The United States Senate has proclaimed August 21 to be Fentanyl Prevention and Awareness Day,¹ in a move to increase perception of the dangers of this particularly potent opioid drug.

Illicitly manufactured fentanyl  has led to a substantial increase in the amount of drug overdose deaths  - with 70,601 reported in 2021.³ Fentanyl is 50 times stronger than heroin, 100 times more potent than morphine, and only 2mg of the drug can cause sudden death.²

Fentanyl is often used as a combination product to cut other drugs, and has been found in cocaine, heroin, Xanax, Adderall and marijuana as well as a number of other drugs.²

The DEA reports that 4 in 10 counterfeit pills manufactured with fentanyl are deadly,and this poisoning can happen very quickly (within just 2 minutes of use).² Fentanyl essentially suffocates the body by shutting down the neurological and respiratory systems.²

So what does this mean for the workplace?

While the safest workplace is a drug-free workplace, 2022 saw a 4.6% overall positivity rate in urine drug tests, which is the highest rate in 20 years.⁴ And while 75% of U.S. employers have been directly affected by opioids, only 17% feel extremely well prepared to deal with the issue, according to a 2021 survey by the National Safety Council.⁵

All workplaces should begin by consulting their legal teams and ensuring that they have a comprehensive drug-free workplace program in place. Alongside this, employers should ensure that their employees have access to resources like Employee Assistance Programs (EAPs) to help address access to care for individuals with a substance use disorder and resources for recovery needs.

But what if an overdose does happen in the workplace? Nearly 9% of occupational injury deaths in 2021 were contributed to workplace unintentional overdoses.⁶

Employers and supervisors should be well-trained in how to recognize signs of an overdose, a few of which are outlined below. The Drug Free America Foundation, Inc. highly recommends our employee and supervisor trainings which walk through this process in far more detail (find more information here: https://www.ndwa.org/services/training/).

Signs of opioid overdose could include¹:

• Non-responsiveness or stupor
• Pinpoint pupils
• Slow, weak, or no breathing
• Cold and/or clammy skin
• Discolored (bluing) skin, especially of lips and nails
• Seizure-like activity

As an overdose is a life-threatening medical emergency, 911 should be notified immediately.

Another important step employers can take is having naloxone (brand names NARCAN, EVZIO) in the workplace. Naloxone is a drug that can temporarily reverse many of the life-threatening effects of opioid overdose.¹ There are two forms (nasal spray and injection), and the drug is easy to administer with training.⁶ While naloxone is available in all 50 states, employers should always consult their legal teams to ensure they are following all state laws regarding naloxone use. You can find more information about administering Naloxone here: https://www.cdc.gov/stopoverdose/naloxone/index.html

Employers can take the opportunity presented by National Fentanyl Prevention and Awareness Day to review their alcohol and drug policies and ensure that workplaces are prepared for preventing an overdose. For more information on how to setup a naloxone program, visit https://www.cdc.gov/niosh/docs/2019-101/pdfs/2019-101.pdf.

Resources:

1. Fentanyl. (n.d.). DEA. https://www.dea.gov/factsheets/fentanyl
2. Fentanyl Facts | Facing Fentanyl. (n.d.). Facing Fentanyl. https://facingfentanylnow.org/fentanyl-facts/
3. Drug Overdose Death Rates | National Institute on Drug Abuse. (2023, July 9). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
4. Drug Testing Index | Quest Diagnostics. (2023). https://www.questdiagnostics.com/business-solutions/employers/drug-screening/knowledge-center/drug-testing-index
5. Poll: 75% of Employers Say Their Workplace Impacted by Opioid Use - National Safety Council. (2019). https://www.nsc.org/newsroom/poll-75-of-employers-say-their-workplace-impacted
6. Work Safety Topic: Overdose Deaths - Injury Facts. (2023, March 29). Injury Facts. https://injuryfacts.nsc.org/work/safety-topics/overdose-deaths/