Presentation to Human Resource professionals at the 2016 HRSW (HR Southwest conference) in Fort Worth. Describes tools and practices that HR professionals should consider in developing a Prescription Misuse prevention strategy. Rx spend is rising for employers and the opioid problem is only one aspects of the public health issue. This presentation encourages integration Rx Awareness with workplace health promotion, wellness, or well-being initiatives. Dr. Joel Bennett has been delivering such strategies into workplace for the past 20 years. The most recent article on this work was published in July 2017.

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Joel Bennett, PhD
Organizational Wellness & Learning Systems
Fort Worth, Texas
www.organizationalwellness.com
Employee Prescription Drug Abuse:
Tips, Prevention Guidelines & Education

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RX spend is rising for employers. Adult misuse of prescription drugs is
a growing problem. Such misuse is often due to the need to manage
pain, pressure to increase productivity and attentiveness, and enhance
or manage energy, restlessness, or being overtired. When people at
risk can no longer get access to prescription medication they are
increasingly turning to illegal drugs, including heroin.
According to the CDC, people who are dependent
on prescription opioids are 40 times more likely
to abuse or be dependent on heroin. The best
way to prevent abuse is by addressing these risks
to employees and their families before someone
gets addicted.
An effective solution is using evidence-based
education and training in health consciousness.
Health consciousness means the ongoing ability
to pay attention to what we ingest; getting
exercise, rest; and using our body and mind
together. More preventive measures and training
are needed before people become addicted.
www.organizationalwellness.com

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Participants will be able to:
1. Explain Prescription Drug (PD) misuse
2. Discuss impact on workplace
3. Take simple steps to promote awareness
4. Implement some Lunch and Learn strategies

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Participants will be able to provide a brief
lunch and learn to help employees:
1. Define “health consciousness”
2. Identify healthy alternatives
3. Implement healthy options
4. Use above skills to reduce prescription
drug misuse in their own work setting

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• Simple health communications/posters
• Case studies of coworker sharing of meds
• PowerPoint presentation focusing on
special populations (e.g., teenagers,
college, aging parents) and the brain
science behind abuse
• A Jeopardy "Knowledge" game

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The employee educational module
showcased here is subject to ongoing
research. See this reference to learn
more.
Neeper, M., & Bennett, J. (2016).
Workplace prevention of prescription
drug abuse: pilot assessment of a
new psycho-educational
program. Journal of addiction
research and therapy, 7(2),
e1000277-e1000277.

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The Problem

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• Almost 2 million Americans addicted to painkillers1
• ("Opioid Epidemic,”2) has workplace implications
• Productivity3
• Absenteeism4
• Safety issues5
• Stimulants/cognitive enhancers growing concern6
• Most adults with a PD disorder remain untreated7
• Treatment is major focus (workplace8 & policy9)
• The lack of prevention represents a significant gap
in public health service and employer
[1] (SAMHSA, 2014); [2] USDHHS, 2016; [3] Hernandez & Nelson, 2010; Kuhl, 2015; [4] (SAMHSA, 2015 [5] (National
Safety Council, 2016);[6] Nicholson et al., 2015; Quest Diagnostics, 2015, Sharp, 2016; [7] McCabe, Cranford, & West
2008; [8] (Reif, et al., 2016); [9] (White House, 2016)

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“In 2010, 23% of the U.S. workforce had used prescription
drugs to get high or to self-treat a medication condition
without guidance from a physician or medical
professional.” – National Safety Council (2014)
“Work-related issues associated with increased opioid use
include the potential for work-related injuries to initiate
prescription drug use and possibly subsequent misuse” –
Centers for Disease Control (2016)
"More than 82 percent of voters think prescription drug
abuse is a problem in our country... Nearly half report they
know someone who has abused or is abusing prescription
drugs. " – 2016 Poll; CVS Health (2016)
No industry is immune

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• Benefits costs include unnecessary Rx
• Employees use in ways not prescribed
• Employees fail to report doctor Rx
• Coworkers or supervisors share PD
• Parents dealing with teen use
• Millenials enter workforce with
established habit
• Adult children with aging parents who
have multi-use problems

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– Direct consumer advertising (examples)
– Lack of professional education
– Overprescribing (first suggested treatment)
– Doctor Shopping
– Ineffective prescription monitoring
– Reactive Policies, rather than preventative
– General societal acceptance (no stigma)
– Social learning (increased parental use)

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Quick Tips
Health Communications

