NIOSH Outlines Information on Medication-Assisted Treatment for Opioid Use Disorder

Published May 30, 2019

A new “Workplace Solutions” document published last week by NIOSH provides general information about medication-assisted treatment, or MAT, for opioid use disorder. MAT uses medications approved by the U.S. Food and Drug Administration in combination with counseling and behavioral therapies to treat opioid use disorder. NIOSH notes that MAT has been shown to be effective for many people with this disorder. According to the agency, the opioid overdose epidemic is “taking an especially devastating toll” on certain parts of the U.S. work force. Industries with high injury rates and physically demanding working conditions—construction, mining, and fishing, for example—have seen high rates of opioid overdose deaths. NIOSH states that other job factors, including high job demands, job insecurity, and lack of control over tasks, have also been linked to opioid use. The agency’s new document is intended for employers who wish to assist or support workers with opioid use disorder.

NIOSH stresses that, when starting MAT, workers should avoid driving and hazardous work activities until dosages are stabilized, side effects are managed, and impairment risks related to the work are assessed.

“Research has shown that, when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability,” NIOSH’s publication reads. “However, side effects of the medication(s) may impair a person’s ability to drive, operate heavy machinery, or perform other functions safely.”

According to the agency, side effects may vary depending on the medication, dosage, and duration of treatment. Common drugs used in MAT include methadone, buprenorphine, and naltrexone. Some medications used in MAT reduce the cravings for and the euphoria experienced with opioids, and others may also reduce the risk of a subsequent overdose. NIOSH cautions employers that workers with safety-sensitive jobs maybe subject to restrictions or limits on the tasks they can perform while using these medications.

Employers can help workers with opioid use disorder by ensuring that work is safe and that working conditions do not lead to injury or illness or contribute to painful chronic conditions. NIOSH urges employers to manage workplace stressors and job insecurity as much as possible and take steps to decrease the stigma associated with substance misuse through activities such as awareness building and supervisor training. Employers should also work with health plan providers and pharmacy benefit managers to include treatment of substance use disorders in employer health plans.

Other actions employers can take to assist workers with opioid use disorder are listed in the full NIOSH document, which is available on the agency’s website.