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一种保护工人免受与职业暴露、伤害和压力相关的阿片类药物使用障碍及过量用药影响的公共卫生方法:美国公共卫生协会政策声明第202012号,发布于2020年10月24日。

A Public Health Approach to Protecting Workers from Opioid Use Disorder and Overdose Related to Occupational Exposure, Injury, and Stress : APHA Policy Statement Number 202012, Issued October 24, 2020.

出版信息

New Solut. 2021 Nov;31(3):373-383. doi: 10.1177/10482911211031012. Epub 2021 Jul 6.

Abstract

Opioid overdose mortality, in combination with increased deaths from alcohol and suicide, is having a profound impact on American workplaces, compromising occupational health and safety and increasing workers' compensation and health insurance costs, absenteeism, and lost productivity. The President's Council of Economic Advisers estimates that more than 1 million workers are out of the workforce due to the opioid crisis. The impact on workers is equally profound, including job loss, divorce and family disruption, and potentially imprisonment, injury, illness, and death. Pain from occupational injuries and illnesses and stress are important pathways to opioid use disorder. Effective workplace programs that incorporate the public health approach to prevention offer a significant opportunity to prevent and respond to the opioid crisis. To date, the nation's efforts at combating the crisis have not included the necessary policy reforms to transform the workplace from a pathway to opioid misuse to a pathway to prevention, including education of workers, unions, employers, and health care providers and treatment and recovery of affected workers. Several key policy interventions are recommended to address this disconnect, including prevention of workplace injury, illness, and emotional distress; worker education and training; and replacement of stigmatizing, punitive workplace substance use programs with supportive programs. Increasing access to alternative pain treatment and preventing opioid misuse in workers' compensation systems are other key policy recommendations.

摘要

阿片类药物过量致死,再加上酒精和自杀导致的死亡人数增加,正在对美国职场产生深远影响,损害职业健康与安全,增加工人赔偿和医疗保险成本、旷工率,并导致生产力损失。总统经济顾问委员会估计,超过100万工人因阿片类药物危机而无法工作。对工人的影响同样深远,包括失业、离婚和家庭破裂,甚至可能导致监禁、受伤、患病和死亡。职业伤害和疾病带来的疼痛以及压力是导致阿片类药物使用障碍的重要途径。采用公共卫生预防方法的有效职场项目为预防和应对阿片类药物危机提供了重大契机。迄今为止,美国应对这场危机的努力尚未包括必要的政策改革,以将职场从阿片类药物滥用的途径转变为预防途径,其中包括对工人、工会、雇主和医疗保健提供者进行教育,以及对受影响工人进行治疗和康复。建议采取几项关键的政策干预措施来解决这种脱节问题,包括预防职场伤害、疾病和情绪困扰;对工人进行教育和培训;用支持性项目取代带有污名化和惩罚性的职场药物使用项目。增加获得替代疼痛治疗的机会以及防止工人赔偿系统中的阿片类药物滥用是其他关键的政策建议。

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