Pain in the Workplace IS PAIN HURTING YOUR

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Pain in the Workplace IS PAIN HURTING YOUR BUSINESS? MELODY HICKS, MC, LPC

Pain in the Workplace IS PAIN HURTING YOUR BUSINESS? MELODY HICKS, MC, LPC

What to Expect • • • Introductions What is Pain? How much does pain

What to Expect • • • Introductions What is Pain? How much does pain cost employers? Prescription pain medication Preventing Pain; dealing with pain Summary & Resources

Introductions • Melody Hicks, MC, LPC – Behavioral Health Integration Manager in the Healthcare

Introductions • Melody Hicks, MC, LPC – Behavioral Health Integration Manager in the Healthcare Innovation Department at Maricopa County Public Health • Sherry Haskins, MPA, Worksite Initiatives Manager at Maricopa County Public Health • Angela Moreth & Vincent Lopez – webinar crew from Maricopa County Public Health

What is Pain? “Pain is a common human malady that spares no group and

What is Pain? “Pain is a common human malady that spares no group and often impairs function. ” from a study published in the Journal of the American Medical Association

Types of Pain Chronic Episodic Pain (Migraines) Chronic Persistent pain (pain from arthritis) Acute

Types of Pain Chronic Episodic Pain (Migraines) Chronic Persistent pain (pain from arthritis) Acute pain (sudden, intense…related to an emergent health problem or injury) Pain is difficult to measure & has an emotional component

How Prevalent is Pain? From 2008 World Health Organization Survey… 43% of people in

How Prevalent is Pain? From 2008 World Health Organization Survey… 43% of people in the U. S. -approximately 100 million adults report having “common chronic pain conditions” Leading persistent pain - headaches (migraines); back pain and neck pain 40 to 50% of Americans feel that pain interferes with their mood, activities, sleep, ability to work or enjoyment of life

2014 Bureau of Labor Statistics 2. 8 million reported on the job injuries

2014 Bureau of Labor Statistics 2. 8 million reported on the job injuries

Workman’s Compensation • Work related Musculoskeletal disorders refer to disorders of the neck, back,

Workman’s Compensation • Work related Musculoskeletal disorders refer to disorders of the neck, back, hand/wrist, elbow and shoulder affecting muscles, tendons, nerves and joints not caused by acute trauma Up to 80% of all claims

How much does Pain cost employers? In 2010 the Institute of Medicine of the

How much does Pain cost employers? In 2010 the Institute of Medicine of the national Academies Report compiled information about pain for employers. They looked at three factors: 1. Days missed because of pain 2. Hours of work lost because of pain 3. Wages lowered because of pain Dollars lost between 297 to 335. 5 billion annually Incremental Health care costs range from 261 to 300 billion

Prescription Drugs for Pain - Opioid pain relievers are often prescribed for injuries and

Prescription Drugs for Pain - Opioid pain relievers are often prescribed for injuries and after surgery - Acute vs. chronic pain - Increase in abuse and misuse in past 25 years

Some medications for pain • • • Codeine Fentanyl Hydrocodone Hydromorphone Meperidine Morphine Oxycontin

Some medications for pain • • • Codeine Fentanyl Hydrocodone Hydromorphone Meperidine Morphine Oxycontin Oxycodone Tramadol

The risks of taking prescription (Opioid) drugs for pain - Low blood pressure; slowed

The risks of taking prescription (Opioid) drugs for pain - Low blood pressure; slowed respiratory rate - Memory problems - Physical dependence - Addiction/misuse - Decreased work performance - Increase in risky behavior; accidents - For women of childbearing age, risks with pregnancy

Few Facts about Prescription Opioids 37 % of drug overdoses involve prescription opioids –

Few Facts about Prescription Opioids 37 % of drug overdoses involve prescription opioids – age range at most risk 45 -64; substantial number of women Arizona ranks 12 th in prescription opioid overdose deaths Effectiveness of opioids for chronic pain is questionable

What Can Employers Do? Start the Conversation… What is your organization doing to educate

What Can Employers Do? Start the Conversation… What is your organization doing to educate employees about pain medications and disposal of such medications? What is your organization doing to prevent or reduce pain created in the workplace?

