How private sector can fight opioid epidemic

Health 21:47 19.09.2018
Companies across America today are confronting two critical and related national problems: A dearth of potential new employees is forcing managers to scramble to find workers for empty spots on assembly lines, in offices and at construction sites.
 
Meanwhile, the opioid epidemic, which killed more than 72,000 Americans last year, has made the worker shortage worse. Large numbers of job applicants are failing pre-employment drug tests and being refused jobs. At some companies in hard-hit areas, the failure rate can be as high as 50 percent.
 
But there is something dramatic and effective that the private sector can do to help expand the number of available workers and, at the same time, fight the drug plague. Companies can create drug-treatment programs for failed job applicants. In such programs, employers promise to give permanent jobs to those applicants who have tested positive for drug use but who then commit to long-term treatment, to regular testing and to remaining drug-free.
 
One company is trying this approach. Belden Inc., which has a manufacturing plant in Richmond, Ind., was straining to keep its computer-networking factory running at full capacity. But more than one in ten of its job applicants were testing positive for drugs.
 
So, last February, management committed to hiring people who tested positive for drug use with an innovative new program that I helped design. Working with nonprofits and others in the community, Belden established its pilot Pathways to Employment program with the hope that the project might more than pay for itself by increasing the plant’s productivity in the long term. It also would help a community that has been devastated by the opioid epidemic.
 
I know this all might sound idealistic. But, from my decades of experience as an addiction psychiatrist and as president of Phoenix House, the national drug-treatment organization, I believe this enlightened program has a good chance to succeed.
 
From a clinician’s point of view, the program makes perfect sense. In most cases, addicted substance abusers do not voluntarily enter treatment unless they feel significant pressure to do so. Often that comes from a spouse, a parent, or a court that offers an addict a choice of treatment or imprisonment. With the Belden program, the inducement into treatment is clear and positive: If you use drugs, you will be unemployed; if you stay clean, you will have a good job.
 
The clear logic of the Belden program is beginning to attract national attention. The U.S. Chamber of Commerce recently praised the program and, yesterday, the plant was visited by a delegation of federal officials, including Surgeon General Jerome Adams, Secretary of Labor Alexander Acosta, the president's senior counselor, Kellyanne Conway, and Vice President Pence's wife, Karen.
 
The quandary that Belden faced in its manufacturing plant in Indiana exists across the country, especially in regions at the epicenter of the epidemic. Research by Princeton University economist Alan Krueger found that, in the last 15 years, the labor force participation rate fell more in counties where more opioids were prescribed heavily.
 
As the opioid crisis has deepened, the number of people failing work-related drug tests has climbed. Federal data shows, for example, that the number of truck and bus drivers, commercial pilots, railroad operators and pipeline workers who failed federal drug tests jumped by 77 percent since 2006.
 
The overall costs of the opioid epidemic are staggering. In Indiana, annual drug overdoses cost the state $1 billion, measuring medical expenses and lifetime earnings losses. For the entire country it’s roughly $500 billion, the White House Council of Economic Advisers estimated in a 2017 report. In Massachusetts, a recent survey by the Department of Public Health found that people with jobs made up more than three-quarters of the opioid-related overdose deaths in the state, mostly in physically demanding industries like construction.
 
For its part, Belden puts up more than $5,000 for each qualified candidate they believe will become a suitable employee. Substance abusers are assessed and placed in treatment with a network of local providers. Once they pass a series of drug screens, candidates can start a staged process that leads to a normal full-time job. To keep their positions, they must continue in treatment and pass random follow-up tests.
 
Corporate America can’t single-handedly solve this drug crisis. It must be part of a comprehensive national effort. But programs like Pathways to Employment can serve as a model for companies to address the labor shortage, fight addiction, and support the communities in which they work and live.
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