It is a situation Dr. Eric Smiltneek sees repeatedly: A patient addicted to alcohol or drugs refuses to admit there’s a problem until work performance begins to suffer.
“Their important relationships have fallen apart, and they have money problems, but they still don’t see the addiction as a problem because they still have a job,” says Smiltneek, a family medicine physician at ThedaCare Physicians-Oshkosh who is also on the staff at Nova Counseling Services- Oshkosh. “But when that addiction interferes with work, it becomes a different story. People are more willing to seek help. For many people, their job plays an important role in how they see themselves.”
Until five or six years ago, Smiltneek says alcohol was the No. 1 addiction he saw at Nova and in clinic. Now, it is opioids. While the opioid epidemic’s impact on communities across the country is well documented, businesses are feeling the pain, too.
A study released earlier this year by the U.S. government found that while 6 million job openings are available nationwide and unemployment is at a 17-year low, the percentage of people working or looking for work is about the same as it was before the recession. The reason, according to the study authors, is that the abuse of prescription painkillers has taken thousands of working-age people out of the hiring pool.
Wisconsin employers see the negative effects the opioid crisis has on the workforce, says John Dipko, communications director for the Wisconsin Department of Workforce Development.
“As DWD executives travel the state, they hear from employers who say one of their primary challenges is finding skilled workers who can pass a pre-employment drug test,” he says. “While we are aware of only national studies on this issue, we know that in speaking with employers from across the state, drug addiction is often cited as an employment barrier that many individuals face.”
Opioids, whether it is a prescription painkiller such as OxyContin, heroin or a synthetic opioid such as fentanyl, are taking a deadly toll on the country. The National Institute on Drug Abuse estimates at least 115 people die daily from overdoses.
Today’s crisis traces its roots back to the 1990s when pharmaceutical companies began heavily promoting opioid painkillers to physicians with the assurance the medications were non-addictive. As medical providers increased the number of opioids prescribed, it quickly became clear the painkillers were addictive and it was hard for patients to get off them. When doctors stopped prescribing the pills, patients began looking to heroin and other drugs to get their fix.
Dr. Paul Pritchard, vice president and chief of quality with Prevea Health in Green Bay, says opioid addicts come from all backgrounds and locations.
Pritchard says the medical community needs to be a part of the solution to the crisis since doctors played a role in creating the problem. He says doctors have created stricter rules and protocols about prescribing painkillers.
“Some people would get their painkillers by visiting the ER, and now it is really clamped down about when those medications can be prescribed,” Pritchard says.
Kicking opioid abuse is tough, Smiltneek says, adding that withdrawal symptoms are like “the worst stomach flu you ever had — nausea, diarrhea, vomiting.”
“Some patients say they want to quit, but they are so scared of the withdrawal,” he says.
There is medication to help patients through the process. Smiltneek says patients travel from the rural areas west of Oshkosh, including the Green Lake, Berlin and Wautoma areas, to seek treatment, which includes naltrexone and buprenorphine.
In the workforce
Nearly all employers require a drug test prior to putting an individual on their payroll. Smiltneek, who also handles some occupational health duties, says that drug test can be a real barrier.
“There are people out there who cannot pass a drug screen due to their addiction,” he says. “We have a whole drawer full of contraptions that people have tried to use to cheat the test. It doesn’t work.”
Dipko says helping addicts get clean not only improves their health, but also raises their chances of landing a good-paying, stable job.
“With Wisconsin’s economy performing at historically strong levels, we need to do what we can to tap the talents of all Wisconsinites who want to work, including those who struggle with substance abuse,” he says.
For addicts in the workplace, many believe if they give 75 to 80 percent of their normal effort, no one will notice, Smiltneek says.
“They think ‘I won’t get into trouble. Everything will be fine.’ But that doesn’t work forever,” he says.
Some patients find their way to a health care clinic or Nova for treatment after being referred through an Employee Assistance Program. Workers often turn to EAPs after a friend, family member, fellow employee or supervisor confronts them about their behavior and warns they could lose their job if they don’t make a change, Smiltneek says. Occasionally, employees realize on their own that they need help.
“We help employees get the treatment they need so they are able to return to work,” he says.