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Opioids are a group of drugs that includes products such as morphine, heroin, methadone, fentanyl and oxycodone. This group of drugs is often prescribed to manage pain. Opioids can cause euphoria feeling of being high , which increases the potential for the drugs to be used improperly. Fentanyl is 50 to times more powerful than morphine. Other drugs from the same group, such as carfentanil, can be 10, times more powerful than morphine for those who have not built a tolerance to the drug. As stated by the Government of Canada , opioids are intended to treat pain. Doctors may also sometimes prescribe them for other conditions, such as moderate to severe diarrhea, or moderate to severe cough. However, in the case of illegal drugs it is not always possible to determine if other components have been added. Fentanyl, for example, has no taste or smell. However, only a few grains similar to grains of salt can cause severe harm, including death. In some cases, fentanyl is found in counterfeit pills that are made to look like prescription opioids, and it can be mixed with other drugs such as heroin or cocaine. Health and Safety Programs. Opioids include three categories of pain-relieving drugs: Natural opioids also called opiates which are derived from the opium poppy, such as morphine and codeine Semi-synthetic opioids, such as the prescription drugs hydrocodone and oxycodone and the illegal drug heroin Synthetic opioids, such as the prescription drugs methadone, tramadol, and fentanyl Fentanyl is 50 to times more powerful than morphine. If you have been prescribed an opioid medicine, it should: only be taken as prescribed never be used by someone for whom it was not prescribed never be taken with alcohol or other medications except as prescribed Prescription opioid medications are available in various forms, such as: Syrups Tablets Capsules Nasal sprays Skin patches Suppositories Liquids for injection However, in the case of illegal drugs it is not always possible to determine if other components have been added. Opioid use can be a concern in the workplace for several reasons: Use as a result of workplace injuries Opioids are prescribed to manage pain, including injuries that have resulted from the workplace. Workplaces that have, for example, slip and trip hazards or heavy work can be associated with opioid use. Opioid use and misuse tend to be higher in workplaces that have lower paid sick leave and lower job security, suggesting that individuals may feel they need to return to work quickly after an injury and use these substances to control pain. Lack of paid sick leave and lower job security may also make workers reluctant to take time off to get appropriate treatment. Effects of taking opioids, including safety when working e. Short-term side effects include drowsiness, nausea, vomiting, euphoria feeling high , difficulty breathing, headaches, dizziness, and confusion. These effects may cause impairment and the individual may not be able to do their job safely. Long-term side effects include increased tolerance, substance use disorder or dependence, liver damage, and worsening pain. Problematic opioid use or substance use disorder People who use prescription drugs may misuse them, which may lead to the development of a dependence. It has been noted that prescription misuse for opioids may lead to illegal drug use, including the use of heroin or other street drugs. As a person develops an addiction, they begin to crave the drug and continue to use it regardless of the harmful effects. This need becomes the focus of their feelings, thoughts, and activities. As a result, the individual may not be focused on their work or may be unable to do the job safely. Dealing with a poisoning You may encounter a customer, client, member of the general public, or co-worker who has been poisoned by the product. Safety of the first responder A first responder may encounter the product when performing first aid measures or routine law enforcement duties. Workplaces can: Prevent injuries. Injuries such as those caused by lifting manual materials handling , working in awkward positions, repetitive manual operations, pushing and pulling , or slips, trips and falls can lead to the need for pain medication. Provide a mechanism for employees to report when they feel impaired, or if they suspect impairment in others. Include the use of prescription medication in polices about impairment in the workplace. This policy can include that it is not permissible for employees to offer their prescribed medications to others, even if the other person has a similar prescription. Encourage employees to discuss options for other options for pain control with their health care providers. Provide education and training, including the following topics. Safe working and lifting techniques, including work-related musculoskeletal disorders. Back injury prevention. Awareness of the impact of using opioids, even when prescribed. Recognition of impairment in self and others. Safety during first response activities e. Provide appropriate training to first aid responders and provide naloxone as part of your first aid response program. Offer 'return to work' programs to allow an employee time to recuperate before returning to full duties. Offer health care benefits that include access to services such as physical or massage therapy as methods to treat the injury or pain where appropriate. Offer employee assistance programs EAP or access to similar programs to assist employees dealing with drug use issues, dependence, addiction, etc. The Government of Canada suggests: Keep your medication safe to help prevent problematic use by others by: never sharing your medication with anyone else this is illegal and may also cause serious harm or death to the other person ; keeping track of the amount of pills remaining in a package; storing opioids in a safe and secure place, out of the reach of children and teenagers. Unused portions of opioid medicine should always be: kept out of sight and reach of children and pets; stored in a safe place to prevent theft, problematic use, or accidental exposure; returned to a pharmacy for safe disposal if it is no longer needed or expired. Safe disposal prevents any possibility of illegal use and protects the environment from contamination. Fact sheet last revised:
'Cognitive-enhancing drugs' are pharmaceutical substances claimed to improve mental performance, such as focus, concentration, memory or motivation.
