EE addicted to pain medication

Paul in Cannon Beach · January 2004

An ee just told his manager that he has been addicted to pain medication for the past six months after a shoulder injury and surgery. The ee made the admission after his supervisor confronted him about recent lateness, being distracted, forgetfulness on the job. Basically the manager said "whats up?"

The ee's performance has slipped and he will need to get his act together but we are committed to helping him however we can. We have an EAP and I can refer him to that.

If we suspect he is still abusing the pain med (Percodin I believe) do we need to suspend him? What course of action would you propose? Any angles or issues to consider?

Anyone else dealt with this before? I appreciate the forum's assistance in thinking this through.

Thanks!

Hatchetman · January 2004

[font size="1" color="#FF0000"]LAST EDITED ON 01-02-04 AT 08:19PM (CST)[/font][br][br]What does your policy say regarding the misuse of prescribed medication (as compared to the illegal use of drugs)? You should follow what your policy provides, including referral to EAP.

Has he discussed the medication addiction with his doctor? Is he willing to do that if he hasn't already?

Is there any claim that the shoulder injury is still affecting his ability to work?

Can you have him provide a current doctor's statement about his medical condition related to the shoulder injury.

FMLA may be consideration for dealing with any ongoing need for a leave.

ADA and reaaonable accommodation could come into play if he is diagnosed having a medical addiction and recovers from that.

Right now there is too little information about the medical condition and the medication to identify a definitive approach.

Don D · January 2004

It is correct that you have some missing pieces. It is indeed unusual for one to continue on prescribed pain medication for six months after shoulder surgery, so you 'may' have the illegal use of drugs going on here. I wouldn't try the EAP forced referral. He may or may not WANT or accept that. I'd work it through his prescribing physician. If the man has him on post surgery perc six months later, he won't be surprised that he's addicted. Right now, all you have is a supervisor asking 'what's up?' and an employee saying he's still taking pain meds after surgery and he's taking too much of it. I would tell the employee my intentions to contact his physician if he says he won't go and discuss it with him. Then I would write the physician a letter telling him what the employee fessed up to. It may piss him off, but then again, it may save him.

ray a · January 2004

I have an ee going through the same problem. He has become addicted to pain medication for a recurring back injury from a WC case of several years ago. Fortunately, he came to the conclusion on his own before we were even aware of it that he had a problem. But, his manager had suspected something was wrong based on recent performance problems, but kept it to himself. Anyway, just before Christmas he checked himself into a rehab program through one of the local hospitals. Reports are he is heading in the right direction. Paul, maybe he just needs a friendly nudge in the right direction seeking professional help.

Don, I'm a little confused by your answer. In another recent thread, you strongly cautioned against contacting an ee's doctor saying the doctor would never talk to an employer anyway. Now you recommend contacting the doctor. Would you really try to contact the doctor or just use the threat of contact as a ploy to get the ee to make the right decision?

guidedspirit · January 2004

Without going indepth, if the ee refuses the EAP, isn't it true that under HIPPA, you are not authorized to receive any information re his problem?

Is the ee unionized?

ADA comes into play only if he completes a program

Their is even less leverage with FMLA re the info Personnel/HR may receive.

Just my thoughts #0

Don D · January 2004

If you check my post carefully, you will see that I did not suggest a conversation with his physician or any attempt to gather information from the physician. This is not inconsistent with my prior posts telling someone a doctor will not talk to him anyway. What I suggest in this case is this: If the employee has admitted what may be an addiction problem and tells you he will not reveal that to his prescribing physician or treating physician, I would WRITE a letter to the treating physician describing my relationship as employer and advising that the ee has told us that his performance is related to percodan six months post surgery and I would include a synopsis of the jobs duties and physical demands. No effort to establish any sort of dialog at all, as you WILL NOT get that and that is not your goal to begin with. I would not use this as a ploy (as Ray seemed to infer from my post) nor would it be a threat. Just a fact. Tell him up front it is our goal to assist him through this crisis and return him to productive employment with the company and this is the route I've chosen to accomplish that. Call it tough love or whatever you like. It's merely an overt effort to accomplish what's needed. And there's no downside to this approach at all. There may be a naysayer out there who will think this is a violation of confidence of some sort. Think about it.... revealing to one's physician something the patient told me that may be of interest to the physician in his overall effort to get the man well and back to work at my company? Show me a downside in that.

ray a · January 2004

Mea Culpa, Don. When I read your statement that you would contact his physician, I interpreted that as a call. But, you did in your next sentence specify the contact will be by letter. I misinterpreted what you were saying. Maybe the word "ploy" was too strong, and I was trying to avoid the word "threat". I think we both had the same idea in mind - convince the ee to do the right thing and if necessary we would do what we believe is in the best interests of the company and the ee.

