Dr. Nathan Charlton is a professor of emergency medicine at the University of Virginia and a specialist in addiction medicine. Every Wednesday afternoon, he works in a clinic counseling patients with substance abuse disorders, including opioid use disorders. “We have a naïve approach to who we think is using opioids,” he says.

It’s not that society — and businesses — is no longer unaware of the opioid crisis that started in 2011, when opioid prescriptions peaked. In 2022, 108,500 people died of a drug overdose, and over 82,136 of those deaths involved opioids, according to the Centers for Disease Control and Prevention (CDC). Those statistics are attention-grabbers and cited in any number of newspaper and magazine articles, mainstream media TV news shows, books, documentaries, YouTube videos and other media outlets. 

Awareness certainly comes from first-hand experience with the epidemic. A friend, family member, coworker, neighbor suffers and struggles — and sometimes overdoses. This makes the opioid use disorder very real and personal. “I had a family member who died of an opioid overdose 15 years ago. This is a very important topic for me, so any chance I get to teach a class (using American Red Cross training such as “Opioid Overdose and Naloxone Administration”) I jump and do it,” says Mathew O’Neil, one of the founders of Purple Heart and Safety, a training school in Elkridge, Maryland.

All walks of life

Educating the public and the business community about opioid use disorder is challenged by a stereotype many people carry with them — the street junkie living in a tent. This image misleads the public and many employers. “I have patients in my clinic who come from healthcare, come from the streets, come from blue-collar jobs, white-collar jobs,” says Dr. Charlton, who is the chair of the Red Cross Scientific Advisory Council’s First Aid Sub-council. “[Opioid abuse] really affects all walks of life.”

In the business world, helping employees with opioid use disorder is often set aside not only because of stereotypes but also because employees can function well on the drug. It is similar to alcoholism. There are very functional alcoholics, and very functional employees with opioid use disorder, says Dr. Charlton. 

That might help explain why so many businesses are unprepared to deal with opioids at work. Fewer than 20 percent of companies felt extremely well prepared to combat the opioid crisis, according to 2017 survey by the National Safety Council. Just 13 percent were very confident they could identify risky use. This despite 70 percent of employers reported in the survey that their businesses had been affected by prescription drug abuse, including absenteeism, presenteeism (on the job but impaired), positive drug tests, injuries, incidents and overdoses.

A massive increase in training

In 2023, six years after the National Safety Council survey, the number of employers prepared to confront the opioids scourge and capable of identifying risky use has likely increased. A massive education effort is the reason why. The Red Cross launched “First Aid for Opioid Overdoses” in 2018. “Awareness through education is the key because people don’t know what they don’t know,” says Tony Rootes, vice president of training, consulting, licensing and compliance for American Security and Investigations, LLC.

Training courses to recognize the signs and symptoms of an opioid overdose, how to give appropriate care, and how to give naloxone are offered by government agencies such as the Centers for Disease Control and nonprofits including the Red Cross. 

“Education can help build resiliency in the workplace among workers,” says Dr. Charlton. “I’m a firm believer that first aid education prepares people to recognize crises, whether they are an opioid overdose or a bleeding emergency or a cardiac arrest.” 

Rootes offers the online Red Cross “Until Help Arrives” course to his customers, especially those who have tenants in the building. “These clients want to know ‘Hey, what can I do if my coworker collapses in front of me?’ ‘Until Help Arrives’ is a phenomenal course for them because it gets right to the point.” 

O’Neil of Purple Health offers the 45-minute Red Cross “Skill Boost: Opioid Overdose and Naloxone Administration.” He continues to add locations as he expands across of the country. The more of these types of courses that we can teach, then the greater impact that we can have,” he said. “If we can do our part and awareness increases, then maybe we can start to put a dent in this horrible crisis.”

A disease, not a character flaw

Treating opioid use disorders and other substance abuse cases as a disease, not a moral issue, is part of many training courses today. “It’s not anyone’s fault that they have this substance use disorder,” says Dr. Charlton. “Nobody grows up thinking that this is what they’re going to do with their life. We all want good jobs. We all want to be healthy and happy. It is a disease; it is not a moral issue.”

Beyond reacting to overdoses

“We can all do a great job of scrambling to react,” says O’Neil. “But if we didn’t have to do as much scrambling and reacting that would be even better.”

Some employers are proactive. “We like to look down the road a little bit,” says Rootes. “Not that we can read the tea leaves all the time, 100 percent accurately. But we like to look down the road and see what’s coming so we can provide better training. And we have some clients who are really concerned about the opioid overdoses.”

Training (online, video or in the classroom) goes beyond the reactive “how to handle opioid emergencies.” “There is a very different vibe in the room,” says O’Neil. “There is a level of commitment or of concern that doesn’t exist to the same level when I’m teaching a basic First Aid and CPR class. When it comes to the opioid course, you can hear a pin drop. At any time, at any part of that course, people are tuned in, they’re hearing every word, and they feel they want and need to know the material.”

Life-and death-stakes

This intense commitment to understand and help comes from the life-or-death stakes of opioid use disorders and overdoses. “People want to know, ‘Hey, what can I do if my coworker falls down in front of me’,” says Rootes.

Education can boost looking out for each other, says O’Neil. “If we all look out for each other, if you see something that instinctively tells you maybe someone is experiencing a health problem, observe more closely and maybe say something like, ‘Do you mind if I just ask you a couple of questions about what you’re experiencing?’ Maybe it turns out to be a big nothing. Or maybe upon further questioning it turns out the person needs to get checked out.”

Looking out for each other is safety 101. It’s what behavior-based safety is all about. It’s embedded in the mantra, “If you see something, say something.” And many employers have come to see that such safety practices and other pays dividends. The payoff that comes with being proactive about opioid use disorder includes fewer injuries, reduced absenteeism, increased productivity, lower healthcare and workers’ comp costs (large employers spent $2.6 billion on treating opioid abuse and overdoses in 2016, according to the Peterson-Kaiser Health System tracker), increased job loyalty and increased health and wellbeing.

In 2023 there is no excuse for being ignorant about opioid use disorder and unprepared to deal with a crisis. There is too much education and training on the market. Too much media saturation on the issue. Just as many companies put dollars into safety programs, time and dollars must go to being proactive about the opioid scourge. It is a matter of life and death.