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1.What Can Employers Ask Employees About PD Use?
2.Modifying Drug-free Workplace Programs To Address Nonmedical
Use Of Prescription Drugs
3.Structuring Health Benefits Package Sensitive To PD Misuse Issues
4.Role Of Insurers In Preventing Misuse (What Employers Can Do)
5.5 Reasons Not To Share Prescription Drugs At Work
6.Preparing For An Employee's Return To Work After PD Misuse
National Safety Council (Employer Kit) 1
Give a Presentation 2
[1][http://www.nsc.org/learn/NSC-Initiatives/Pages/prescription-drug-employer-kit.aspx;
[2] http://www.samhsa.gov/capt/sites/default/files/resources/preventing-prescription-abuse.pdf
[3] http://publichealth.hsc.wvu.edu/icrc/prevention-of-prescription-drug-abuse-in-the-workplace/samhsa-fact-sheets
Consult Fact Sheets (SAMHSA PAW) 3

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Posters
National Institute of
Drug Abuse
Infographics (pinterest)
Secret Drug Test
National Safety Council HR Direct
Your EAP

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Concerns
— Fact-based presentations often
not engaging or effective
— Fact sheets give background
knowledge to help employees
— Posters raise awareness but need
follow-up calls-to-action
Alternatives
— Integrate PD prevention
with wellness
— Focus on healthy
alternative (de-stigmatize)
— Make it fun

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Health Consciousness
Training & Lunch and Learn

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Participants will be able to :
1. Define “health consciousness” (to prevent
prescription drug misuse)
2. Identify healthy alternatives to risks for misuse
3. Take steps to implement healthy options
4. Use the above skills to reduce prescription drug
misuse and abuse in their own work setting

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Take care of your body.
It's the only place you
have to live.
- Jim Rohn
Health Consciousness
Paying attention to what we ingest; getting
exercise, rest; and using our body and mind
together for a health enhancing purpose

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Clarification
• If you are currently taking prescription
medications:
– This training supports your continued use as
prescribed.
– And encourages you to review how you use in ways
that support your health and well-being.
– This training also will review processes and healthy
life-styles/alternatives that you are invited to
consider.

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use misuse abuse
Use: only as prescribed and then
dispensing in safe manner
Misuse: without a prescription or in ways
not prescribed; and/or sharing with others
Dependence: tolerance for or dependency
on drugs; using excessively; taking/stealing;
life/work function is disrupted

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• Jeopardy Game
1. Health Consciousness Exercise
2. Special Topics
3. Scenarios
• Jeopardy Game

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Team
Jeopardy
Game

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Section 1

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Consciousness 1.of motives for
using/misusing
2.of risks and
benefits
3.of alternatives

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Anxiety
Panic
Tension
From Table 2 Hernandez, S. H., & Nelson, L. S. (2010). Prescription drug abuse: insight into the epidemic. Clinical Pharmacology & Therapeutics, 88(3), 307-317.
Pain
Energy
Weight Loss
Relax
Attention*
MOT I VAT ION WH AT
*cognitive enhancement
www.organizationalwellness.com

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Flip chart general
benefits and risks
Flipchart 1: Your Views on
Benefits and Risks
Anxiety
Panic
Tension
Pain
Energy
Weight Loss
Relax
Attention
Benefits Risks
Q. Do you
Have any risks?
A. Get Help

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Health Consciousness
Paying attention to what we ingest; getting
exercise, rest; and using our body and mind
together for a health enhancing purposeAnxiety
Panic
Tension
Pain
Energy
Weight Loss
Relax
Attention
Benefits Risks
Healthy
Alternatives [1]
What if You Know
Someone at Risk [2]
Our
Prevention
Focus in this
Training
is in this Area
Flipchart 2: Healthy
Alternatives & Nudging
[1] See Module 4 “Raw Coping Power” in Team Awareness or Centering Module in Team Resilience
[2] See Module 6 “Encouragement” in Team Awareness or Compassion Module in Team Resilience

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use misuse abuse
Use: only as prescribed and then
dispensing in safe manner
Misuse: without a prescription or in ways
not prescribed; and/or sharing with others
Dependence: tolerance for or dependency
on drugs; using excessively; taking/stealing;
life/work function is disrupted

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Anxiety
Panic
Tension
Pain
Energy
Weight Loss
Relax
Attention

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Health
Consciousness

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Behaviors and lifestyles can protect us
from seeking refuge in addictive behaviors
• Use healthy alternatives:
habits, tactics, acts, self-reminders to
keep us in a state of Health
Consciousness
• Put ourselves in healthy situations:
(social, work, play, healthy
environments) that “pull” us to choose
Health Consciousness
• Reach out and be with others:
who “push” or “Nudge” us to choose
Health Consciousness
Know
Protective
Factors
You are worthy!
And so knighted!