Don D · January 2004

That's right Ray. And watch out who you accuse of engaging in a ploy. It just so happens that I know people in high places who can deal your remarks 'the death blow'. And don't be calling me a culpa either. I know perfectly well what that means in several languages.

ray a · January 2004

Me-a culpa, you-a culpa. I'm OK, you're OK. Sounds like 1960's philosophy. x;-)

LindaS · January 2004

If the employee is willing to seek treatment for his addiction, refer him to your EAP on a voluntary basis. If he appears to be under the influence of the medications at work, does your drug and alcohol policy allow for reasonable suspicion testing? If so that may be a route to take if the employee refuses to seek treatment on a voluntary basis.

Our policy allows for reasonable suspicion testing and if an employee's test comes back positive, they are automatically mandated to the EAP and must follow whatever treatment is prescribed as well as be subject to random tests for one year to maintain their position.

At this point, unless the employee is seeking treatment for his addiction, or is willing to seek treatment, I don't think either FMLA or ADA would apply. These would only apply as it pertains to treatment, not as an excuse for absences or performance due to being under the influence of the medication.

As far as contacting the physician, unless this is a W/C injury, I don't think you'll get anywhere going that route. Deal with the performance and other issues, refer the employee to the EAP from a voluntary standpoint right now unless you have solid proof that the employee is under the influence of the medication while at work.

Don D · January 2004

I think we posted at about the same time. Please read my post above yours. I'm not familiar with any policy that would mandate an EAP referral based on the positive test results caused by legally prescribed medication. In fact, when the MRO reviews the case and the results and has his discussion and it is revealed that the prescription is legal, THIS WILL NOT BE REPORTED AS A POSITIVE.

Paul in Cannon Beach · January 2004

I apologize for the sketchy details. I don't have all of the information yet myself.

The EE is not unionized. I don't believe that the shoulder injury is a continuing problem although I assume the EE is telling his doctor that he still has pain to keep getting the pain killers.

Our substance abuse policy includes prescription drugs and actually requires employees to notify their supervisor if they are using prescription drugs that may affect their work performance. We have a reasonable detection policy as well so I think we are covered there.

My plan is to follow our policy and focus solely on the work performance issues and recommend to the employee that he use the avenues available to him to seek whatever treatment needed to get his act together. I think I will strongly encourage him to contact his physician.

Does anyone have a problem with me requiring him to submit to random drug testing for six months? One year?

Thanks again for your help. Its interesting to read the various responses.

marc · January 2004

And through all of this, do not forget to document the performance and attendance issues. Even if you take all the steps suggested, you cannot overlook those issues or you are getting yourself into another type of pickle altogether. We have had several posts on drug and alcohol problems with strong advice not to go so far down the road with the EE that we overlook the requirement to perform just like any other EE.

Leslie · January 2004

This is going to be long. I had an employee who with our help detoxed over pain meds – no rehab. About two months ago, her performance started to deteriorate again. We were told it was Oxycontin and she was mumbling, incoherent, "getting in your face", crying, glassy eyed, falling asleep at her desk and nodding out during conversations, staring at her computer screen for long periods of time with no work being accomplished, paranoid, wandering around, shaking, just generally spacey. During an on-site collection we did a reasonable suspicion. Hydrocodone positive, but no Oxycontin. I call my consultant to ask what's up. Turns out we don't test for it. Stupid me, I assumed because we test for codine, we tested for all codines. Course we all know what assuming does for you. Anyway, because P&P says we test for, "including but not limited to," I ran the sample again for the Oxycontin. There it is. The consultant clears her by script - a script for 30 pills to be taken twice a day written in April. We try to get her to go to the EAP, but now that she's clear she becomes bold, and a week later folks are really talking about her appearance, performance, attitude, etc. We RS her again, and say this time give us a dosage in her system, because P&P also states it must be taken as prescribed. Comes back that we have to do a blood test for dosage. We suspend til she takes the test . Send her on a Friday – she can’t find the place (!?!?) - we let that go because her grandmother died while she was on suspension. Takes the test Monday – comes back she’s mixing all kinds of prescription stuff (two pain killers as above, a stress reliever, and a sleep aid x:o) but all with scripts and in dosage, so we are now effectively screwed. Has a fitness to return to work exam with a doctor of our choice (and signed releases) Christmas Eve. The doc says she isn’t fit and needs to get detoxed and rehabbed. So last week, she goes into seizures, ends up in an emergency room and leaves messages all over the company that she’s going into detox. She qualifies for FMLA so we put her on, but that’s the last we’ve heard. We’re zero tolerance. It’s a mess, every employee seems to know, they think our drug program is a joke (take a hit off a joint and get fired, but abuse prescription drugs all day long and nothing happens.) So beware of all the helping hands - you sometimes get bit.

