Preventing opioid overdose deaths in the workplace
January 5, 2024
This is a reprint of a post from March, 2023.
There were over 100,000 deaths from narcotic overdoses in the US in 2022, and communities across the country are reeling from the impact of fentanyl contaminating illegal drugs like heroin, or being substituted for more expensive narcotics in pills sold illegally. The Food and Drug Administration recommended last year that naloxone (Narcan) be made available with no prescription, which could make it easier for family members and those nearby to give drug users this antidote should they lose consciousness and stop breathing. Naloxone is available both as an injection and as a nasal spray; the spray requires no special training, although is more expensive than the injection. (Update - Naloxone is now available with no prescription, and some employers have this on the ‘preventive medicine’ list so there is no cost sharing. GoodRx lists the price for two sprays at $30-$36. )
Few employees actively use drugs when they are at work, but workplace overdoses happen, and ready access to naloxone can save lives. The US Surgeon General recommended that employers stock naloxone in first aid kits in 2018, and the National Institute of Occupational Safety and Heath has a guide for employers seeking to provide naloxone for emergency on-site use. Naloxone is already available without a prescription in many states, and this week the Food and Drug Administration voted unanimously to make naloxone nasal spray over the counter, and final approval is expected soon. This change would make the product more accessible; it could be available in vending machines, convenience stores and supermarkets. Future naloxone products could be higher potency and longer duration.
Employees should call 911 whenever naloxone is used, as the narcotic reversal can be short-acting and drug-induced respiratory depression or unconsciousness can return. Some who have overdosed require a second dose before emergency medicine technicians arrive.
Implications for employers:
Naloxone as part of a workplace first aid kit can save lives. Kits should include at least two doses, and these should be replaced as they expire.
Employers that provide access to naloxone should develop clear policies and procedures around its use and should communicate clearly to workers.
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