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The use of drugs for non-medical reasons as cognitive enhancers is starting to spread and become normalised among students and certain groups of workers. In the context of increasingly competitive society and working environment the use of these performance-enhancing drugs is expected to grow in the future while the long-term consequences are still unknown. Employees obtain the drugs by another means such as buying them off someone who does have a prescription or off the internet. However, there are three main pharmaceutical drugs which are commonly associated with cognitive enhancing:. Ascertaining quantitative measures of prevalence of cognitive enhancers is difficult, particularly due to non-prescribed use and internet sales. However, there is evidence of specific groups using or abusing of performance-enhancing drugs in the context of employment and the workplace:. Military: modafinil is made available to combat personnel serving with various military forces under medical supervision and clearly defined circumstances. Transportation workers: long distance transport workers are associated with the use stimulants principally amphetamines to cope with long shifts. Shift Work Sleep Disorder is a diagnostic category in the USA with modafinil recognised as a medically approved treatment to promote alertness. Other groups of workers in high pressure, competitive or bullying work cultures, including city traders, academics and lawyers, are associated with the use of these drugs for a variety of reasons, e. The use of these substances is rising not only at universities but also at schools. Those students who have already used performance-enhancing drugs may be more likely to continue use as they move into graduate occupations. In general terms they have the potential to produce a degree of alertness or the ability to concentrate on a task e. The findings from a number of scientific studies do not seem to be in agreement with regard to the enhancing potential of these drugs in healthy individuals, nor do they agree on the side effects, for both short and long term usage, including their addictive potential. Causal effects of drugs have been tested within patients with health problems but there are no studies with healthy users. Performance-enhancing drugs are not predominantly used under prescription and medical advice so the doses used are not under medical supervision. Individual tolerance to the drugs usually increases over time, therefore posing the problem of employees taking increasing amounts, and the chances of adverse side-effects and addiction increase with higher doses. Although the focus of performance-enhancing drugs is on cognitive effects, they simultaneously have physical and emotional effects which should not be overlooked. Adverse side effects may pose a risk both to the organisation of work as well as to the employees concerned and the may be subject to important individual differences. Those effects can include:. Amphetamines: increased risk of heart problems, high blood pressure and stroke; tolerance and addiction; mental health problems; sudden discontinuation can produce withdrawal symptoms. Methylphenidate: similar risks to amphetamines but potentially less addictive; more adverse symptoms through long term use, especially psychotic disorders in children. Modafinil: skin reactions; cardiac events, high blood pressure and arrhythmias; psychotic disorders. Considered to pose a low risk of dependency in short term use but dependence for long term use has not been ruled out. In considering the effects of the drugs, it is important to note that research shows that although there may be improvements in the performance of some cognitive tasks, the performance of others may be degraded. In addition, overconfidence with abilities overestimated could be problematic in the context of decision making in critical situations. Overconfidence could also pose a problem in the context of teamwork, potentially undermining group cohesion and co-operation. Any effect of performance-enhancing drugs on mood, emotion or motivation has a potential to impact performance at work, including relationships with others and teamwork. A trade-off between increasing concentration or focus and a decrease in sociability would be useful when individuals work alone on a task but could be problematic in the context of teamwork. The general potential risks arising from the use of performance-enhancing drugs on workers and on work have been described above. However, the use of these drugs poses other occupational safety and health OSH problems in the workplace:. Existing OSH approaches tend to assume that drug use including alcohol is primarily a non-work activity and poses a problem for the workplace, linking any sort of drug use with poor work performance. But performance-enhancing drugs are used to cope with or to enhance work, sometimes with explicit or tacit approval or acceptance by an organisation. Thus, if existing workplace drug policy and procedure assume that drug use necessarily impairs performance, then this is not a useful basis to consider policy for substances that are at least intended to improve performance and safety even if this is not substantiated in practice. Furthermore, traditional approaches to drug use and the workplace tend to focus on the individual worker as drug ab user, defining them as a problem to be treated either through disciplinary procedure or through welfare programmes. This is a very partial approach which brackets off the work environment itself and the interaction between employee and their working conditions. Welfare or wellbeing schemes which only focus on the individual employee will be unable to adequately address cognitive enhancers use in the workplace. Existing research into substance abuse in the workplace links individual behaviours with employment characteristics. A preventive OSH approach to the issue should identify and adapt the working conditions that lead employees to use cognitive enhancers, e. Another issue for employers is how and whether to determine if workers are using performance-enhancing drugs in order to cope with work. In relation to drug testing, it is problematic and controversial. Attitudes to and practices around workplace drug testing vary between countries. Specific legislation exists only in Ireland, Finland and Norway. Elsewhere practices steer a course between the thorny issues of individual freedom compared to duty of care and a safe working environment; and employee consent balanced against a fundamental right to privacy. Thus drug tests cannot test for impairment or intoxication at the time of testing. There is also a significant problem of the false positive. All of these factors suggest that the