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April 29 — An increasing number of employees are looking to boost their energy levels at work, which would seem to be a good thing for employers, except for the way in which they are doing it—by abusing prescription medications used to treat attention deficit disorder, such as Adderall.
While ADD medication can help people get more done in a shorter period of time or stay awake later, it also induces anxiety and increases stress, and can cause long-term physiological damage, management attorney Nancy Delogu, a shareholder in Littler Mendelson's Washington office, told Bloomberg BNA April 28.
There has been a doubling of prescriptions for ADD medicine over the last couple of years, “so we’re very much still on this escalation ramp,” Dr. Todd Simo, chief medical officer for background screening company HireRight, told Bloomberg BNA April 27. He added that we “have not seen a plateau yet,” and the problem shows no sign of abating.
The ramifications of the prevalence of ADD medication abuse in the workplace are multi-fold, Simo said. It can lead to increased medical costs for employers, increased workers' compensation costs because of related safety issues and decreased productivity. At its most dangerous, he said, “this is actually killing people.”
Adderall is an amphetamine and is one of the drugs employers usually test for, Delogu said. If an employee doesn't have a prescription for the medicine but still tests positive for it, it will be considered illegal drug use, she said.
According to Delogu, younger employees are more likely to be abusing ADD medicine.
Simo noted that stimulant abuse can no longer be confined to one type of industry or job. “Type-A personalities who want to excel” tend to be the ones who are abusing this kind of medication, he said. People feign ADD symptoms to get such drugs to gain an edge in the workplace, he added.
However, Simo noted, the more an employee uses the drug, the higher the dosage the employee needs to maintain the desired effect. This escalation in the drug's use can “profoundly affect” the chemistry in an individual's brain, he said.
An employee who exhibits a marked change in productivity or attitude may be showing signs of drug abuse, whether it’s amphetamine abuse or something else, Simo said.
As part of its drug-free workplace program, a company should already have a “reasonable suspicion” protocol, Simo said. This means there should be people in the workplace—ideally managers and supervisors—who can observe these changes in behavior and have the training to identify issues, he said.
Once an individual is identified as having symptoms of drug abuse, Simo said, “reasonable suspicion” evaluations should be performed by a health care provider working as an agent of the company to discover the source of the behavior.
Employers should approach this holistically by making the drug screen a part of an overall medical exam to see what is impairing the individual, Simo recommended.
If there is a medical diagnosis of “impairment,” the company can look at a drug screen next. The drug screen and the medical evaluation together, Simo said, give the employer the full picture of what is going on with an individual. It can help the employer decide whether the employee needs to use company resources, such as an employee assistance program, needs an adjustment in the dosage of his or her medication, or is even still employable, he said.
Employers face a bigger quandary when the employee with behavior issues has a prescription for ADD medicine, Delogu said. Normal drug-testing protocol means drug-testing companies will report back a negative test result if the employee has a prescription. However, if there is a safety concern, the drug-testing firm can flag a result that is positive for a prescription drug, she said.
Delogu advised that employers need to take safety concerns on a case-by-case basis. She recommended communicating directly with employees in hope that they will be honest about medication use or abuse. Overall, if the employee continues to exhibit concerning behavior for medications being taken legally, the employer has a right to terminate the employee's services, Delogu said.
Still, she said, the issue of abuse of prescription medications can only partially be addressed by employers, and also should be a concern for the medical field.
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