CDME Module 8: Drug Abuse & Alcoholism-ACOEM Practice Guidelines Opioids and Safety-Sensitive Work

Pdf Summary

ACOEM has updated its treatment guidelines regarding opioids and safety-sensitive work. The guidelines recommend against the use of opioids for patients who perform safety-sensitive jobs, such as operating motor vehicles, other modes of transportation, forklift driving, overhead crane operation, heavy equipment operation, and tasks involving high levels of cognitive function and judgment. The updated guidelines are based on comprehensive literature reviews and the evidence consistently demonstrates an increased risk of vehicle crashes among opioid-using patients. The guideline also highlights the lack of evidence regarding other safety-sensitive work tasks. The rating level for the recommendation is "C" with moderate confidence. The panel agrees with this guideline recommendation. The evidence base for the guidelines includes large epidemiological studies, different study designs, and different countries, providing strong support for the recommendation. However, there may be patients taking opioids while employed in safety-sensitive jobs, and there are currently no validated tools to assess their safety while consuming opioids. The guidelines suggest that the benefits of implementing these recommendations include potential reductions in accidents and injury risks to the individuals themselves, the public, and coworkers, while the potential harms may include preclusion of individuals from working who may not be at increased risk but lack a validated method to demonstrate their safety while consuming opioids.

Asset Caption

Hegmann KT, Weiss MS, Bowden K, et. al.
JOEM 2014;56(7)e46-e53

Keywords

ACOEM

treatment guidelines

opioids

safety-sensitive work

vehicle crashes

evidence

recommendation

validated tools

benefits

harms