discussion about Europe-wide random workplace drugs testing to deal with the increased use of performance-enhancing drugs, would in itself be inadequate to deal with the health and safety and other employment issues related to the use of these drugs in the workplace. The effect of performance-enhancing drugs on OSH and other managerial issues is complex. This is an evolving area, which suggests dynamic changes in the future. More work needs to be done to better understand the potential effects of performance enhancement drugs in the workplace. The amount of literature that continues to be generated on this is enormous, and the different views reflect the broad range of interested actors, including neuroscientists, ethicists, popular media, the biohacking community, and professional bodies representing various occupations. Thus there is a growing need for dialogue and the formulation of health and safety policy and practice that specifically addresses this area. Home Themes OSH in general Identifying new and emerging risks A review on the future of work: performance-enhancing drugs. A review on the future of work: performance-enhancing drugs. Further reading. This article is not available in other languages. Share this on:. Introduction The use of drugs for non-medical reasons as cognitive enhancers is starting to spread and become normalised among students and certain groups of workers. What are performance-enhancing drugs? However, there are three main pharmaceutical drugs which are commonly associated with cognitive enhancing: Amphetamines — stimulants used to treat ADHD or narcolepsy. They increase dopamine levels. Adderall trade name is a mixture of amphetamine salts. Other branded amphetamines in this category include Dexamed dexamfetamine sulphate , also branded in Europe as Attentin and Tentin. Methylphenidate - is a central nervous system stimulant used for treating ADHD and narcolepsy. It increases levels of the neurotransmitters dopamine and norepinephrine. Its exact action on the brain is not fully understood but it is known to interact with neurotransmitters such as dopamine and norepinephrine. Prevalence of current use Ascertaining quantitative measures of prevalence of cognitive enhancers is difficult, particularly due to non-prescribed use and internet sales. However, there is evidence of specific groups using or abusing of performance-enhancing drugs in the context of employment and the workplace: Military: modafinil is made available to combat personnel serving with various military forces under medical supervision and clearly defined circumstances. Those effects can include: Amphetamines: increased risk of heart problems, high blood pressure and stroke; tolerance and addiction; mental health problems; sudden discontinuation can produce withdrawal symptoms. Implications for occupational safety and health The general potential risks arising from the use of performance-enhancing drugs on workers and on work have been described above. However, the use of these drugs poses other occupational safety and health OSH problems in the workplace: Management efforts to increase productivity may lead to either direct coercion or indirect expectations — social pressure to conform - on employees to use drugs, given the inherent imbalance of power in the employment relationship and that it is just as likely that managers and senior professionals themselves could be users. Employee choice and discretion are thus seriously reduced, with consequences for employee motivation and commitment. The use of performance-enhancing drugs will give some employees an unfair advantage over others and may pose a risk of discrimination by employers against individuals who choose not to engage in such enhancement. In both cases there is a matter of individual adaptation as a means of coping with the demands of the workplace instead of the necessary adaptation of the work to the individual. The assumption that performance enhancement can be achieved by individuals taking enhancing drugs might lead to cultures where it is accepted that employees will work longer hours, take on more intensive work loads, be able to cope with working at a greater pace, etc. In the longer term this has consequences on the safety and health of workers e. At present there is not a distinct group of drugs which can be obtained and used for cognitive enhancing. Existing prescription drugs used off-label, some illicit drugs, and over-the-counter nutritional and other substances are used for these purposes. OSH responses need to take this diversity and lack of medical guidance into account. Concluding remarks The effect of performance-enhancing drugs on OSH and other managerial issues is complex. New drugs and uses for existing drugs are constantly being developed and trialled. Although at present, prescription is limited to medical therapy, either a change in attitude towards prescription for human enhancement purposes or the development of cognitive-enhancing drugs which are acknowledged to be safe and therefore can be sold over-the-counter for enhancement, would significantly increase the availability and acceptance of enhancement through drugs. Employment relations which lead to high-pressure, highly competitive workplaces, high-stress and low employee control workplaces, are likely to increase the perceived need and use of performance-enhancing drugs. Identifying new and emerging risks. Select theme. Biological agents Carcinogenic, mutagenic, reprotoxic CMR substances Chemical agents Dust and aerosols Endocrine Disrupting Chemicals Indoor air quality Irritants and allergens Nanomaterials Occupational exposure limit values Packaging and labeling Process-generated contaminants Risk management for dangerous substances Vulnerable groups. Anthropometry Cognitive ergonomics Ergonomic work design Ergonomics in office work Human errors Human machine interface Musculoskeletal disorders Physical ergonomics. Accidents and incidents Errors and violations Fire and explosion Machinery and work equipment Maintenance Road safety Slips, trips and falls Working on height Workplace transport. Discrimination Harassment Job satisfaction, engagement and performance Mental Health Psychosocial issues in specific sectors and groups Psychosocial risk factors Violence Work-life balance Work-related stress management. Health and well-being Health, screening and surveillance Occupational diseases Substance abuse. Karen Dale. Lancaster University. Brian Bloomfield. Related articles OSH in general. OSH in general.
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Provides hazards and solutions for employee exposure to hazardous chemicals, such as pesticides, disinfectants, and hazardous drugs in the workplace. Pharmacy.
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