Industry Voices—Is there a correlation between opioid abuse and workplace violence in healthcare?

hospital
With the alarming rise in overdoses, healthcare workers are left treating patients that may be under the influence of drugs or painfully experiencing their harmful side effects. (Getty/urfingussl)

It can happen anytime, anywhere. Workplace violence isn’t confined to one person, one room or one act.

In the healthcare industry, workplace violence can mean a number of things: a doctor bullying a nurse, a patient physically assaulting a caregiver, or a family member raising his or her voice at the front desk. Sadly, this violence is not new to the healthcare industry.

According to OSHA, 75% of nearly 25,000 workplace assaults reported annually occurred in healthcare and social service settings. Moreover, from 2002 to 2013, incidents of serious workplace violence were four times more common in healthcare than any other industry. Because of this, it is imperative that healthcare organizations identify triggers for such incidents to better protect their patients, visitors, staff and associates.

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Many believe that the majority of incidents of healthcare workplace violence occur between co-workers. However, the same OSHA study found that 80% of these workplace incidents in healthcare actually stem from patients. These assaults remain grossly underreported as well.

RELATED: Study finds vast majority of violent incidents treated in the ED are never reported to police

Many different factors can contribute to workplace violence in healthcare. Heightened emotions, extreme distress and a growing sense of anxiety are all common in the healing environment. Several other factors contribute to this violence, however—including the rising misuse of opioids.

Medical service professionals know that opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine and many others. Opioid misuse in the United States has had a long history, from unrestrained opioid prescriptions in the 19th century to downplaying the drugs’ addictiveness, thereby decreasing its prescription cost, throughout the 1990s. Not to mention the fact that every day, more than 130 people in the U.S. die from an opioid overdose.

With the alarming rise in overdoses, healthcare workers are left treating patients that may be under the influence of drugs or painfully experiencing their harmful side effects. This increases the risk of violence, as opioids have the ability to send users into a state of psychosis, causing aggressive behaviors such as physical agitation and irritation that could be taken out on caregivers.

Healthcare facilities also house several common prescription opioids, such as oxycodone, hydrocodone and morphine. The intense addictive nature of these drugs causes some users to go to extreme lengths to feed their addiction. This may include threatening or bullying healthcare workers into giving them what they want. Likewise, patients may become irate if they are denied a prescription, which could lead to further violence.

It is crucial that healthcare facilities implement strong preventative measures and advanced protocols in order to best handle workplace violence stemming from the abuse of opioids. After all, the healing environment must remain a safe one for employees and patients alike.

Is your facility experiencing a rise in workplace violence and opioid abuse? Here are three ways healthcare facilities can minimize the physical threat to employees stemming from addiction to opioids.

Recognize the risks.

Risk factors must first be identified in advance in order for healthcare workers to ensure all personnel are as safe as possible in the organization. Ask questions about your facility's location, past experiences and more to fully understand the risk at hand. For example, is the workplace located in an area with a high drug abuse rate? Do employees deal with people known to have or suspected to have a history of violence and opioid use? Understanding these risks and educating employees on what they can do to minimize this risk will help contribute to your facility’s first steps in remaining safe. When such factors are considered and understood, healthcare workers are more likely to be protected from these potentially violent occurrences.  

RELATED: Workplace violence bill would require hospitals to meet OSHA safety standards

Establish threat assessment teams. 

Another method of ensuring workplace safety is the implementation of threat assessment teams. This important group is comprised of formally trained healthcare administrators, counselors, law enforcement personnel, current staff and behavioral health professionals. Their diverse backgrounds and individual strengths help make this group responsible for addressing concerns about threatening or potentially threatening behavior that could result in violence.

End the abuse.

Over 63% of people that abuse opioids stated their goal was to relieve physical pain. Merely denying opioids or even sending the patient to a rehabilitation program may not end the abuse, if pain management is not part of the treatment program. Between 2002 and 2014, opioid abuse declined in younger age groups but nearly doubled among those over age 50.

As the United States’ opioid crisis continues to unravel and the rates of workplace violence in healthcare steadily increase, healthcare facilities must do everything they can to minimize potentially threatening situations. Understanding how the opioid crisis has affected safety in the healthcare setting is important in knowing how to reduce violence within it.

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