction 鈥擳odd Panigutti says those tests are actually pretty easy to beat. Panigutti, 46, has worked as a cement finisher practically his entire adult life.
He is also a former opioid addict. At a halfway house in Cleveland's Jefferson neighborhood called The Lantern, Panigutti recounted how, for almost a decade, he managed to juggle both his addiction and his job.

鈥淚've snorted OxyContin on the job sites,鈥 he said. 鈥淲hen my disease progressed to shooting heroin, I would shoot heroin in the Porta-Potties.鈥
During his period of addiction, Panigutti said, he never once failed a drug test, thanks to a product called Quick Fix, which he would purchase once a year when it was time for his annual mandatory drug test.
鈥淚t鈥檚 the synthetic urine,鈥 he said. 鈥淎nd it has a nice temperature gauge right there so you can heat it up.鈥 When it鈥檚 time to take the test, dump it in the cup, and you鈥檙e good to go. Panigutti said it has been years since he actually had to use it, because he has been sober since 2010.
In the past few years, however, some employers have begun changing the way they test for opioids. Some are testing more often. Others are testing for a wider array of substances, such as prescription painkillers, that were not on their radar before.
鈥淭he single biggest change that employers have made with the opioid epidemic is that they're now starting to test for those widely abused opioids,鈥 said Karen Pierce, Managing Director of Policy Development at Working Partners, a consulting firm that helps businesses develop their drug-free workplace policies.
Pierce said the changes are not just about safety, they鈥檙e also about the bottom line. Employees who abuse opioids cost companies three times as much in healthcare as those who don鈥檛, she said. Additionally, according to a 2012 estimate by the Ohio Department of Health, unintentional drug overdoses cost Ohio businesses an average of .
Still, for some of Pierce鈥檚 clients, there鈥檚 a tension between maintaining a drug-free environment and just keeping their companies staffed.
鈥淵ou take a look at our available workforce right now and it is low, low, low,鈥 she said. 鈥淪o, I鈥檓 hearing now, 鈥楽hoot, should I still test when a drug test might be a barrier for me to getting bodies that I desperately need?鈥欌

To try and hold on to some of those bodies, Pierce said more employers are considering switching from a zero-tolerance drug policy to a 鈥渟econd chance鈥 policy. That鈥檚 where employees who fail a drug test aren鈥檛 immediately fired. Instead, they鈥檙e allowed to return to work if they get clean.
However, most employers are not thinking that far ahead, Pierce said. Last year, Working Partners surveyed over 3,000 Ohio businesses, and found that half didn鈥檛 have a comprehensive drug policy鈥攖hat is, written instructions that detail how a company will prevent drug abuse, educate managers and employees, help employees seek treatment, and more.
鈥淭here need to be rules, and the rules aren鈥檛 just, 鈥楧on鈥檛 do drugs,鈥欌 Pierce said.
Without a fleshed-out policy, employers could run into situations where they aren鈥檛 sure how to act, leading to unnecessary costs or even legal liability, she said.
For instance, what if an employee who is struggling with opioid addiction has a doctor鈥檚 prescription? How will an employee鈥檚 privacy be protected? And when should an employer intervene if they鈥檙e worried about potential drug use?
Greg DeLapp, CEO of the Employee Assistance Professionals Association, said the earlier employers intervene, the better. For example, if an employee gets injured and is prescribed pain medication, DeLapp said the employer should talk with them about it.
鈥淲hy are we waiting two months, three months before they come back to work?鈥 said DeLapp. 鈥淲hy not have these conversations now?鈥
At least one business advocacy group is trying to spark that conversation. Last month, the Ohio Chamber of Commerce, in partnership with Anthem BlueCross BlueShield and Working Partners, released a series of free educational videos called 鈥A Dose of Reality for Employers.鈥

The goal, as the Chamber鈥檚 President, Andy Doehrel, says in the first installment, is to help employers concerned about 鈥減reventing and responding to an employee鈥檚 misuse of opioids.鈥
Even with the growing awareness of opioids, however, there鈥檚 still one more looming issue. What happens to folks who fall out of the workforce because of addiction? How do they get back in? Todd Panigutti said after he got clean, it took him almost two years to return to having steady employment.
鈥淎 lot of people, a lot of contractors, a lot of guys in the field knew I was high on heroin at that time, and they didn鈥檛 want me around,鈥 he said.
And many employers apparently feel the same way about hiring individuals with drug issues in their past. According to the Working Partners survey, over 90 percent of employers said they wouldn鈥檛 hire an applicant who failed an initial drug screening, even if that person later tested clean and was cleared by a counselor.
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