Connections between workplace drug policies, mental health and opioid misuse

A new study from the Texas A&M University School of Public Health uses national data on drug use and mental health to explore how workplace drug policies correlate with opioid use and misuse and psychological distress in American workers.

Aurora Le, PhD, associate professor in the Department of Health Behavior, and colleagues from the University of Michigan analyzed data to answer questions about interactions between psychological distress, workplace drug policies and opioid misuse.

Using data from the 2020 National Survey on Drug Use and Health, researchers focused on adults over age 18 who worked full or part time. The data included information on misuse of opioids during the past year as well as type of opioid used, a measure of psychological distress and details on workplace drug policies such as whether a positive drug test resulted in immediate termination, known as a punitive workplace drug policy.

Le and colleagues sought to answer three questions: were workers reporting psychological distress in the past year more likely to have misused opioids, did punitive policies influence opioid misuse, and did psychological distress and harsher drug policies correlate with opioid misuse?

“The findings on psychological distress, drug policies and opioid misuse highlight a need for workplaces to reassess their drug policies,” Le said. “We found that workplace drug policies are intended to reduce physical hazards like accidents, but punitive policies could also worsen psychological distress, exacerbate existing health disparities or even discourage reporting of hazards.”

The researchers found that 3.38 percent of the people in the study reported misusing opioids in the past year, with prescription pain relievers being the most common. Workers who reported past year misuse were also more likely to have high psychological distress scores, as expected. Surprisingly, they found no association between punitive policies and opioid misuse overall; however, further analysis highlighted interactions related to age and race that could indicate more complex interactions.

The researchers also noted that the relationship between psychological distress and opioid misuse varied with respect to punitive policies and race and ethnicity. Additionally, the analysis showed that non-Hispanic white workers and those with higher education and income levels were more likely to misuse opioid prescriptions than others.

They also note that this disparity could be due to differences in access to care and prescription pain relief among different racial and ethnic groups or biases within health care. These findings indicate that there may be multiple factors at play that warrant further study.