Don D · January 2004

This is a serious question: Does this affect her gaming license application? In this state, in order to be employed in a casino, one must pass a background test that one is given for a gaming license. This would probably show up and affect her ability to be employed in the industry in this state, if I understand the law on that.

marc · January 2004

Similar situation for Nevada. A fingerprint background check is performed for criminal record type stuff, but I am not certain if any drug testing is involved.

TN HR · January 2004

>This is a serious question: Does this affect her
>gaming license application?

Maybe she switched job titles like DeNiro's character in Casino....

Seriously though, I have to agree with Leslie 100%. When you're dealing with addicts and alcoholics who are in active addiction you are dealing with ticking time bombs. You can be as compassionate and caring as you possibly can, but the dog will bite you until he/she is ready for help.

Gene

Paul in Cannon Beach · January 2004

After weighing your responses, I am making a recommendation that our director request that the EE see his doctor and present to us a fit for duty letter. If not, we will place him on unpaid leave for violating our substance abuse policy.

Also, we will recommend our EAP and encourage the EE to get whatever help he needs to get his act straight. We will follow up with 6-12 months of periodic testing.

I don't think I will send a letter to the doctor. Its an interesting, aggressive idea but probably not my style.

Ultimately, I hope the guy gets his act together for his own sake and those who love him.

Don D · January 2004

Sensible approaches to H.R. problems is not a matter of 'style'. Whether or not something is your 'style' is totally irrelevant. You need to think of the organization, and, perhaps the employee, not your 'style'. If you continue to let your personality dictate your human resources decisions, your outcomes will not ever be different. The fact that you interpreted the recommendation as 'too aggressive' and your 'hope' that the employee will 'get his act together' are both largely meaningless in the employee's conquering his problem. Hope and Faith don't get us very far in the real H.R. world. Taking appropriate, often aggressive action, often will. Good luck to you.

Paul in Cannon Beach · January 2004

I think HR people all have their "style". Some are whip sharp and tough as nails, others may be extremely sensitive and discerning, some are fun and make the workplace enjoyable.

A successful HR person in my estimation is one whose style meets the needs of the organization. Our organizational culture is not aggressive here. We don't play hardball very often.

Plus, I will be the first to say I lack the experience and knowledge that someone like you has and so I would be wary of taking any course of action that I wasn't totally certain of.

I think we all have to practice HR in a manner that fits our personal style, blends in well with the organization's culture, and meets business needs. That may look a little different in different scenarios with different HR professionals.

LindaS · January 2004

Leslie, we are in a similar situation with an employee who is taking prescription pain meds. and have received reports from various employees and supervisors that this employee is exhibiting some of the same behaviors that you state in your post. Because this is prescription medication, testing for the presence of the medication won't do us any good so our policy, which was written before I was here, allows for a "fitness for duty" test to be administered if there is a situation wherein an employee appears under the influence of drugs or alcohol.

What I did was have the coordinator from our local rehab. facility (they also perform pre-employment physicials, etc.) come to our facility, take a tour and talk with her regarding what types of skills an employee needs to have to be "fit for duty". She went back and is putting together a test (approx. 15 min. in length) that will allow them to assess a person's fitness for duty. This will be given in addition to the urine screen. We will be providing the parameters, etc. based on our job descriptions, production rates, etc.. We are also going to be providing some of the equipment so the test will accurately depict what an employee needs to do.

Urine tests that show the presence of prescription meds. in conjunction with this test will allow us to prevent the employee from working while they are taking this medication which helps us from a safety standpoint and an employee will be placed on leave until they present verification they are no longer taking the medication. Illegal drugs or alcohol will be handled through our EAP as our policy dictates.

Leslie · January 2004

Don & Marc, no it doesn't affect her gaming license. Drug test results and/or drug tests are not part of the background check - we do that pre-employment. Plus, she's been with us for four plus years - so her renewal background check is very basic - as long as there were no arrests that's about as far as it goes.

And remember, her results are legal - by law and by our P&P. So far, everything she's taking is a legal script taken in dosage - although I've just been informed the doctor is writing an extended report on the blood test results, which I will get today, eight days after the fact.

However, the aggregate of what she is taking is making her a zombie and unfit for work.

LindaS, your second paragraph states a great idea. This may be the first time I have to deal with this, but probably not the last. The doctors blood test opinion and fitness for work evaluation is costing us a fortune. I'd sure like to trim it down for the next event.

Good luck, Paul. You never know - the threat of perhaps losing their job can turn some around, but then their are others where a swift kick in the butt doesn't help. I have my case in point.

EE addicted to pain medication

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