Consider creating policies around use of prescription medication Remember the ADA (Americans Disability Act)

Consider creating policies around use of prescription medication Remember the ADA (Americans Disability Act) is important to review/understand with regards to the use of over-the-counter/prescription drug use • Create policies for assisting employees who might be dependent/abusing substances to get assistance and to protect their confidentiality • Create policies around those returning to work from treatment Drug Testing – When and Why to do it? 15

Train Supervisors and Managers how to identify employees in pain or using prescription pain

Train Supervisors and Managers how to identify employees in pain or using prescription pain medication and how to approach employees Signs/symptoms: • • • Inconsistent or declining productivity Trouble concentrating Increasing absences, illnesses, accidents or injuries Bad judgment, risky behavior, improbable excuses Increasing problems with supervisors, colleagues Deteriorating grooming or personal appearance Approach: State observable behaviors or changes in behavior/productivity and come from a place of concern. Ask open-ended questions. Suggest use of Employee Assistance but work from a performance issue standpoint. 16

Offer Options for Reducing/preventing pain in the workplace • Occupational Therapy options for those

Offer Options for Reducing/preventing pain in the workplace • Occupational Therapy options for those that report pain or are injured • Complementary and Alternative Medicine (CAM) options • Identifying ergonomic hazards that pose the risk of injury to the musculoskeletal system and reducing ergonomic stress • Employee Assistance Programs (EAP) for assistance with mental health and substance use problems 17

Success Stories 18

Success Stories 18

Ergonomics BMW in 2007 implemented a pilot project for workers on an assembly line.

Ergonomics BMW in 2007 implemented a pilot project for workers on an assembly line. • • Replaced cement floors to reduce impact on knees Barbershop chairs were installed to allow workers to sit at workstations Orthopedic footwear provided to reduce strain on feet Adjustable worktables to reduce physical strain and facilitate personnel rotation during shifts In the first year – 7% increase in productivity reduction from 7% to 2% of absenteeism

Service. Master of Seattle, which is a disaster restoration service company decided in 2007

Service. Master of Seattle, which is a disaster restoration service company decided in 2007 to move their cleaning and storage facility because their lease was up. Before moving they decided to consult an ergonomics expert to improve productivity and to reduce pain and injuries. Changes: - Shortened the reach to conveyer belts/counter depth - Bought easy to move tables for staging and storage - Bought rolling racks to easily move items As of 2008 productivity was up by 8 percent; they also saved 2% in building costs for their new cleaning stations. 20

Complementary Alternative Medicine Ronald J Borden & Company is a Chicago based accounting firm

Complementary Alternative Medicine Ronald J Borden & Company is a Chicago based accounting firm that offers employees monthly on-site massage therapy to increase their energy levels (and morale got a boost, too). The Colorado Health Institute in Denver implemented a program that included yoga and “two o’clock walks” involving 20 minute walks on and around the organization’s grounds to combat stress and heavy workloads. 21

Prescription Drug Toolkit from the Arizona Criminal Justice Commission • • The toolkit is

Prescription Drug Toolkit from the Arizona Criminal Justice Commission • • The toolkit is easy to use and is color coded for better navigation. The Rx Drug Misuse and Abuse Initiative toolkit’s eight sections include: Strategy 1 - Reduce illicit acquisition and diversion of prescription drugs PDF Version Word Version Strategy 2 - Promote responsible prescribing and dispensing policies and practices PDF Version Word Version Strategy 3 - Enhance Rx drug practice and policies in law enforcement PDF Version Word Version Strategy 4 - Increase public awareness and patient education about Rx drug misuse and abuse PDF Version Word Version Strategy 5 - Enhance assessment and referral to substance abuse treatment PDF Version Word Version Action Plan - The Action Plan is color coded by strategy and provides easy to follow goals, objectives and action items. PDF Version Word Version http: //azcjc. gov/ACJC. Web/Rx/toolkit. aspx 22

HAWP Resource http: //healthyazworksites. org/pain-in-the-workplace/ Additional Resources and information about pain for employers 23

HAWP Resource http: //healthyazworksites. org/pain-in-the-workplace/ Additional Resources and information about pain for employers 23