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Alternative Approaches to Pain
Research!America. (2013). National Poll: Chronic Pain and Drug Addiction. Zogby Analytics. Retrieved November 22,
2013 from http://www.researchamerica.org/uploads/March2013painaddiction.pdf.
There are many different ways to manage and reduce chronic pain. Based on your experience or what you
have heard, which of the following treatments would you try to relieve chronic pain? (multiple responses
allowed) [1016 National Poll; Mar 2013]
http://www.consumerreports.org/pain-
relief/pain-relief-what-you-need-know/
April, 2016

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Exercise and
Sleep*
• Quicker to sleep
• Better quality
• Better day-time functioning
• Less disturbed sleep
• Less dependence on
prescription drugs for sleep
*http://www.sciencedirect.com/science/article/pii/S1836955312701066
Alternatives for stress
• Practice mindfulness
• Body scan
• Sitting meditation
• Gentle yoga
• Encourages observation of body
sensations, urges, and
environmental stimuli
• Exercise
• Enough sleep

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General alternatives to
prescription drug treatments
• Alternatives for pain
– Steroid injections
– Nerve blocks
– Physical therapy
– Cognitive behavioral therapy
– Biofeedback
– Therapeutic Exercise
– Manipulative Therapy
– Cold/Heat
– Micro-stimulation (Electrotherapy)
– Ultrasound
 Acupuncture
 Breath practices
 Meditation
 Guided imagery
 Progressive relaxation
 Tai chi
 Yoga
 Spinal manipulation
 Massage therapy
 Feldenkrais Method
 Alexander Technique
 Pilates
 Hypnosis
 Trager Integration
 Reiki
 Healing touch
 Qi gong
 Craniosacral therapy
 Reflexology

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Are you Now
Conscious? 1.of motives for
using/misusing
2.of risks and
benefits
3.of alternatives

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Section 2

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1 Take inventory of the prescription and OTC drugs you
have at home. Do any of them have the potential for
abuse? Properly destroy unused or outdated medicine.
2 Monitor and safeguard any and all prescription drugs
that a child is currently taking.
3 Role model care and careful use (not misuse) of any and
all prescription drugs you use. Use opportunity to
educate.
4 Openly discuss the risks of use and the importance of
medical supervision and proper disposal.
5 Understand motives behind signs of use or misuse (eg.
weight loss, pain, better grades) and speak
compassionately first.
6 Personally avoid websites that sell prescription drugs.
7 Be honest (come clean) if your child challenges your own
use.
8 Discuss how avoidance is part of HEALTH
CONSCIOUSNESS.
Things
Parents Can
Do to Help
Teens Avoid
Risks
http://medicineabuseproject.org/assets/documents/parent_talk_kit.pdf
http://www.iowa.gov/odcp/images/pdf/Parentskids.pdf

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Think About It!
• We drink
caffeine
because we
know it gives
us energy
and wakes us
up
• But do we
really know
EXACTLY what
Prescription
Drugs are doing
to our brain?

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It’s Your Brain: Be Nice to It!

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Healthy Diet
and Exercise
_______________________________
Stretching
Body
Posture
LESS
Pain
MORE
Healthy
Sleep* and
Recovery
LESS
Stress
It All
Starts
with
Healthy
Lifestyle
*http://www.sciencedirect.com/science/article/pii/S1836955312701066
Open
loop
positive
feed
back

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Poor Diet and
Exercise
-----------
No Stretching
Poor Body Posture
More
Pain
Less Sleep
and
Energy
Recovery
More
Stress
Closed
loop
of
negative
habit
Be
Mindful,
Breathe,
Explore
Healthy
Options

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It’s Your Brain: Be Nice to It!

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Our Brains are Wired to

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Easy Brain Health Tips
• Know the alternatives (to pain, sleep, stress, and
attention problems)
• Practice a healthy lifestyle (exercise, diet, sleep,
relationships)
• Treat your brain well
• Health Consciousness: Know what you take in
Only about ½ or less in
most cases were able to
accurately read and
interpret label warnings!
RESEARCH:

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Section 3

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Response (see handout)
• Phase 1. Contact and Suspend the Alleged
Supervisor
• Phase 2. Conduct a Workplace
Investigation
• Phase 3. Decision
• Phase 4. Aftermath

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Team
Jeopardy
Game

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Review
• Reviewed Problem (public
health, workplace)
• Reviewed Quick Tips
• Sampled Health Consciousness
training
– Healthy Alternatives (flip chart)
– Special Topics
– Scenario

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Contact Information
Joel Bennett
Organizational Wellness & Learning Systems
3200 Riverfront (Suite 102)
Fort Worth, Texas, 76107
817.921.4260
owls@organizationalwellness.com

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