December 2014 / January 2015

Drug abuse trends impact treatment

Two classes of drugs are being abused in U.S. workplaces in epidemic proportions. Reports by the federal government, drug abuse treatment centers, hospital emergency rooms and law enforcement point to consistent increases in the number of people abusing opiates and marijuana.

Teamsters Assistance Program’ (TAP) statistics confirm the national trends which are having a direct impact on referrals to treatment by TAP counselors. Both the level of treatment and length of treatment have increased over the last five years.

Prescriptions for opiates have increased from 75.5 million to 209.5 million from 1991 to 2010 and continue to increase. Prescriptions account for only legal opiates. In addition to Vicodin, oxycontin, oxycodone, morphine and other opiates available by prescription, these same drugs are illegally entering the U.S. along with an increased amount of heroin.

Consequently, an increased number of high school students report using opiates, with the highest rate of abuse among 12-25 year olds. The same age group shows an enormous increase in marijuana and synthetic marijuana use. Almost 40% of high school seniors report using marijuana in the last year. The statistics for high school dropouts is almost twice that number.

The trend of increased use includes the elderly (ages 65-84) who are being prescribed opiates in record number and is expected to increase 100% by 2020 to almost 3 million people. The number using marijuana has increased 150%.

As members, spouses and newly insured 18-25 year olds are seeking treatment for opiate addiction, TAP counselors are sending more clients for detoxification, which is the most costly level of treatment because it requires medical supervision. Once “detoxed,” clients can begin rehabilitation in residential or outpatient settings, depending on their individual circumstances and medical needs.

A different problem is developing for some union members who seek treatment for marijuana abuse or who have been referred due to a positive drug test. Some who test positive at work are able to keep their job provided they complete treatment recommended by TAP. In those cases the returning worker must test negative on a return to duty test. This can be a big problem.

The marijuana available in 2014 is sometimes more than 5-8 times as potent as marijuana in the 1970s. Additionally, some products available at dispensaries in California such as hash, cannabis butter/oil, wax and tinctures may contain 75-90% THC.

Clients abusing 2014 marijuana products may continue to test positive long after they no longer need primary treatment, sometimes for up to 90 days in extreme cases. Physicians are not willing to keep these patients on state disability simply because they cannot produce a clean urine specimen. Consequently, an employee who is eligible to return to work following successful completion of treatment in a 30-day residential treatment program may find him/herself in a dilemma. They must pass a drug test to return to work but they are no longer eligible for disability because they do not meet the criteria for primary substance abuse treatment.

TAP has dealt with several such cases recently and anticipates more in the future. Some treatment center doctors are willing to provide a letter excusing TAP clients from work until clean drug test results can be obtained. However, such clients must attend outpatient classes and support groups 3-5 days per week while they wait for THC to clear their system but are not collecting payments from disability.