SUMMARY What is Pain? Types of Pain Prevalence of Pain Cost of Pain for

SUMMARY What is Pain? Types of Pain Prevalence of Pain Cost of Pain for Employers Prescription Drug use/abuse What Employers Can Do Success Stories 24

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Contact Information HAWP Information & Trainings Information about Pain in the Workplace Melody Hicks,

Contact Information HAWP Information & Trainings Information about Pain in the Workplace Melody Hicks, MC, LPC Behavioral Health Integration Manager Melody. HIcks@mail. maricopa. gov 602/359 -3286 We. Are. Public. Health. org 26

References http: //www. aota. org//media/corporate/files/aboutot/professionals/whatisot/hw/facts/pain%20 rehabilitation%20 fact%20 sheet. pdf (fact sheet from the American

References http: //www. aota. org//media/corporate/files/aboutot/professionals/whatisot/hw/facts/pain%20 rehabilitation%20 fact%20 sheet. pdf (fact sheet from the American Occupational Therapy Association about Pain Rehabilitation) http: //painsproject. org/wp/wp-content/uploads/2014/09/pain-policy-issue-5. pdf (identifying non-pharmacological approaches to deal with pain) http: //www. asam. org/magazine/read/article/2014/06/12/twelve-step-recovery-and-medication-assistedtherapies (American Society of Addiction Medicine’s site – explaining how Medication Assisted Therapies (MAT) and 12 -Step programs work) http: //www. mayoclinic. org/healthy-lifestyle/adult-health/in-depth/back-pain/art-20044526? pg=1&p=1 (Mayo Clinic sheet on preventing back pain at work – tips and suggestions) http: //safety. uchicago. edu/tools/faqs/ergonomics. shtml (University of Chicago Ergonomics page – explains what Ergonomics and Ergonomic hazards and provides some basic information and guidelines) http: //www. cdc. gov/nationalhealthyworksite/docs/Issue_Brief_No_1_Older_Employees_in_the_Workplace_712 -2012_FINAL(508). pdf (for those considered “older” helping to find ways to reduce potential injuries or pain) http: //azlwi. org/about-arizona-living-well-institute/healthy-living-with-chronic-pain-cpsmp (Healthy Living with Chronic Pain workshop is a chronic pain self-management program) 27

References http: //www. lni. wa. gov/safety/Sprains. Strains/casestudies/default. asp (case studies that worked to prevent

References http: //www. lni. wa. gov/safety/Sprains. Strains/casestudies/default. asp (case studies that worked to prevent injuries) http: //jamanetwork. com/article. aspx? articleid=197628 (article from Journal of American Medical Association about Lost Productive Time and Cost Due to Common Pain Conditions in the US workforce) http: //www. nsc. org/Rx. Drug. Overdose. Documents/proactive-role-employers-can-take-opioids-in-theworkplace. pdf (the booklet for employers about Opioids – suggestions and ideas about how to deal with this issue with employees) https: //theacpa. org/uploads/documents/ACPA_Resource_Guide_2016. pdf (a guide for consumers for pain medications and treatments ) https: //iprcc. nih. gov/National_Pain_Strategy/NPS_Main. htm (2016 National Pain Strategy for improving pain care in America) http: //www. propertycasualty 360. com/2011/08/05/musculoskeletal-disease-is-major-pain-in-work-comp (looks at workman compensation claims and reasons for claims) http: //www. lni. wa. gov/safety/research/files/wmsds. pdf (from state of Washington about workman compensation for musculoskeletal disorders) http: //www. painmed. org/patientcenter/ (The American Academy of Pain Medicine site which offers information about pain for patients and interested adults) 28

References http: //azcjc. gov/ACJC. Web/Rx/toolkit. aspx (The Arizona Criminal Justice Commission website which houses

References http: //azcjc. gov/ACJC. Web/Rx/toolkit. aspx (The Arizona Criminal Justice Commission website which houses the Toolkit to help with Prescription Drug Misuse and Abuse) http: //healthyazworksites. org/pain-in-the-workplace/ (Healthy Arizona Worksites Program website that provides additional information and resources regarding dealing with pain in the workplace) 29